Fasting ghrelin levels are decreased in obese subjects and are significantly related with insulin resistance and body mass index

© 2017 Dimitrios Papandreou, Christos Karavolias, Fotini Arvaniti, Eleana Kafeza, Fatima Sidawi. BACKGROUND: Ghrelin is a 28-amino acid peptide that predominantly produced by the stomach. Strong evidence indicates the effects of ghrelin in the regulation of metabolic functions and its potential role in the aetiology of obesity. AIM: The aim of this study was to investigate the relationship of ghrelin levels with obesity, insulin resistance and glucose in normal and obese subjects. METHODS: Thirteen normal (n = 13) and seven (n = 7) obese weight subjects aged 20-22 participated in the study. Fasting plasma ghrelin, insulin and glucose levels were measured after overnight fasting. HOMA-IR was calculated to evaluate insulin resistance. RESULTS: Ghrelin and insulin levels were found to be statistically significantly lower and higher in obese subjects (P \u3c 0.001), respectively. Glucose levels were clinically higher in obese subjects but not statistically significant. Fasting plasma ghrelin was negatively correlated with BMI (r = -0.77, P \u3c 0.001), fasting insulin levels (r = -0.55, P \u3c 0.001) and HOMA-IR (r = -0.66, P \u3c 0.001). There was no correlation between ghrelin and glucose. In multiple regression analysis, insulin levels (Beta: -2.66, 95% CI: -2.49, -2.78, P \u3c 0.001) HOMA-IR (Beta: -2.41, 95% CI: -2.33, -2.55, P \u3c 0.001) and BMI (Beta: -1.77, 95% CI: -1.66, -1.89, P \u3c 0.001) were significant independent determinants of fasting ghrelin. CONCLUSION: Obese subjects have low fasting ghrelin levels that they are significantly related to insulin resistance and body mass index. More prospective studies are needed to establish the role of ghrelin in the pathogenesis of human obesity

Consumption of Raw Orange, 100% Fresh Orange Juice, and Nectar- Sweetened Orange Juice-Effects on Blood Glucose and Insulin Levels on Healthy Subjects

OBJECTIVE: The aim of this study is to investigate the effect of consumption of raw orange (RO), 100% fresh orange juice (FOJ), and nectar-sweetened orange juice (NSOJ) on postprandial glucose and insulin levels in non-diabetic young Emirati women. RESEARCH METHODS: This is a prospective, three-way, crossover study design. Blood records of thirteen normal weight and seven healthy obese university students were analyzed from Zayed University on three random days with the following three meal samples: 2 ROs, 100% FOJ, and NSOJ. Venous blood was collected at 0, 30, 60, 90, and 120 minutes after the respective meal consumption. Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves (AUC) for each one of the meal samples. RESULTS: Total fasting glucose and insulin levels did not differ by treatment in the normal versus obese group. All three meals had no significant effects on the plasma glucose levels. However, there was a significant change in plasma insulin concentrations at 120 min compared with that at 0 min for RO: -14 (-27.05, -0.90, P \u3c 0.001); 100% FOJ -13.7 (-28.80, 1.44, P \u3c 0.001); and NSOJ: -9.2 (-28.75, 10.30, P \u3c 0.001). CONCLUSIONS: This study shows that whole fresh fruit, 100% fruit juice, and sweetened fruit juice did not have a significant effect on the blood glucose levels in non-diabetic Emirati university students. However, a significant decrease in insulin response and HOMA-IR on all three sample meals was observed

Gait analysis and functional effect of ACL reconstruction using hamstrings as autograft

INTRODUCTION. The anterior cruciate ligament rapture is a very common, usually sports related, injury in both men and women. Different kind of operations and grafts have been used for the reconstruction of the ACL in order to restore the stability of the knee and enable the patient to return completely to the previous the injury level of activities. It is very important to identify gait adaptations due to ACL-deficient knee. It is also very important to study the influence of ACL reconstruction on gait. Stair climbing requires a larger range of knee motion than level walking, as have been shown from various kinematic studies. Furthermore larger forces are required to ascent body. HYPOTHESIS. The evaluation of the hypothesis that the kinematics, kinetics and balance figures of ACL deficient knee were affected, and that they return back to normal after ACL reconstruction using Hamstrings. AIM. The aim of the study was to compare the preoperative, postoperative and normal level walking and stair climbing analysis for patients who underwent arthroscopic reconstruction of the ACL with the use of hamstrings. Also to evaluate whether there is restoration of the normal gait pattern or not, 6 months post ACL reconstruction. PATIENTS and METHOD. In this prospective clinical and laboratory study, thirty subjects were included. Fifteen males with unilateral ACL rupture (8 right and 7 left) confirmed by clinical exam and magnetic resonance imaging, with no other ligamentous or meniscal tear of the knee and without any neurological, orthopaedic or other diseases. The patients underwent arthroscopic reconstruction using four bundle hamstrings graft. The operations were performed from the same surgical team, and the patients followed the same rehabilitation protocol. Gait analysis was performed pre-op ACL reconstruction and 6 months post-op. ACL subjects (Mean Age 25±6.36 years, Mean Height 177,27±9.43 cm and mean Weight 77.5±9.5 kgr. Normal subjects (Mean Age 28.53±5.07 years, Mean Height 173,53±7.61cm and mean Weight was 71.4±15.98 kgr). RESULTS. Although pre-op measurements for the step length, cadence, velocity and the stance showed differences from those of the control group they tend to return back to normal after the reconstruction of the ACL using hamstrings as autograft. The same tendency appears when the balance is been evaluated using parameters such as the ellipse area and the length of the COP, the average velocity and the percentage (%) load of the limb with eyes open and closed even though they do not reach completely the normal values. The key moment kinematic and kinetics analysis showed no significant alterations among the groups for the hip, pelvis and trunk. However knee analysis especially during stair climbing showed a decreased knee flexion at initial contact as well as less maximum knee flexion in swing for the preoperative ACL ruptured group. These were found to be altered after the ACL reconstruction towards the normal levels of knee flexion. The ankle analysis showed a more neutral position at initial contact and less dorsi-flexion in the first half of stance. Normal subjects and post-op exhibited more dorsi-flexion. The stance phase duration was not found to differ among groups (73±2% of the cycle). CONCLUSIONS. It was concluded that ACL rupture affects the balance of the body and the knee and ankle kinetics and kinematics during stair climbing. Arthroscopic reconstruction using four bundle hamstrings graft, showed more normalized values six month after the operation but the use of a rehabilitation programme, specially focused on the balance and the proprioception may be very beneficial.ΕΙΣΑΓΩΓΗ. Η ρήξη του προσθίου χιαστού συνδέσμου αποτελεί αρκετά συχνή, συνήθως αθλητική, κάκωση τόσο σε άνδρες όσο και σε γυναίκες. Για την αποκατάσταση του συνδέσμου έχουν χρησιμοποιηθεί διαφορετικές επεμβάσεις και μοσχεύματα με σκοπό την ανάκτηση της σταθερότητας του γόνατος και να επιτρέψουν στον ασθενή να επανέλθει στο προ του τραυματισμού επίπεδο δραστηριοτήτων. Είναι πολύ σημαντικό να προσδιοριστούν οι προσαρμογές της βάδισης που συμβαίνουν σε ανεπάρκεια του χιαστού και πως επηρεάζεται η βάδιση μετά την χειρουργική αποκατάσταση του. Η ανάβαση κλίμακας απαιτεί μεγαλύτερο εύρος κίνησης από ότι η βάδιση σε επίπεδο έδαφος όπως έχει δειχθεί σε διάφορες κινηματικές μελέτες. Επιπλέον ασκούνται μεγαλύτερες δυνάμεις για την άρση του σώματος. ΥΠΟΘΕΣΗ. Εξετάσθηκε η υπόθεση ότι η κινηματική, κινητική και η ισορροπία του κάτω άκρου με ανεπάρκεια προσθίου μεταβάλλεται κατά τη διάρκεια δραστηριοτήτων της καθημερινής ζωής και ότι επανέρχεται στο φυσιολογικό μετά την αποκατάσταση του συνδέσμου. ΣΚΟΠΟΣ. Ο Σκοπός της παρούσας εργασίας είναι η μελέτη της επίδρασης της ανεπάρκειας και στη συνέχεια της αποκατάστασης του ΠΧΣ στην λειτουργικότητα του κάτω άκρου με τη βοήθεια ανάλυσης βάδισης. Παρότι η εφαρμογή διαφόρων τεχνικών αποκατάστασης του ΠΧΣ αυξάνουν τη σταθερότητα του γόνατος λίγες από αυτές έχουν εκτιμηθεί αντικειμενικά σχετικά με την επίδραση που έχουν στη δυναμική λειτουργικότητα του γόνατος και των άλλων αρθρώσεων των κάτω άκρων κατά τη διάρκεια βάδισης ή σε καταστάσεις της καθημερινής ζωής αυξημένου έργου όπως είναι η ανάβαση κλίμακας. ΑΣΘΕΝΕΙΣ-ΜΕΘΟΔΟΣ. Σε αυτή την προοπτική κλινική και εργαστηριακή μελέτη συμπεριελήφθησαν τριάντα άτομα. Δεκαπέντε άρρενες με ρήξη προσθίου χιαστού (8 δεξιά γόνατα και 7 αριστερά) όπως διαπιστώθηκε κλινικά και επιβεβαιώθηκε με μαγνητική τομογραφία, χωρίς άλλη συνδεσμική ή συνοδό μηνισκική ρήξη και χωρίς άλλη νευρολογική ή ορθοπαιδική πάθηση. Οι ασθενείς υποβλήθηκαν σε αρθροσκοπική αποκατάσταση με τη χρήση τετραπλής δέσμης ισχνού προσαγωγού-ημιτενοντώδους, από την ίδια χειρουργική ομάδα και ακολούθησαν το ίδιο πρόγραμμα μετεγχειρητικής αποκατάστασης. Ανάλυση βάδισης έγινε προεγχειρητικά καθώς και 6 μήνες μετά την επέμβαση. Η ομάδα των ασθενών είχε μέση ηλικία 25±6.36 έτη, μέσο ύψος 177,27±9.43 cm και μέσο βάρος 77.5±.5 kgr. Ενώ η ομάδα των υγιών (ομάδα ελέγχου) είχε μέση ηλικία 28.53±5.07 έτη, μέσο ύψος 173,53±7.61cm και μέσο βάρος 71.4±15.98 kgr. ΑΠΟΤΕΛΕΣΜΑΤΑ. Στην ομάδα των ασθενών προεγχειρητικά, οι μετρήσεις που αφορούν το μήκος βηματισμού (step length), τη συχνότητα βηματισμού (cadence), την ταχύτητα (Velocity) και τη στήριξη (Stance) εμφανίζονται σαφώς επηρεασμένες συγκρινόμενες με τις αντίστοιχες της ομάδα ελέγχου. Μετά την επέμβαση αποκατάστασης με τετραπλή δέσμη ισχνού-ημιτενοντώδους καταγράφεται μία σαφής τάση επανόδου κοντά στις φυσιολογικές τιμές. Ανάλογα ευρήματα προκύπτουν και από τον έλεγχο της ισορροπίας και ιδιοδεκτικότητας. Η επιφάνεια που καλύπτει η κίνηση του COP (ellipse area) η μέση ταχύτητα του (average velocity) και τέλος το συνολικό μήκος της κίνησης του (length) με τα μάτια ανοικτά και κλειστά καθώς και η ποσοστιαία φόρτιση ανά σκέλος (% load of the limb) ανάμεσα στο αυτό που έχει υποστεί ρήξη ΠΧΣ και στο υγιές επανέρχονται αλλά όχι πλήρως μετεγχειρητικά και στο χρονικό διάστημα που διήρκησε η μελέτη. Τέλος από τη μελέτη των στοιχείων της κινηματικής και κινητικής ανάλυσης σε σημαντικές χρονικές στιγμές (key moments-χρονικές στιγμές «κλειδιά») του κύκλου βάδισης δεν προέκυψαν μεταβολές στο ισχίο, τη λεκάνη και τον κορμό παρά μόνο στο γόνατο και στη ποδοκνημική στο οβελιαίο επίπεδο και μάλιστα κατά τη διάρκεια ανάβασης κλίμακας που είναι μία πιο απαιτητική δραστηριότητα σε σχέση με τη βάδιση σε επίπεδο έδαφος. Ωστόσο μετά την αποκατάσταση του ΠΧΣ οι καμπύλες των αντίστοιχων τιμών ομαλοποιούνται και πλησιάζουν προς τα φυσιολογικά. ΣΥΜΠΕΡΑΣΜΑ. Παρά την σημαντική μετεγχειρητική επάνοδο των ασθενών με ρήξη ΠΧΣ, για να είναι αυτή πλήρης ίσως απαιτείται περισσότερη έμφαση στο πρόγραμμα αποκατάστασης και μάλιστα στις ασκήσεις ιδιοδεκτικότητας και ισορροπίας

Consumption of Raw Orange, 100% Fresh Orange Juice, and Nectar- Sweetened Orange Juice—Effects on Blood Glucose and Insulin Levels on Healthy Subjects

Objective: The aim of this study is to investigate the effect of consumption of raw orange (RO), 100% fresh orange juice (FOJ), and nectar-sweetened orange juice (NSOJ) on postprandial glucose and insulin levels in non-diabetic young Emirati women. Research Methods: This is a prospective, three-way, crossover study design. Blood records of thirteen normal weight and seven healthy obese university students were analyzed from Zayed University on three random days with the following three meal samples: 2 ROs, 100% FOJ, and NSOJ. Venous blood was collected at 0, 30, 60, 90, and 120 minutes after the respective meal consumption. Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves (AUC) for each one of the meal samples. Results: Total fasting glucose and insulin levels did not differ by treatment in the normal versus obese group. All three meals had no significant effects on the plasma glucose levels. However, there was a significant change in plasma insulin concentrations at 120 min compared with that at 0 min for RO: −14 (−27.05, −0.90, P < 0.001); 100% FOJ −13.7 (−28.80, 1.44, P < 0.001); and NSOJ: −9.2 (−28.75, 10.30, P < 0.001). Conclusions: This study shows that whole fresh fruit, 100% fruit juice, and sweetened fruit juice did not have a significant effect on the blood glucose levels in non-diabetic Emirati university students. However, a significant decrease in insulin response and HOMA-IR on all three sample meals was observed

Physical training modulates proinflammatory cytokines and the soluble Fas/soluble Fasligand system in patients with chronic heart failure

AbstractObjectivesWe sought to investigate the effects of physical training on circulating proinflammatory cytokines and the soluble apoptosis mediators Fas (sFas) and Fas ligand (sFasL) in patients with chronic heart failure (CHF).BackgroundRecent investigations have shown an overexpression of circulating proinflammatory cytokines and soluble apoptosis mediators in patients with CHF, which may be related to their exercise intolerance and clinical deterioration.MethodsPlasma levels of tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptors I and II (sTNF-RI and sTNF-RII, respectively), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), sFas and sFasL were measured in 24 patients with stable CHF (New York Heart Association functional class II/III; left ventricular ejection fraction 23.2 ± 1.3%) and in 20 normal control subjects before and after a 12-week program of physical training in a randomized, crossover design. Functional status of patients with CHF was evaluated by using a cardiorespiratory exercise test to measure peak oxygen consumption (Vo2max).ResultsPhysical training produced a significant reduction in plasma levels of TNF-alpha (7.5 ± 1.0 pg/ml vs. 4.6 ± 0.7 pg/ml, p < 0.001), sTNF-RI (3.3 ± 0.2 ng/ml vs. 2.7 ± 0.2 ng/ml, p < 0.005), sTNF-RII (2.6 ± 0.2 ng/ml vs. 2.3 ± 0.2 ng/ml, p = 0.06), IL-6 (8.3 ± 1.2 pg/ml vs. 5.9 ± 0.8 pg/ml, p < 0.005), sIL-6R (34.0 ± 3.0 ng/ml vs. 29.2 ± 3.0 ng/ml, p < 0.01), sFas (5.5 ± 0.7 ng/ml vs. 4.5 ± 0.8 ng/ml, p = 0.05) and sFasL (34.9 ± 5.0 pg/ml vs. 25.2 ± 4.0 pg/ml, p < 0.05), as well as a significant increase in Vo2max (16.3 ± 0.7 ml/kg per min vs. 18.7 ± 0.8 ml/kg per min, p < 0.001). Good correlations were found between a training-induced increase in Vo2max and a training-induced reduction in levels of the proinflammatory cytokine TNF-alpha (r = −0.54, p < 0.01) and the apoptosis inducer sFasL (r = −0.57, p < 0.005) in patients with CHF. In contrast, no significant difference in circulating cytokines and apoptotic markers was found with physical training in normal subjects.ConclusionsPhysical training reduces plasma levels of proinflammatory cytokines and the sFas/sFasL system in patients with CHF. These immunomodulatory effects may be related to the training-induced improvement in functional status of patients with CHF