149 research outputs found
Opera Finita: 30 jaar Heelkunde Maastricht, Visies en gevoelens:Afscheidscollege door Peter B. Soeters
Reduction of sleeping metabolic rate after vertical banded gastroplasty.
Department of Surgery, University Hospital Maastricht, The Netherlands. OBJECTIVE: To investigate whether long-term weight loss after vertical banded gastroplasty (VBG) results in a sustained reduction of sleeping metabolic rate (SMR) as a persistent risk factor for weight regain. DESIGN: Longitudinal clinical intervention study of morbidly obese patients undergoing VBG. PATIENTS: Group I: Six patients in which body composition and SMR were measured before and at 3, 6 and 12 months after VBG. Group II (long-term effect): nine patients in which body mass (BM) was measured before VBG, and body composition and SMR were measured 98+/-30 months after VBG. MEASUREMENTS: Body composition was assessed by deuterium dilution and hydrostatic weighing. SMR was measured (SMRm) in a respiration chamber and predicted (SMRp) based on body composition. RESULTS: In group I, fat mass and fat free mass decreased significantly after VBG (P < 0.05). SMRm decreased from 11.1+/-1.8 (s.d.) MJ/d before VBG to 8.1+/-0.9 MJ/d (P < 0.05) at 12 months after VBG. In group II at a mean of 98 months after VBG, the SMRm (6.9+/-0.7 MJ/d) was lower than the preoperative value of group I (P < 0.05). SMRm was lower than SMRp at all intervals after VBG (P < 0.05). The ratio measured vs predicted SMR was in group I: 1.02+/-0.05 before VBG, 0.91+/-0.08 at 12 months after VBG (P<0.05), and in group 11: 0.94+/-0.08 at a mean of 98 months after VBG (P < 0.05). CONCLUSION: The reduction of SMR adjusted for body composition after VBG is sustained as long as weight loss is maintained. The sustained and disproportional reduction of SMR may reflect the persistent susceptibility of the postobese to weight regain
Derangement in aerobic and anaerobic energy metabolism in skeletal muscle of critically ill and recovering rats.
Derangement in aerobic and anaerobic energy metabolism in skeletal muscle of critically ill and recovering rats. Rooyackers OE, Gijsen AP, Saris WH, Soeters PB, Wagenmakers AJ. Department of Human Biology, University of Limburg, Maastricht, The Netherlands. [email protected] As part of our research into the mechanisms of protein wasting and muscle weakness during critical illness, we here investigate various aspects of energy metabolism. Intraperitoneal injection of zymosan in rats leads to an acute phase of critical illness followed by a prolonged recovery phase. Previously we observed low activities of mitochondrial enzymes, reduced protein synthesis rates and low concentrations of glutamine in skeletal muscle of zymosan-treated rats. In the present study we investigated (1) whether decreases in high energy phosphates are present in skeletal muscle of these rats and (2) whether an impairment in the glycolytic pathway or the tricarboxylic acid cycle leads to these decreases. Concentrations of creatine phosphate and ATP were decreased in zymosan-treated rats to approx. 85% of pair-fed control values respectively on day 2 and on days 4 and 6 after treatment. Concentrations of tricarboxylic acid (TCA) cycle intermediates were decreased to 80% on day 6 after zymosan treatment. Lactate/pyruvate ratio and concentrations of lactate and glycogen were normal at all sampling times. We conclude that no major changes in concentrations of high energy phosphates and in concentrations of intermediates of TCA cycle, glycolysis and glycogenolysis were present. This indicated that, although the maximal oxidative capacity (mitochondrial content) is decreased, no derangement in energy metabolism seems to be present in skeletal muscle of critically ill and recovering rats
The evolutionary benefit of insulin resistance
Insulin resistance is perceived as deleterious, associated with conditions as the metabolic syndrome, type 2 diabetes mellitus and critical illness. However, insulin resistance is evolutionarily well preserved and its persistence suggests that it benefits survival. Insulin resistance is important in various states such as starvation, immune activation, growth and cancer, to spare glucose for different biosynthetic purposes such as the production of NADPH, nucleotides in the pentose phosphate pathway and oxaloacetate for anaplerosis. In these conditions, total glucose oxidation by the tricarboxylic acid cycle is actually low and energy demands are largely met by fatty acid and ketone body oxidation. This beneficial role of insulin resistance has consequences for treatment and research. Insulin resistance should be investigated at the cellular, tissue and whole organism level. The metabolic pathways discussed here, should be integrated in the accepted and valid mechanistic events of insulin resistance before interfering with them to promote insulin sensitivity at any cost. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserve
Opera Finita: 30 jaar Heelkunde Maastricht, Visies en gevoelens: Afscheidscollege door Peter B. Soeters
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