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Biomedical subjects

P Berchtold

Publications and source records attributed to P Berchtold.

At least 55 records · Page 3Linked to original sources

Physical training as a part of the therapy for adult-onset diabetes.

Albeit physical exercise and training have been recommended as an integral part of diabetes therapy only limited data are available to prove such beneficial effects of physical exertion in normalizing the metabolism in diabetes. It is the purpose of this review to critically summarize studies concerning the effects of physical training in maturity-onset diabetes. Based upon available evidence in animal experimentation, i.e. in normal and fat ZUCKER rats, as well as on data in non-diabetic man, physical training is expected to increase peripheral insulin sensitivity; thus a decrease of insulin requirements might be achieved in the course of a physical training program. So far, however, the preliminary evidence of only two studies on the effect of training in maturity-onset diabetes has been presented: slight improvements of glucose tolerance and a considerable, but--at least in one study--short-lived decrease of circulating insulin levels have been described. These improvements have to be weighed against the possible hazards of physical training programs in maturity-onset diabetic patients who--as a group--have to be considered at high coronary risk. More and more detailed and prolonged studies, however, are urgently needed to document and to prove beyond any doubt the benefits of physical training in the metabolic syndrome of maturity-onset diabetes mellitus.

Animals↗

The "metabolically-obese," normal-weight individual.

A great many disorders including maturity-onset (type II) diabetes, hypertension, and hypertriglyceridemia are frequently associated with adult-onset obesity and improve with caloric restriction. It is the premise of this brief review that there are patients with these disorders who are not obese according to standard weight tables or other readily-available criteria; but who would also respond favorably to caloric restriction. It is proposed that such individuals might be characterized by hyperinsulinism and possibly an increase in fat cell size compared to patients of similar age, height, and weight and/or to themselves at an earlier time. The possibility is also discussed that inactivity is a contributing factor in some of these individuals and that for them, the appropriate therapy might be exercise.

Adipose Tissue↗

Cardiovascular risk factors and HDL-cholesterol levels in obesity.

In 1332 patients with different degrees of obesity (344 men, mean age 36 +/- 13 years, Broca Index 1.46 +/- 0.23; 988 women, mean age 37 +/- 13 years, Broca Index 1.67 +/- 0.30), cardiovascular risk factors (RF), serum HDL-cholesterol, and insulin levels were investigated. The most frequent RF was diastolic hypertension (68 per cent), followed by systolic hypertension (56 per cent), glucose intolerance (55 per cent), hypertriglyceridemia (31 per cent), hyperuricemia (19 per cent) and hypercholesterolemia (18 per cent). Only 9.4 per cent of the patients were without RF, and these patients were younger and less obese than patients with RF. Compared with controls, HDL-cholesterol levels were decreased in obese patients, however, the negative linear correlation between relative body weight and HDL-cholesterol levels was only significant in women, not in men. HDL-cholesterol levels were higher in women than in men. Serum insulin levels were correlated positively with relative body weight and negatively with age. Partial correlation analysis revealed a stronger influence of age than body weight on blood pressure, serum levels of total cholesterol, LDL-cholesterol, triglycerides and blood glucose levels. Uric acid levels correlated positively, and HDL-cholesterol levels negatively with relative body weight alone and not with age. On the basis of prevalence of RF, low serum HDL-cholesterol and high insulin levels, obese patients must be considered at high risk with respect to the development of cardiovascular disease.

Adult↗

Epidemiology of obesity and hypertension.

Based on the reviewed literature and the data from the düsseldorf Obesity Study there is a close association between obesity and hypertension. This association is found in adults, adolescents and children. Hypertension is the most frequent cardiovascular risk factor in obesity. The black population shows higher blood pressure levels than the white population within the same relative weight. Prospectively investigated normotensive obese subjects are more likely to develop hypertension than normal weight subjects. In Western population there is also an association between hypertension and age. This is not seen in tribal populations, where after the age of 20 years body weight does not increase, suggesting body weight to be an important factor for the regulation of blood pressure. Present epidemiological evidence strongly calls for detailed prospective studies of obesity and hypertension, in order to define particularly hypertension-prone obesity subtypes.

Aging↗

[Blood-sugar self control. A means for the diabetic of controlling his metabolic management. Quality control of a battery-run pocket size reflectometer (glucose-meter)].

Home blood glucose monitoring by diabetic patients has recently been advocated as an effective means to improve metabolic control. The Glucocheck apparatus, a pocket-size battery-driven reflectance-meter (in Germany commercially available under the name Glucose-meter), has been evaluated for accuracy and practicability. In 450 blood glucose measurements, the variance between the values obtained using the Glucocheck apparatus and routine clinical laboratory procedures was +/- 11.7%. Especially in the low range of blood glucose concentrations, the Glucocheck method was very reliable. The quantitative precision of the Glucocheck method depends, however, quite considerably on the ability of the patient to use the apparatus correctly. In order to profit from Glucocheck in clinical practice, particular efforts to educate the patients in its use are necessary.

Adult↗

[Obesity: state of research and therapy].

The classification of obesity into a hypertrophic and a hyperplastic type is apparently becoming less accepted since preadipocytes are not covered by investigation of adipose tissue cellularity. Obesity-associated insulin resistance is probably due to a decrease in number of insulin receptors, induced by hyperinsulinemia. Metabolic factors may contribute to insulin resistance. Long-standing hypersecretion of insulin may exhaust the B-cell, resulting in glucose intolerance and diabetes. There is increasing interest in the (possibly) disturbed energy metabolism in obesity, though clearcut conclusions are not yet possible. For the management of obesity an integrated treatment schedule is recommended including a 1000 calorie mixed diet, intensive nutritional education, motivation, group and individual psychotherapy, physical exercise and physiotherapy. Drastic methods for the treatment of obesity are critically reviewed.

Diet, Reducing↗

[The effect of clanobutin on bile excretion in rat and dog (author's transl)].

The effect of 4-[p-chloro-N-(p-methoxyphenyl)-benzamido] butyric acid (clanobutin, Bykahepar) on bile formation was studied in anesthetized male Sprague-Dawley rats and in non-anesthetized female boxer dogs. Following i.v. injection of 40 mg/kg body weight of clanobutin, a marked choleresis paralleling the biliary excretion of the drug was observed in both species. The biliary elimination of 1 mumol clanobutin (and metabolites) caused on the average an increment of bile flow of 90 microliter and 11.5 microliter in the rat and dog, respectively. Bile flow was linearly related to clanobutin excretion in rat and dog. Within the period of observation 55% of the dose of clanobutin in the rat, and 80% of the dose in the dog were eliminated via the bile; urinary excretion amounted to 3% of the dose. In rat bile, 32% of the clanobutin was present as the parent compound; the remaining 68% consisted of 3 metabolites. Measurement of the erythritol clearance in the dog suggests that clanobutin stimulates the bile salt-independent, canalicular bile formation. In addition, however, the observed changes in the bile/plasma concentration ratio of erythritol, as well as a predominant excretion of bicarbonate and chloride point to a possible ductular effect of clanobutin. In these acute studies, the drug did not influence the bile salt, phospholipid or cholesterol excretion. Cholesterol saturation of bile was unaffected.

Animals↗