PubMed · 10052438
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N R Buist, S C Winter. 1999-02-24. HELLP syndrome.. https://pubmed.ncbi.nlm.nih.gov/10052438/
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Impaired mitochondrial function and structure and intramyocellular lipid (IMCL) accumulation have been associated with obesity and Type 2 diabetes. We examined whether endurance exercise training and sex influenced IMCL and mitochondrial morphology using electron microscopy, whole-body substrate use, and mitochondrial enzyme activity. Untrained men (n = 5) and women (n = 7) were tested before and after 7 wk of endurance exercise training. Testing included 90 min of cycle ergometry at 60% Vo(2 peak) with preexercise muscle biopsies analyzed for IMCL and mitochondrial size/area using electron microscopy and short-chain beta-hydroxyacyl-CoA dehydrogenase (SCHAD) and citrate synthase (CS) enzyme activity. Training increased the mean lipid area density (P = 0.090), the number of IMCL droplets (P = 0.055), the number of IMCL droplets in contact with mitochondria (P = 0.010), the total mitochondrial area (P < 0.001), and the size of individual mitochondrial fragments (P = 0.006). Women had higher mean lipid area density (P = 0.030) and number of IMCL droplets (P = 0.002) before and after training, but higher individual IMCL area only before training (P = 0.013), compared with men. Women oxidized more fat (P = 0.027) and less carbohydrate (P = 0.032) throughout the study. Training increased Vo(2 peak) (P < 0.001), %fat oxidation (P = 0.018), SCHAD activity (P = 0.003), and CS activity (P = 0.042). In summary, endurance exercise training increased IMCL area density due to an increase in the number of lipid droplets, whereas the increase in total mitochondrial area was due to an increase in the size of individual mitochondrial fragments. In addition, women have higher IMCL content compared with men due mainly to a greater number of individual droplets. Finally, endurance exercise training increased the proportion of IMCL in physical contact with mitochondria.
Both regular physical exercise and carnitine supplementation exert a role in energy metabolism and may improve endurance capacity. We investigated whether a combination of long-term carnitine ingestion and exercise training reveals any interactive effects on cytosolic fatty acid-binding protein (FABPc) expression and beta-hydroxyacyl CoA dehydrogenase (beta-HAD) activity in human skeletal muscle. Twenty-eight untrained healthy males randomly divided into four experimental groups: a placebo (CON; n = 7), exercise training (ET; n = 7, 40 min session(-1), five times per week at 60% VO2max), carnitine supplementation (CS; n = 7, 4 g day(-1)), and exercise training and carnitine supplementation (CT; n = 7). Before and after 6-week treatment, muscle biopsy samples were taken from the vastus lateralis. Nonesterified carnitine and acid-soluble acylcarnitine concentrations were increased in CT (P < 0.05), and serum triacylglycerol concentration was elevated almost twofold in ET and CT (P < 0.05). No interactive effects in FABPc expression were shown from any of treatment groups. Although FABPc increased by 54% in ET compared to CON, it failed to reach statistical significance. In addition, there was no change in FABPc expression from any of experimental groups. Similar trends with FABPc contents were demonstrated in beta-HAD activity. It is concluded that the combination of exercise training and L-carnitine supplementation does not augment in FABPc expression and beta-HAD activity in human skeletal muscle indicating that combined treatment does not exert additive effect in fat metabolism. Thus L-carnitine supplementation would be unlikely to be associated with the enhanced exercise performance.
The incidence of overweight and obesity is increasing among children with long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) or mitochondrial trifunctional (TFP) deficiency. Traditional treatment includes fasting avoidance and consumption of a low-fat, high-carbohydrate diet. A diet higher in protein and lower in carbohydrate may help to lower total energy intake while maintaining good metabolic control. To determine the short-term safety and efficacy of a high protein diet, subjects were admitted to the General Clinical Research Center and fed an ad-libitum high-protein diet and a high-carbohydrate diet for 6 days each using a randomized, crossover design. Nine subjects with LCHAD or TFP deficiency, age 7-14 were enrolled. Body composition was determined by DEXA. Total energy intake was evaluated daily. Resting energy expenditure and substrate utilization were determined by indirect calorimetry. Post-prandial metabolic responses of plasma glucose, insulin, leptin, ghrelin, acylcarnitines, and triglyceride were determined in response to a liquid meal. Subjects had a higher fat mass, lower lean mass and higher plasma leptin levels compared to reference values. While on the high protein diet energy consumption was an average of 50 kcals/day lower (p = 0.02) and resting energy expenditure was an average of 170 kcals/day higher (p = 0.05) compared to the high carbohydrate diet. Short-term higher protein diets were safe, well tolerated, and resulted in lowered energy intake and increased energy expenditure than the standard high-carbohydrate diet. Long-term studies are needed to determine whether higher protein diets will reduce the risk of overweight and obesity in children with LCHAD or TFP deficiency.