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PubMed2005

Effect of moderate incremental exercise, performed in fed and fasted state on cardio-respiratory variables and leptin and ghrelin concentrations in young healthy men.

BACKGROUND: Although hormonal responses to exercise performed in fed state are well documented, far less in known about the effect of a single exercise bout, performed after overnight fasting, on cardio-respiratory responses and hormones secretion. It has been reported that recently discovered hormones as leptin and ghrelin may affect cardiovascular responses at rest. However, their effect on the cardiovascular responses to exercise is unknown. AIMS: This study was designed to determine the effect of overnight fasting on cardio- respiratory responses during moderate incremental exercise. We have hypothesised that fasting / exercise induced changes in plasma leptin / ghrelin concentrations may influence cardiovascular response. MATERIAL AND METHODS: Eight healthy non-smoking men (means +/- SE.: age 23.0 +/- 0.5 years; body mass 71.9 +/- 1.5 kg; height 179.1 +/- 0.8 cm; BMI 22.42 +/- 0.49 kg x m(-2) with VO2max of 3.71 +/- 0.10 l x min(-1)) volunteered for this study. The subjects performed twice an incremental exercise test, with the increase of power output by 30 W every 3 minutes. Tests were performed in a random order: once in the feed state--cycling until exhaustion and second, about one week later, after overnight fasting--cycling until reaching 150 W. RESULTS: In the present study we have compared the results obtained during incremental exercise performed only up to 150 W (59 +/- 2 % of VO2max) both in fed and fasted state. Heart rate measured during exercise at each power output, performed in fasted state was by about 10 bt x min(-1) (p = 0.02) lower then in fed subjects. Respiratory quotient and plasma lactate concentration in fasted state were also significantly (p<0.001) lower than in the fed state. Pre-exercise plasma leptin and ghrelin concentrations were not significantly different in fed and fasted state. Exercise induced increase in hGH was not accompanied by a significant changes in the studied gut hormones such as ghrelin, leptin, and insulin, except for plasma gastrin concentration, which was significantly (p = 0.008) lower in fasting subjects at the power output of 150 W. Plasma [IL-6] at rest before exercise performed in fasted state was significantly (p = 0.03) elevated in relation to the fed state. This was accompanied by significantly higher (p = 0.047) plasma noradrenaline concentration. Plasma IL-6 concentration at rest in fed subjects was negatively correlated with plasma ghrelin concentration (r = -0.73, p < 0.05) and positively correlated with plasma insulin concentration (r = 0.78, p < 0.05). Significant negative correlation (r = -0.90; p < 0.05) was found between plasma insulin and ghrelin concentration at rest in fed subjects. CONCLUSIONS: We have concluded that plasma leptin and ghrelin concentrations have no significant effect on the fasting-induced attenuation of heart rate during exercise. We have postulated that this effect is caused by increased plasma norepinephrine concentration, leading to the increase in systemic vascular resistance and baroreceptor mediated vagal stimulation. Moreover we believe, that the fasting-induced significant increase in plasma IL-6 concentration at rest, accompanied by higher plasma norepinephrine concentration and lower RQ, belongs to the physiological responses, maintaining energy homeostasis in the fasting state.

Adult↗
PubMed1984

Fasting breath hydrogen concentration: normal values and clinical application.

Excretion of hydrogen in breath commonly persists despite an overnight fast. Although elevation of hydrogen concentration above the fasting value after administration of a test sugar is evidence of malabsorption, the significance of the fasting value itself is unknown. We determined the normal limits of fasting breath hydrogen in healthy children and adults, and in patients with chronic diarrhea or recurrent abdominal pain. Fasting breath hydrogen in 221 healthy children and 9 healthy adults averaged 7.1 +/- 5.0 parts per million (mean +/- SD), exceeding 30 parts per million in less than 1%. No value exceed 42 parts per million. In 73 patients with recurrent abdominal pain and 76 patients with chronic diarrhea, fasting breath hydrogen was less than 42 parts per million in 97% and 83%, respectively. History and laboratory data were reviewed in the 15 patients where fasting breath hydrogen exceeded 42 parts per million. Seven had documented small bowel bacterial overgrowth and an additional 3 patients had radiographic evidence of intestinal stasis. Using test dinner meals, we prospectively evaluated the effect of previously ingested foods containing complex carbohydrates on fasting breath hydrogen. Dinner meals consisting of rice, wheat, or beans influenced fasting breath hydrogen values, but did not result in elevated fasting breath hydrogen in healthy individuals. Rice bread resulted in uniformly low fasting breath hydrogen values in healthy subjects (2.0 +/- 2.5 parts per million), but fasting breath hydrogen remained elevated in patients with bacterial overgrowth. Our studies indicate that conditions for measurement of the fasting breath hydrogen value may be standardized to improve discrimination between normal and abnormal values.

Abdomen↗
PubMedDate not supplied

Fasting glucose/insulin ratio. An index to differentiate normo from hyperinsulinemic women with polycystic ovary syndrome.

OBJECTIVE: To evaluate a simple laboratory index useful to differentiate normo from hyperinsulinemic women with polycystic ovary syndrome. DESIGN: Open and prospective study. SETTING: Outpatient infertility clinic of a third level medical institution. PATIENTS: Twenty five women 27.8 +/- 3.4 years of age with chronic anovulation, hirsutism and hyperandrogenemia (free testosterone [free-T] > 3.4 pg/mL) but no acanthosis nigricans (group 1) were compared with ten healthy women 27.5 +/- 1.5 years of age (group 2). INTERVENTIONS: Three fasting blood samples were obtained followed by a 100-g, 2-hours oral glucose tolerance test (OGTT). MAIN OUTCOME MEASURES: Glucose, insulin, FSH, LH, E2, free-T, androstenedione (A), DHEAS and 17 alpha-hydroxyprogesterone (17-OHP) were measured in the three fasting samples. Glucose and insulin were also determined in the OGTT samples. The fasting glucose/insulin (G/I) ratio was calculated. RESULTS: In group 2 the fasting insulin was < 16.8 microU/mL, the sum of serum insulin (sigma INS) during the OGTT was < 385 microU/mL (mean + 3SD) and the fasting G/I ratio was > 4.5. The fasting LH, FSH, free-T, cortisol, and insulin were higher in group 1 than in group 2. In group 1, eleven women had a sigma INS below and fourteen above 385 microU/mL. Fasting insulin had a linear correlation with sigma INS (r = 0.780) while the fasting G/I ratio had an exponential correlation with sigma INS (r = -0.699). Fasting insulin versus the G/I ratio best fitted a reciprocal regression model (r = 0.912). For screening of hyperinsulinemia during OGTT, fasting insulin had a 75% sensitivity and 62% specificity while for the G/I ratio it was 79% and 73%, respectively. CONCLUSIONS: Both fasting hyperinsulinemia (> 16.8 microU/mL) and a fasting G/I ratio < or = 4.5 can satisfactorily differentiate women with hyperandrogenism and hyperinsulinemia from those with normoinsulinemia. However, the ratio does not require a previous definition of a normal value as for fasting or post-oral glucose insulin levels, and thus, it can be easily calculated in daily clinical practice to establish specific therapeutic maneuvers at an early stage of the evaluation of such patients.

Adult↗
PubMed2005

Fast-food intake and diet quality in black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To examine trends in fast-food consumption and its relationship to calorie, fat, and sodium intake in black and white adolescent girls. DESIGN: A longitudinal multicenter cohort study of the development of obesity and cardiovascular risk factors in black and white female adolescents. Data collection occurred annually using a validated 3-day food record and a food-patterns questionnaire. SUBJECTS AND SETTINGS: A biracial and socioeconomically diverse group of 2379 black and white girls recruited from 3 centers. MAIN OUTCOME MEASURE: Three-day food records and a food-patterns questionnaire were examined for intake of fast food and its association with nutrient intake. We compared patterns of exposure to fast food and its impact on intake of calories, fat, and sodium. RESULTS: Fast-food intake was positively associated with intake of energy and sodium as well as total fat and saturated fat as a percentage of calories. Fast-food intake increased with increasing age in both races. With increasing consumption of fast food, energy intake increased with an adjusted mean of 1837 kcal for the low fast-food frequency group vs 1966 kcal for the highest fast-food frequency group (P<.05). Total fat in the low fast-food frequency group was 34.3% as opposed to 35.8% in the highest fast-food frequency group (P<.05). Saturated fat went from 12.5% to 13% and sodium increased from 3085 mg to 3236 mg in the lowest vs the highest fast-food frequency group (P<.001). CONCLUSIONS: Dietary intake of fast food is a determinant of diet quality in adolescent girls. Efforts to reduce fast-food consumption may be useful in improving diet and risk for future cardiovascular disease.

Adolescent↗
PubMed1994

Fast-track recovery of the coronary bypass patient.

A new approach termed "fast-track recovery" ws undertaken at both the Baystate Medical Center and Hartford Hospital. The fast-track protocol involves the following principles: (1) preoperative education; (2) early extubation; (3) methylprednisolone sodium succinate before bypass followed by dexamethasone for 24 hours postoperatively; (4) prophylactic digitalization, metoclopramide HCl, docusate sodium, and ranitidine HCl; (5) accelerated rehabilitation; (6) early discharge; (7) a dedicated fast-track coordinator to perform both daily telephone contact and a 1-week postoperative examination; and (8) a routine 1-month postoperative visit with a PA or MD. To evaluate the effects of this approach on patient care, a retrospective 1-year analysis was undertaken in both institutions with all coronary artery bypass grafting patients compared in a consecutive manner before the origin of the fast-track protocol and subsequent to its beginning. There were 280 patients in the fast-track and 282 in the non-fast-track group. The two groups were not significantly different except inexplicably there was a lower ejection fraction in the fast-track group and a longer cross-clamp time. Postoperatively, the mean time to extubation decreased from 22.1 to 15.4 hours, and peak weight gain decreased from 2.8 to 1.6 kg from the non-fast-track to the fast-track group (p < 0.01). This was accompanied by significant (p < 0.001) decreases in intensive care unit duration from 2.4 to 1.9 days and in postoperative length of stay from 8.3 to 6.8 days from the non-fast-track to the fast-track group. There was no increase in morbidity or mortality associated with the fast-track protocol either early or late. Thirty-day hospital readmission was not significantly different between the two groups. Fast-track methodology is effective, and we routinely employ this approach for all patients undergoing cardiopulmonary bypass.

Aged↗
PubMed2004

FAST is a survival protein that senses mitochondrial stress and modulates TIA-1-regulated changes in protein expression.

The Fas-activated serine/threonine phosphoprotein (FAST) is tethered to the outer mitochondrial membrane, where it interacts with BCL-X(L) (17). Here we show that RNA interference-mediated knockdown of endogenous FAST results in apoptosis, whereas overexpressed recombinant FAST inhibits Fas- and UV-induced apoptosis, indicating that FAST is a survival protein. The antiapoptotic effects of FAST are regulated by interactions with the translational silencer TIA-1: a FAST mutant lacking its TIA-1-binding domain does not inhibit apoptosis, and overexpressed recombinant TIA-1 inhibits the antiapoptotic effects of FAST. Because the antiapoptotic effects of FAST require ongoing protein synthesis, we hypothesized that FAST might function by preventing TIA-1-mediated silencing of mRNAs encoding inhibitors of apoptosis. Consistent with this hypothesis, FAST promotes the expression of cotransfected reporter proteins, a process that requires its TIA-1-binding domain and is inhibited by overexpressed recombinant TIA-1. More compellingly, recombinant FAST increases the expression of endogenous cIAP-1 and XIAP, but not GAPDH, in transfected HeLa cells. Because FAST is released from mitochondria in cells undergoing Fas- or UV-induced apoptosis, we propose that FAST serves as a sensor of mitochondrial stress that modulates a TIA-1-regulated posttranscriptional stress response program.

Animals↗
PubMed2005

Age and kidney function are the primary correlates of fasting plasma total homocysteine levels in non-diabetic and diabetic adults. Results from the 1999-2002 National Health and Nutrition Examination Survey.

BACKGROUND: Plasma total homocysteine (tHcy) is commonly elevated in persons with diabetes. This may be due to effects of insulin and/or glucose and/or metabolic control on the metabolism or plasma levels of tHcy. This study examined the effects of fasting plasma glucose status on fasting tHcy levels among adults without diabetes, and diabetes per se among adults with a self-report history of diabetes. METHODS: Analysis of data on adults (> or = 20y) who had fasted at least 8 hours, from the National Health and Nutrition Examination Survey (1999-2000 and 2001-2002). Subjects with no self-report history of diabetes were grouped according to fasting plasma glucose status as normal (< 100 mg/dL = NFG, n = 2,244), impaired (> or = 100 < 126 mg/dL = IFG, n = 1,108), or a provisional diagnosis of diabetes (> or = 126 mg/dL = DFG, n = 133). Subjects with a self-report history of diabetes (n = 275) were examined separately. RESULTS: Fasting tHcy was higher (Ps < 0.01) among non-diabetic subjects with DFG and IFG, compared to NFG (median [95% confidence interval] = 8.6 [8.0-9.2], 8.3 [8.1-8.5], and 7.4 [7.3-7.5] micromol/L, respectively). Diabetic subjects had levels similar to non-diabetic subjects with DFG and IFG (8.3 [7.9-8.6] micromol/L). Age and estimated creatinine clearance were strong correlates of fasting tHcy among non-diabetic subjects (r = 0.38 to 0.44 and r = -0.35 to -0.46, respectively) and diabetic subjects (r = 0.41 and r = -0.46, respectively) (Ps < 0.001), while fasting glucose and glycohemoglobin (HbA1c) were weaker (but still significant) correlates of tHcy in non-diabetic and diabetic subjects. Fasting glucose status was not a significant independent predictor of fasting tHcy levels in non-diabetic subjects, and HbA1c was not a significant independent predictor of tHcy in diabetic subjects (Ps > 0.05). CONCLUSION: Fasting tHcy levels are elevated among non-diabetic adults with elevated fasting glucose levels, compared to persons with normal fasting glucose levels, and among diabetic adults. However, elevations in fasting tHcy appear to be mediated primarily by age and kidney function, and not by measures of glucose metabolism.

Journal Article↗
PubMed2001

The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes.

OBJECTIVES: The prevalence of type 2 diabetes in American adolescents has increased markedly during the past generation. Although the factors that contribute to the development of type 2 diabetes are complex and not wholly elucidated, the triad of severe obesity, hyperinsulinemia, and a family history of type 2 diabetes places a child at an increased risk for development of the disease. Current approaches to the prevention of type 2 diabetes, including dietary counseling and exercise, have had limited success. We reasoned that drugs that increase glucose tolerance in diabetic patients might prove useful in preventing the progression to glucose intolerance in high-risk patients. To that end, we conducted a double-blind, placebo-controlled study of the effects of metformin on body mass index (BMI), serum leptin, glucose tolerance, and serum lipids in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes. METHODS: The study population consisted of 29 white and black adolescents aged 12 to 19 years. All had BMIs exceeding 30 kg/m(2). Criteria for enrollment included: 1) a fasting insulin concentration exceeding 15 microU/mL; and 2) at least 1 first- or second-degree relative with type 2 diabetes. All patients had fasting plasma glucose concentrations <110 mg% and hemoglobin A1c concentrations </=6.0%. All had normal linear growth and sexual development for age, with no marked hirsutism, severe acne, or menstrual irregularities characteristic of polycystic ovary syndrome. Eight participants had acanthosis nigricans. After baseline laboratory studies including a rapidly sampled intravenous glucose tolerance test, patients were randomized to receive metformin (500 mg twice daily) or a placebo for a total of 6 months. The effects of metformin on BMI standard deviation score, serum leptin, glucose tolerance, and serum lipids were analyzed. The study was double-blinded and included no specific dietary restrictions. RESULTS: Metformin caused a decline of 0.12 standard deviation in BMI in study participants (-1.3% from baseline), and a 5.5% reduction in serum leptin in girls. In contrast, BMI and serum leptin rose 0.23 standard deviation (2.3%) and 16.2%, respectively, in the placebo group during the treatment period. Metformin caused a progressive decline in fasting blood glucose (from a mean of 84.9 to 75.1 mg%) and a reduction in fasting insulin levels (from 31.3 to 19.3 microU/mL). In contrast, fasting glucose levels in the placebo group rose slightly from 77.2 to 82.3 mg%, and fasting insulin levels did not change. Insulin sensitivity, as assessed by the ratio of fasting insulin to glucose concentrations and the quantitative insulin sensitivity check index (1/[log fasting insulin + log fasting glucose]) and homeostasis model assessment insulin resistance index (fasting insulin x fasting glucose/22.5) indices, increased slightly in the metformin-treated participants. However, the insulin sensitivity measured using Bergman's minimal model did not change. There were also no significant changes in glucose effectiveness, hemoglobin A1c, serum lipids, or serum lactate in the metformin or placebo groups. Metformin was tolerated well by the majority of patients. Transient abdominal discomfort or diarrhea occurred in 40% of treated participants; there were no episodes of vomiting or lactic acidosis. CONCLUSIONS: The treatment of obesity and insulin resistance in adults often proves ineffective because the vicious cycle leading to type 2 diabetes may have become entrenched and, to some extent, may be irreversible. Early detection and therapy of the obese adolescent with a family history of type 2 diabetes may interrupt the cycle of weight gain and insulin resistance that leads to glucose intolerance in adulthood. Through its ability to reduce fasting blood glucose and insulin concentrations and to moderate weight gain, metformin might complement the effects of dietary and exercise counseling and reduce the risk of type 2 diabetes in selected patients.

Adolescent↗
PubMed1992

Effect of duration of fasting on postmolt laying hen performance.

Two experiments were conducted to examine the effects of varying length of feed withdrawal on postmolt laying hen performance. Commercial laying hens (65 wk of age) were fed continuously or fasted for 4 or 10 days in Experiment 1 and fed continuously or fasted for 4, 7, or 14 days in Experiment 2. Egg production performance was evaluated for 35 wk of production following initiation of fasting. Hen-day egg production (Weeks 1 to 35) and egg weight (Weeks 5 to 35) did not differ between treatments in Experiment 1; however, in Experiment 2, egg production was depressed for the 14-day fasted hens compared with the fed hens. Lower egg weight also occurred for the 14-day fasted hens compared with the fed, 4-, or 7-day fasted hens in Experiment 2. Egg yield (grams of egg per hen per day) for Weeks 5 to 35 was lower for fed hens versus the 4- or 10-day fasted groups in Experiment 1, but no treatment differences occurred in Experiment 2. Feed efficiency (grams of egg per gram of feed) for Weeks 5 to 13 was not affected by length of fasting in Experiment 1, but feed efficiency of hens fasted for 14 days was lower (P less than .05) than that of hens on other treatments in Experiment 2. Egg specific gravity was highest for hens fasted for 10 or 14 days and was lowest for fed hens, with egg specific gravity for hens fasted for 4 or 7 days being intermediate (P less than or equal to .05). The results indicated that fasting periods of less than 10 days may yield satisfactory egg production and egg weight but that eggshell quality may be enhanced by using fasting periods of 10 days or longer.

Animals↗
PubMedDate not supplied

Relationship between natriuresis and changes in plasma atrial natriuretic factor, renin activity and aldosterone levels in fasting obese subjects.

This study was conducted to assess whether changes in atrial natriuretic factor (ANF) secretion could account for the natriuresis of the early phase of fasting. To this end, 8 AM (supine) and 10 AM (standing) plasma ANF concentrations were determined daily and compared with plasma renin activity and aldosterone levels in 8 obese subjects submitted to a 7-day total fast. Depiste constant daily sodium intake (51 mmol), urinary sodium excretion increased from 35 +/- 7 to 109 +/- 8 mmol/day after 4 days of fast (p less than 0.001) and declined thereafter. Urinary ketone excretion progressively increased over the whole period of fasting (p less than 0.001). Interestingly, fasting induced a decrease in plasma ANF concentrations (p less than 0.05). A contrast analysis revealed no significant change in ANF during the initial natriuretic phase of fasting but a decrease at the end of fasting averaging 36% (p less than 0.05) and 18% (p less than 0.05) at 8 and 10 AM respectively. In contrast, plasma aldosterone rose during fasting (p less than 0.05), the difference being significant at the end of fasting (p less than 0.01). Plasma renin activity and cortisol did not change significantly over the fasting period. Postural and/or diurnal changes of ANF, aldosterone, renin and cortisol were preserved during fasting (p less than 0.01). Postural changes of ANF were, however, attenuated at the end of fasting (p less than 0.05). These data indicate that the fasting natriuresis cannot be explained by changes in ANF levels but that the loss of sodium may contribute to a decline of basal ANF levels, with an attenuation of their physiological postural changes, and to a stimulation of the aldosterone secretion.

Aldosterone↗
PubMed1994

Fat-suppressed MR of the orbit and cavernous sinus: comparison of fast spin-echo and conventional spin-echo.

PURPOSE: To compare T2-weighted fat-suppressed fast spin-echo imaging with fat-suppressed conventional spin-echo imaging in the detection of normal intraorbital and pericavernous anatomy and orbital disease, and to determine the efficacy of fat saturation with T2-weighted fast spin-echo imaging of the cavernous sinus. METHODS: Contrast-to-noise ratios of normal intraorbital anatomy were calculated and compared in 10 consecutive patients using fat-suppressed fast spin-echo and conventional spin-echo T2-weighted images. Contrast-to-noise ratios of common intraorbital lesions were calculated and compared using fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo. Qualitative evaluation was performed and compared for normal intraorbital anatomy using both fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo in 16 patients. Qualitative evaluation for the detection of normal anatomic structures of the pericavernous region was performed and compared using fast spin-echo with and without fat suppression and fat-suppressed conventional spin-echo T2-weighted images in 16 patients. Fat saturation was performed using standard commercially available chemical saturation technique. RESULTS: Reduced imaging time allowed more acquisitions for fat-suppressed fast spin-echo images, which significantly improved visibility of intraorbital and pericavernous anatomy over fat-suppressed conventional spin-echo. Anatomic visibility was also improved because of reduced motion, phase encoding, and susceptibility artifacts. There was no significant difference between contrast-to-noise ratios for fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo imaging of the lateral and medial rectus muscles. Contrast-to-noise ratios of fat suppressed fast spin-echo of orbital disease was significantly greater than contrast-to-noise ratios of fat-suppressed conventional spin-echo. Detection of several normal anatomic structures of the pericavernous region was significantly improved with non-fat-suppressed fast spin-echo over fat-suppressed fast spin-echo because of significantly reduced magnetic susceptibility artifact. CONCLUSIONS: Fat-suppressed fast spin-echo is superior to fat-suppressed conventional spin-echo for T2-weighted orbital imaging. Non-fat-suppressed fast spin-echo is the preferred pulse sequence for T2-weighted imaging of the cavernous sinus because of the minimal susceptibility artifact.

Adipose Tissue↗
PubMed2003

Relation of triglyceride levels, fasting and nonfasting, to fatal and nonfatal coronary heart disease.

BACKGROUND: It remains unclear whether hypertriglyceridemia is an independent risk factor for coronary heart disease (CHD), and whether fasting and nonfasting triglyceride (TG) levels are equally predictive. METHODS: A total of 2809 (of 12 866) men randomized during 1973 through 1975 into the Multiple Risk Factor Intervention Trial with fasting and nonfasting TG levels measured at baseline were followed up for CHD incidence and death. Proportional hazards regression models were used to assess associations of fasting and nonfasting TG levels with CHD. RESULTS: Average fasting and nonfasting TG levels were 187 and 284 mg/dL (2.11 and 3.21 mmol/L), respectively. Prevalence of hypertriglyceridemia (200 mg/dL [2.26 mmol/L] or more) was 31% for fasting and 61% for nonfasting. There were 175 nonfatal or fatal CHD events during 8 years and 328 CHD deaths during 25 years. Compared with TG levels less than 200 mg/dL, risk factor-adjusted hazard ratios for CHD mortality for hypertriglyceridemia were 1.24 (P =.09) for fasting and 1.26 (P =.07) for nonfasting. For nonfatal or fatal CHD, fasting and nonfasting TG levels were similarly predictive with hazard ratios of 1.64 (P =.004) for fasting and 1.46 (P =.03) for nonfasting. These associations for fasting TG levels were assessed to be underestimated by 56% because of regression dilution bias, with attenuation likely greater for nonfasting TG levels. CONCLUSIONS: Greater ease of obtaining nonfasting than fasting measurements, greater prevalence of hypertriglyceridemia with nonfasting than fasting values, and similarly increased risk with each indicate that nonfasting TG levels may be more useful than fasting ones for risk stratification.

Adult↗
PubMed1999

Is fasting glucose sufficient to define diabetes? Epidemiological data from 20 European studies. The DECODE-study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis of Diagnostic Criteria in Europe.

AIMS/HYPOTHESIS: The World Health Organisation Consultation recommended new diagnostic criteria for diabetes mellitus including: lowering of the diagnostic fasting plasma glucose to 7.0 mmol/l and introduction of a new category: impaired fasting glycaemia. The diagnostic 2-h glucose concentrations for diabetes and for impaired glucose tolerance were unchanged. This study identifies fasting plasma glucose concentrations predicting a diabetic 2-h plasma glucose of 11.1 mmol/l or more, analyses the sensitivity and specificity of different screening strategies for diabetes and describes the cardiovascular risk profile in people with impaired fasting glycaemia. METHODS: European population based studies (n = 17) or large, representative samples of employees (n = 3) with both fasting and 2-h post load glucose concentrations following 75-g oral glucose tolerance tests were included (18,918 men and 10,190 women). The Iceland study (8881 men and 9407 women) is presented separately as a 50-g glucose load was used. RESULTS: The fasting plasma glucose predicting a 2-h plasma glucose of 11.1 mmol/l or more with optimal sensitivity and specificity was a) 5.8 mmol/l in women and 6.4 mmol/l in men; b) independent of age; c) increased with obesity. Fasting plasma glucose of 7.0/7.8 mmol/l or more predicted a diabetic 2-h plasma glucose with sensitivities of 49.0/29.8% and specificities of 98.2/99.7%, respectively. CONCLUSION/INTERPRETATION: If fasting glucose is used alone, the 31% of diabetic subjects with a non-diabetic fasting glucose but a diabetic 2-h glucose, will not be diagnosed; impaired fasting glycaemia and impaired glucose tolerance do not identify the same people; the risk profile of people with impaired fasting glycaemia depends on 2-h glucose concentrations. Obesity is the main confounder in the association between fasting and 2-h glucose.

Adult↗
PubMed2002

Combined effects of fasting and alanine on liver function recovery after cold ischemia.

The effect of donor nutritional status on hepatic function recovery after cold ischemia is still debated. We demonstrated previously that a 48-h fast diminished the survival rate of liver-transplanted rats and that the deleterious effect of fasting was prevented by infusion of alanine to the recipient at reperfusion. Whether the duration of fasting influenced the protective effect of alanine and whether this effect was metabolic were not known, and the elucidation of these questions is the aim of this study. The effect on hepatic function recovery of fasting periods of 24 h, 48 h and 72 h prior to cold ischemia were studied in a model of isolated, perfused rat liver. After a cold-ischemic time of 24 h in University of Wisconsin (UW) solution at 4 degrees C, livers were reperfused for 3 h. The combined effect of alanine (8 mM) infusion at liver reperfusion was evaluated for each prior fasting period. The addition of pyruvate (8 mM), a metabolic intermediary of alanine, was only tested in the 72-h fasting group. The evaluation criteria were: liver weight after reperfusion, release of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) in the perfusate, bile production, vascular resistance and liver histology after reperfusion. The enzyme release at reperfusion was significantly higher when livers were harvested from rats submitted to a 48-h fast (ALT) or a 72-h fast (ALT, AST, LDH), as compared to those from fed rats. Vascular resistance was increased in 72-h fasted livers. An addition of alanine (8 mM) at reperfusion lowered the release of AST, ALT and LDH. This effect was more obvious when the fasting duration was increased. By contrast, the addition of pyruvate at reperfusion did not improve the recovery of livers submitted to a 72-h fasting period before preservation. A long fasting period is deleterious as compared to feeding; however, this effect can be compensated by infusion of alanine at reperfusion. The mechanism involved is not metabolic. In a clinical setting, the infusion of alanine to the recipient at reperfusion may be a convenient way to compensate for donor undernutrition, especially after a long stay in an intensive care unit.

Alanine↗
PubMed1999

Induction of preeclampsia like phenomena by stimulation of sympathetic nerve with cold and fasting stress.

The purpose of this study was to examine the effect of cold-stress, fasting stress and cold plus fasting stress on the sympathetic nerve activity. Pregnant and nonpregnant rats were kept in cold environment (0 degrees C), or fasting condition (12 h), and cold plus fasting condition for 2 weeks. Their plasma corticotrophin releasing factor (CRF), catecholamines, insulin levels, and platelets were measured, and histological examinations were performed. In cold plus fasting stress rats, a significant increased CRF, epinephrine (E), norepinephrine (NE), and insulin levels with decreased platelet count (P<0.0001) were observed compared with control. Histological study revealed that diffused enlarged glomeruli with fibrin deposition in the kidney, hemostasis, ischemic necrosis and fibrin deposition in liver and swelling along with hemorrhagic necrosis in adrenal gland of cold plus fasting stress rats. The biochemical and histological changes in cold plus fasting, cold-stressed or fasting rats were similar to human preeclampsia. The findings observed in cold plus fasting stress rats were more pronounced either than cold-stressed or fasting group. These results demonstrate that cold plus fasting stress is an intense stimulator of sympathetic nervous system than either cold stress or fasting.

Adrenal Glands↗
PubMed1981

Effect of antacids on the bioavailability of diflunisal in the fasting and postprandial states.

Diflunisal is long-acting salicylate derivative. We examined the effect of single concomitant doses of three antacids on diflunisal bioavailability under fasting or fed conditions (30 min after finishing a standard meal). With the use of an open, randomized, and balanced design, one 250-mg diflunisal tablet was given to each of 12 healthy men under six conditions: fasted, no antacid; fed, no antacid; fasted, 15 ml of aluminum hydroxide gel; fed, 15 ml of aluminum hydroxide gel; fasted, 10 ml magnesium hydroxide suspension; and fed, 15 ml of an aluminum hydroxide/magnesium hydroxide mixture. Diflunisal plasma 0- to 48-hr area uiven to each of 12 healthy men under six conditions: fasted, no antacid; fed, no antacid; fasted, 15 ml of aluminum hydroxide gel; fed, 15 ml of aluminum hydroxide gel; fasted, 10 ml magnesium hydroxide suspension; and fed, 15 ml of an aluminum hydroxide/magnesium hydroxide mixture. Diflunisal plasma 0- to 48-hr area uiven to each of 12 healthy men under six conditions: fasted, no antacid; fed, no antacid; fasted, 15 ml of aluminum hydroxide gel; fed, 15 ml of aluminum hydroxide gel; fasted, 10 ml magnesium hydroxide suspension; and fed, 15 ml of an aluminum hydroxide/magnesium hydroxide mixture. Diflunisal plasma 0- to 48-hr area under the time curve (AUC), peak plasma concentrations, and 0-to 96-hr urinary excretion were determined. Food (alone) decreased peak plasma concentrations by 16% (P less than 0.05) but did not affect AUC or urinary excretion. Under fasting conditions, aluminum hydroxide reduced AUC by 26% (P less than 0.01), peak plasma concentrations by 46% (P less than 0.01), and urinary excretion by 14% (P less than 0.05). Magenisuum hydroxide suspension (in the fasting state) increased the early plasma concentrations (by 130% at 0.5 hr and 64% at 1 hr, P less than 0.05) and increased AUC by 10% (P less than 0.05) but had no effect on urinary excretion. In the fed state neither aluminum hydroxide nor the aluminum hydroxide/magnesium hydroxide mixture had any detectable effect.

Adult↗
PubMed2000

Blood cholesterol screening influence of fasting state on cholesterol results and management decisions.

OBJECTIVE: To compare fasting and nonfasting total and high-density lipoprotein (HDL) cholesterol values in adults and to determine how closely classification into risk groups for coronary heart disease based on nonfasting blood tests compares with classification based on fasting studies. DESIGN: Cross-sectional study. SETTING: A community hospital general internal medicine clinic. PATIENTS: One hundred eighty-one patients at least 20 years of age receiving medical care at a community hospital general internal medicine clinic. INTERVENTIONS: Total and HDL cholesterol levels were measured twice in each patient within 7 days, once while not fasting and once after a minimum 12-hour fast. MEASUREMENTS AND MAIN RESULTS: Fasting and nonfasting total and HDL cholesterol values were compared, patients were classified into desirable, borderline-high, and high cholesterol groups on the basis of fasting and nonfasting blood studies. There were small, statistically significant but clinically insignificant differences in fasting and nonfasting results for total cholesterol. Nonfasting HDL cholesterol levels were similar to fasting HDL levels. The agreement in classification of patients into desirable and high-cholesterol groups between fasting and non-fasting blood testing was 86.7% and 89.5%, respectively. In the borderline-high group, for whom levels of HDL cholesterol are important in determining subsequent management, there was 95% agreement between fasting and nonfasting HDL cholesterol results. Only a small fraction of the patients were classified into lower-risk groups by the nonfasting assessment, creating the potential for less-rigorous monitoring and treatment of their cholesterol status than if fasting results were utilized. These findings were confirmed in this study also for the subgroups of men aged 35 years and older and women aged 45 years and older. CONCLUSIONS: Screening nonfasting adults for total and HDL cholesterol is appropriate for making decisions about primary prevention of coronary heart disease.

Adult↗
PubMed1996

Effects of fasting and refeeding on structures of the intestinal villi and epithelial cells in White Leghorn hens.

1. The fine structural alterations of villi and epithelial cells in each part of the small intestine were investigated in layer-type hens fasted for 12 h to 20 d or refed for one day after each fasting period. 2. Within the first 24-h-fasting, villi of the duodenum showed a remarkable reduction in height and those of the jejunum revealed a gradual decrease; such a significant reduction of the villus height was not obtained in the ileum. After 36-h-fasting, villus height in each part gradually decreased with days of fasting. 3. All intestinal villus heights increased after only 1-d-refeeding of various kinds of diets following 3-, 10-, or 20-d-fasting. The duodenum especially rapidly recovered even after long-term fasting of 20 d but the ileum showed very slow recovery, suggesting that the ileum seems to be inactive in absorptive function. 4. These variable alterations of villus height in the proximal intestine suggest that the higher intestinal absorptive ability is under the normal feeding, the more rapidly villus height is influenced by nutritional conditions. 5. Cell area and cell mitosis decreased after fasting, the latter showing a marked reduction. However, in spite of a remarkable decrease of cell mitosis in the proximal intestine after fasting, refeeding activated cell renewal and it soon reached control levels, demonstrating that the villus height mainly varied with the numbers of epithelial cells. 6. In the epithelial cells of the proximal intestine in chickens fasted for 20 d, large lysosomal autophagous vacuoles including mitochondria and dense bodies were observed. These were reduced in size by refeeding for only one day, suggesting that fasting may cause intracellular digestion through lysosomal autophagy. 7. These results lead to the conclusion that long-term for force moulting is possible, that a high protein and high energy diet can be fed immediately after fasting and that a cell undergoing lysosomal autophagy in normal chickens indicates undernutrition.

Animals↗