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PubMed2006

Citrus polymethoxylated flavones improve lipid and glucose homeostasis and modulate adipocytokines in fructose-induced insulin resistant hamsters.

The present study was undertaken to determine whether supplementation with polymethoxylated flavones (PMFs) could ameliorate the fructose-induced hypertriglyceridemia and other metabolic abnormalities associated with insulin resistance (IR) in hamsters. Following feeding with the fructose diet, hamsters were supplemented orally with PMF-L or PMF-H (62.5 and 125 mg/kg/day) for 4 weeks. Both PMF-treated groups showed a statistically significant (p<0.05) decrease in serum triglyceride (TG) and cholesterol levels compared to the fructose-fed control group. The fructose control group at the end of the study showed elevated serum insulin and impaired insulin sensitivity (glucose intolerance). On the other hand, PMF-supplemented groups showed a reversal in these metabolic defects, including a decrease in insulin level and an improvement in glucose tolerance. PMF supplementation also reduced TG contents in the liver and heart and was able to regulate adipocytokines by significantly suppressing TNF-alpha, INF-gamma, IL-1beta and IL-6 expression and increasing adiponectin in IR hamsters. The mechanism of PMF on the activation of peroxisome proliferator-activated receptors (PPAR) was also explored. PMF-H supplementation significantly increased PPARalpha and PPARgamma protein expression in the liver. This is the first report of positive effects of PMF on adipocytokine production and on PPAR expression in IR hamsters. This study suggests that PMF can ameliorate hypertriglyceridemia and its anti-diabetic effects may occur as a consequence of adipocytokine regulation and PPARalpha and PPARgamma activation.

Adipocytes↗
PubMed1985

Regulation of gluconeogenesis by glycerol and its phosphorylated derivatives.

Glycerol, glycerol-3-phosphate (G3P), and dihydroxyacetone phosphate (DHAP) were evaluated as inhibitors of gluconeogenesis on rat liver enzymes in vitro, and for their effects on glucose formation in vivo in well-nourished and malnourished rats. DHAP was more potent as an inhibitor than G3P on fructose-1,6-diphosphatase (FDPase), phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G6Pase). The I50 for DHAP was 2, 8, and 9 x 10(-3) M, respectively. No effect was observed on rat liver pyruvate carboxylase (PC). Glycerol was a weak inhibitor of FDPase and PEPCK, but did not inhibit PC and G6Pase. In vivo, when G3P was injected before a parenteral L-alanine (Ala) challenge, it produced a hypoglycemic effect in malnourished rats and a lesser, but noticeable, blood glucose level reduction in well-fed animals. Glycerol caused a smaller reduction in glucose formation from Ala. No comparable effects were observed after a fructose pretreatment. These results underscore the potential hypoglycemic effects of phosphorylated glycerol metabolites and identify the steps in gluconeogenesis where this action is exerted. The study also stresses the nutritional component in the glycerol intolerance syndrome, apparent from the far more severe effects observed in malnourished rats given G3P or glycerol prior to Ala.

Alanine↗
PubMed1986

Carbohydrate malabsorption in black and Hispanic dialysis patients.

Patients on chronic hemodialysis have decreased food intake and decreased fat stores. Malabsorption of carbohydrates such as lactose, sorbitol, or fructose cause functional bowel symptoms. The aim of this study was to assess the role of carbohydrate malabsorption in the nutritional abnormalities of chronic hemodialysis (CHD). Eleven patients on dialysis (six Hispanic, five black Americans) were studied, compared to 11 healthy volunteers age-, race-, and sex-matched. Lactulose 10 g (transit time), lactose 12.5 g, sorbitol 5 g, and fructose 37.5 g were tested fasting. Breath [H2] was measured 4 h postprandially by gas chromatograph analysis. Positive test was defined as 20 ppm [H2] above baseline. Weight, height, and triceps skinfold were measured. One hundred percent of CHD patients were below the 50th percentile for triceps skinfold measurement and 55% were below the 10th percentile. No biochemical abnormalities were noted. Breath [H2] tests: lactulose: all patients in both groups responded with positive tests. No difference in transit time was noted. Lactose: 73% of CHD had positive test compared to 36% control. Sorbitol: 73% of CHD had positive test compared to 27% control (p less than 0.05). Fructose: 27% CHD compared to 0% control. This study confirmed that CHD patients have decreased fat stores. It demonstrates for the first time that CHD patients have increased incidence of malabsorption of sorbitol. This carbohydrate malabsorption may contribute to the nutritional abnormalities of CHD.

Adult↗
PubMed1975

Carbohydrate digestion and absorption studies in the horse.

The ability of the horse to digest and absorb soluble carbohydrates was assessed using a series of oral disaccharide tolerance tests followed in the same animals by tolerance tests with the constituent monosaccharides. In horses older than three years, lactose did not produce an increase in the plasma glucose levels but induced the passing of soft faeces, indicating that adult horses are lactose intolerant. Horses of all ages could absorb the glucose: galactose mixture without any change in the faeces. The tolerance is due to a failure to hydrolyse lactose and does not involve the monosaccharide transport systems. These findings correspond to the known development pattern of brush border lactase activity in the equine small intestine. Both sucrose and maltose were rapidly hydrolysed, the resulting tolerance curves closely approximating to those for the constituent monosaccharides. Galactose was absorbed at a similar rate to glucose, although a dose of 1g/kg was necessary to produce galactosaemia. An oral lactose tolerance test (1 g/kg as a 20 per cent solution) could be of clinical value to determine small intestinal mucosal damage in diarrhoeic foals when the continued ingestion of lactose might be detrimental.

Animals↗
PubMedDate not supplied

Differential effects of honey, sucrose, and fructose on blood sugar levels.

It is now recognized that dietary carbohydrate components influence the prevalence and severity of common degenerative diseases such as dental problems, diabetes, heart disease and obesity. Fructose and sucrose have been evaluated and compared to glucose using glucose tolerance tests, but few such comparisons have been performed for a "natural" sugar source such as honey. In this study, 33 upper trimester chiropractic students volunteered for oral glucose tolerance testing comparing sucrose, fructose and honey during successive weeks. A 75-gm carbohydrate load in 250 ml of water was ingested and blood sugar readings were taken at 0, 30, 60, 90, 120 and 240 minutes. Fructose showed minimal changes in blood sugar levels, consistent with other studies. Sucrose gave higher blood sugar readings than honey at every measurement, producing significantly (p less than .05) greater glucose intolerance. Honey provided the fewest subjective symptoms of discomfort. Given that honey has a gentler effect on blood sugar levels on a per gram basis, and tastes sweeter than sucrose so that fewer grams would be consumed, it would seem prudent to recommend honey over sucrose.

Adult↗
PubMed1977

[Parenteral hyperalimentation (author's transl)].

Intravenous hyperalimentation allows complete nutrition and anabolism in patients who cannot be fed by the oral route. However, several complications have been reported, e.g. septicaemia and hyperglycaemina. In 51 intensive-care patients receiving hyperalimentation, 18% were found to be hyperglycaemic in spite of insulin administration. Hyperglycaemia was frequently associated with stress. In 8 patients undergoing major surgery, which was chosen as a stress model, decreased insulin and increased glucagon, growth hormone and cortisone levels were observed. These findings could explain stress-induced glucose intolerance. In a further experiment, 8 intensive-care patients were given alternative intravenous feedings with either 600g of a mixture of glucose, fructose and xylitol in a ration of 1:2:1 or 600g glucose per day. During both regimens insulin administration was required in 4 patients, but the insulin dosage was lower with the mixture. Plasma glucose during glucose infusion was 205+/-25mg/100ml(M+/-SEM) and the sum of plasma glucose, fructose and xylitol during infusion of the mixture was 176+/-33mg/100ml, the difference being of borderline significance (p less than 0.05). The advantages and disadvantages of infusable substrates are summarized on the basis of the available literature and it is concluded that, in general, glucose is preferable. However, if hyperglycaemia is difficult to control, partial replacement of glucose by glucose substitutes or fat emulsions may be advantageous. A routine infusion programme for central venous feeding is suggested. Causes and prevention of side-effects are reviewed. In many patients receiving central venous nutrition less hazardous and less expensive methods could be used such as nasogastric tube feeding, elemental diet or peripheral venous nutrition.

Blood Glucose↗
PubMed2000

Fructose-1,6-diphosphatase deficiency and glyceroluria: one possible etiology for GIS.

Fructose-1,6-diphosphatase (FDPase) deficiency is characterized by episodes of lactic acidemia, hypoglycemia, and ketonuria. Liver biopsy and subsequent enzyme analysis most reliably make the diagnosis. Review of the literature reveals 85 cases. Glycerol intolerance syndrome (GIS) is less well defined. There are only a handful of cases reported. We describe a patient with FDPase deficiency and significant glyceroluria and propose that GIS may be caused by partial deficiency of FDPase.

Diagnosis, Differential↗
PubMed1976

Postoperative tolerance to glucose and sugar substitutes.

In 51 surgical intensive-care patients, who were given 400 to 650 g glucose per day i.v., 18% of arterial blood sugar values were found to be above 250 mg/100 m1 in spite of frequent insulin administration. In 8 lobectomized patients increased plasma levels of pancreatic glucagon, cortisol, and growth hormone were observed which may in part explain postoperative glucose intolerance. In addition previous carbohydrate deprivation was found to impair glucose tolerance. Several measures are suggested to reduce the incidence of hyperglycemia during i.v. glucose feeding. In a further study 24 cholecystectomized or vagotomized patients received in alternate sequence either a combination of glucose (G), fructose (F) and xylitol (X), the G/F/X-ratio being 1/2/1, or glucose alone for 5 days. The infusion rate was 1.42 g carbohydrate/kg/24 hrs. On operation day and was increased by the same amount every day up to 7.14 g/kg/24 hrs. Tolerance was good in both groups but urinary losses of infused substrates were higher in the group receiving the GFX-combination. It is concluded that after surgery of intermediate magnitude the GFX-combination offers no advantage over glucose alone. However, in severely ill patients, where glucose intolerance is more pronounced, further carefully monitored studies with sugar substitutes appear of interest.

Adult↗
PubMed2001

Hypohidrosis related to the administration of topiramate to children.

PURPOSE: Topiramate (TPM) is an antiepileptic agent, first licensed in the United Kingdom in 1994, that is used in the treatment of patients with refractory seizure disorders. TPM is a monosaccharide d-fructose derivate, with sulfamate function, and so far, few adverse side effects have been reported. METHODS: We describe three patients with epilepsy who were treated with TPM and developed hypohidrosis, heat and exercise intolerance, as well as fever. The sudomotor function was assessed after peripheral stimulation with pilocarpine iontophoresis. RESULTS: Sweat response was reduced in all three patients. Signs and symptoms ceased after drug suppression. CONCLUSIONS: This side effect associated with TPM, which has not been described previously, can be clinically significant during heat stress and exercise challenge.

Adolescent↗