Non-fasting Conditions Research Articles

The effect of sampling procedures and day-to-day variations in metabolomics studies of biofluids

Metabolomics analysis of biofluids is a feasible tool for disease characterization and monitoring due to its minimally invasive nature. To reduce unwanted variation in biobanks and clinical studies, it is important to determine the effect of external factors on metabolic profiles of biofluids. In this study we examined the effect of sample collection and sample processing procedures on NMR measured serum lipoproteins and small-molecule metabolites in serum and urine, using a cohort of men diagnosed with either prostate cancer or benign prostatic hyperplasia. We determined day-to-day reliability of metabolites by systematic sample collection at two different days, in both fasting and non-fasting conditions. Study participants received prostate massage the first day to assess the differences between urine with and without prostate secretions. Further, metabolic differences between first-void and mid-stream urine samples, and the effect of centrifugation of urine samples before storage were assessed. Our results show that day-to-day reliability is highly variable between metabolites in both serum and urine, while lipoprotein subfractions possess high reliability. Further, fasting status clearly influenced the metabolite concentrations, demonstrating the importance of keeping this condition constant within a study cohort. Day-to-day reliabilities were however comparable in fasting and non-fasting samples. Urine sampling procedures such as sampling of first-void or mid-stream urine, and centrifugation or not before sample storage, were shown to only have minimal effect on the overall metabolic profile, and is thus unlikely to constitute a confounder in clinical studies utilizing NMR derived metabolomics.

Modulation of brain activity by hormonal factors in the context of ingestive behaviour

IntroductionMetabolic and hormonal signals have been shown to be associated with brain activity in the context of ingestive behaviour. However, this has mostly been seen in studies using external administration of hormones or glucose. We therefore studied endocrine-brain interaction in a physiological setting with hormone levels determined by metabolic conditions such as normal food intake vs. prolonged fasting. Methods24 healthy, normal weight men participated in two sessions, one involving a 38-hour fasting period and one a non-fasting control condition with standardized meals. Functional magnetic resonance imaging was performed at the end of the experiment with participants being required to rate pictures of food. Brain activation was compared between conditions in predefined regions of interest (ROIs). Multiple blood samples were taken to determine levels of insulin, C-peptide, cortisol, ACTH, glucose and adiponectin. These were used as a predictor variable in a regression analysis on brain activations in the different ROIs. ResultsFood pictures were rated as more desirable in the fasting condition. Univariate analysis of ROI activations revealed mainly effects of food rating and no significant effects of the metabolic state. Multiple regression analysis revealed associations between orbitofrontal cortex activation and blood glucose in the non-fasting condition. In the fasting condition adiponectin was associated with the signal from the caudate nucleus and insulin and C-peptide were associated with functional activity of orbitofrontal regions. DiscussionAssociations of endocrine signals and functional neural regions could be demonstrated in a realistic setting without external administration of hormones. As the current approach was correlational, further studies need to address the causal role of hormonal signals.

SCO-267, a GPR40 Full Agonist, Improves Glycemic and Body Weight Control in Rat Models of Diabetes and Obesity.

The GPR40/FFA1 receptor is a G-protein-coupled receptor expressed in the pancreatic islets and enteroendocrine cells. Here, we report the pharmacological profiles of (3S)-3-cyclopropyl-3-{2-[(1-{2-[(2,2-dimethylpropyl)(6-methylpyridin-2-yl)carbamoyl]-5-methoxyphenyl}piperidin-4-yl)methoxy]pyridin-4-yl}propanoic acid (SCO-267), a novel full agonist of GPR40. Ca2+ signaling and insulin and glucagon-like peptide-1 (GLP-1) secretion were evaluated in GPR40-expressing CHO, MIN6, and GLUTag cells. Hormone secretions and effects on fasting glucose were tested in rats. Single or repeated dosing effects were evaluated in neonatally streptozotocin-induced diabetic rats (N-STZ-1.5 rats), diet-induced obese (DIO) rats, and GPR40-knockout (Ffar1-/- ) mice. Treatment with SCO-267 activated Gq signaling in both high- and low-FFAR1-expressing CHO cells, stimulated insulin secretion in MIN6 cells, and induced GLP-1 release in GLUTag cells. When administered to normal rats, SCO-267 increased insulin, glucagon, GLP-1, glucose-dependent insulinotropic peptide, and peptide YY (PYY) secretions under nonfasting conditions. These results show the full agonistic property of SCO-267 against GPR40. Hypoglycemia was not induced in SCO-267-treated rats during the fasting condition. In diabetic N-STZ-1.5 rats, SCO-267 was highly effective in improving glucose tolerance in single and 2-week dosing studies. DIO rats treated with SCO-267 for 2 weeks showed elevated plasma GLP-1 and PYY levels, reduced food intake, and decreased body weight. In wild-type mice, SCO-267 induced GLP-1 secretion, food intake inhibition, and body weight reduction; however, these effects were abolished in Ffar1-/- mice, indicating a GPR40-dependent mechanism. In conclusion, SCO-267 stimulated islet and gut hormone secretion, improved glycemic control in diabetic rats, and decreased body weight in obese rats. These data suggest the therapeutic potential of SCO-267 for the treatment of diabetes and obesity.

Effect of Fasting on Choroidal Thickness and Its Diurnal Variation

ABSTRACTPurpose: The aim of this study was to assess the effect of Ramadan fasting on choroidal thickness (CT) and its associated diurnal variations using spectral domain optic coherence tomography.Materials and Methods: Ocular measurements were performed on a single eye of 87 healthy individuals. Eyes were evaluated twice a day around 8.00 a.m. and 4.00 p.m. during Ramadan. Evaluations were repeated at the same time of the day, 1 month following Ramadan on the same subjects. Measurements of choroidal and retinal thickness were performed at central, temporal and nasal segments.Results: The comparison of measurements revealed that temporal CT at 8.00 a.m. and foveal, temporal and nasal CTs at 4.00 p.m. were significantly reduced during fasting (p values were 0.005, <0.001, 0.001 and 0.046, respectively). Mean changes of CTs during fasting were 14.76 ± 16.01, 9.90 ± 19.57 and 8.10 ± 16.81 µm at the fovea, temporal and nasal segments, respectively. However, CTs at non-fasting conditions were measured as 6.13 ± 12.93, 3.78 ± 15.23 and 5.05 ± 13.60 µm, respectively. In comparison, diurnal variations of foveal and temporal CTs during fasting were significantly higher than the controls (p values were <0.001 and 0.004, respectively). Additionally, retinal thicknesses during fasting were significantly reduced compared to the controls in all segments measured at 4.00 p.m. (p for all values <0.05)Conclusions: The results of the present study revealed that fasting and dehydration caused a reduction of the choroidal and retinal thicknesses. Likewise, they are also responsible for the increased diurnal variation of CTs. Therefore, early hours of the day may be preferred to evaluate retinal and choroidal thicknesses during Ramadan to avoid the effects of dehydration on the measurement results.

Endocrine responses and food intake in fasted individuals under the influence of glucose ingestion.

IntroductionDifferent metabolic conditions can affect what and how much we eat. Hormones of glucose metabolism and adipokines such as adiponectin take part in the control of these decisions and energy balance of the body. However, a comprehensive understanding of how these endocrine and metabolic factors influence food intake has not been reached. We hypothesised that the amount of food a person consumes differs substantially after a fasting period even after the energy deficit was partially removed by glucose ingestion and endocrine signals like insulin and C-peptide indicated a high glucose metabolic status. Furthermore, the macronutrient composition of the consumed food and a possible association with adiponectin under the influence of glucose ingestion was assessed.MethodsIn a within-subject design, 24 healthy males participated in both a fasting (42 h) and control (non-fasting) condition. A total of 20 blood samples from each subject were collected during each condition to assess serum levels of adiponectin, insulin, C-peptide, cortisol and ACTH. At the end of each condition food intake was measured with an ad libitum buffet after the acute energy deficit was compensated using a carbohydrate-rich drink.ResultsThe total amount of caloric intake and single macronutrients was higher after the fasting intervention after replenishment with glucose. All recorded hormone levels, except for adiponectin, were significantly different for at least one of the study intervals. The relative proportions of the macronutrient composition of the consumed food were stable in both conditions under the influence of glucose ingestion. In the non-fasting condition, the relative amount of protein intake correlated with adiponectin levels during the experiment.Discussion and conclusionAn anabolic glucose metabolism after glucose ingestion following a fasting intervention did not even out energy ingestion compared to a control group with regular food intake and glucose ingestion. Anorexigenic hormones like insulin in this context were not able despite higher levels than in the control condition to ameliorate the drive for food intake to normal or near normal levels. Relative macronutrient intake remains stable under these varying metabolic conditions and glucose influence. Serum adiponectin levels showed a positive association with the relative protein intake in the non-fasting condition under the influence of glucose although adiponectin levels overall did not differ in between the conditions.

Comparison of glucose tolerance between wild-type mice and mice with double knockout of neuromedin U and neuromedin S.

Recently, it has been proposed that neuromedin U (NMU) is “decretin”, which suppresses insulin secretion from the pancreas in vitro. Here we examined the possible involvement of NMU in insulin secretion in vivo by comparing the plasma glucose and insulin levels of wild-type mice with those of double knockout (D-KO) of the NMU and neuromedin S (NMS) genes, as NMS binds to the neuromedin U receptor. If NMU is, in fact, “decretin”, which inhibits insulin secretion from the pancreas, then NMU-deficient mice might result in higher plasma insulin levels than is the case in wild-type mice, or injection of NMU lead to suppression of plasma insulin level. In this study, we found that the fasting plasma level of insulin was not increased in D-KO mice. Glucose tolerance tests revealed no significant difference in plasma insulin levels between wild-type mice and D-KO mice under non-fasting conditions. After peripheral injection of NMU, plasma glucose and insulin levels did not show any significant changes in either wild-type or D-KO mice. Glucose tolerance testing after 3 weeks of high fat feeding revealed no significant difference in plasma insulin levels during 60 min after glucose injection between wild-type and D-KO mice. These results suggest that even if NMU is a decretin candidate, its physiological involvement in suppression of insulin secretion may be very minor in vivo.

The Effects of Fasting on Toluene Metabolite (Hippuric Acid) Excretion in Urine (A Case Study of Shoe-Makers in Tambak Oso Wilangun Village-Surabaya)

Background: An increase in toluene metabolite (hippuric acid) excretion in urine can be stimulated by such factors as fasting, smoking and coffee consumption. This research aimed at studying the effects of fasting on urinary toluene excretion of shoemakers in Tambak Oso Wilangun-Surabaya. Method: This controlled case-study was conducted to 20 workers with purposive sampling method from the population. The independent variables of the study include toluene concentration, fasting or not fasting condition, smoking, and coffee consumption. The dependent variable was urinary hippuric acid concentration. Pearson Correlation test was conducted to identify the correlation between toluene concentration and hippuric acid concentration. Paired-t-test was used to compare hippuric acid concentration in fasting and non-fasting condition. The correlations between coffee consumption and smoking and hippuric acid concentration were analyzed by using chi-square test (I±=0,05). Risk assessment was used to identify the health risk from occupational toluene exposure. Result: The research showed that most of the respondents (65) were at risk to health problems related to toluene exposure (RQ>1). The statistical tests showed no significant correlation between toluene concentration and hippuric acid concentration; there was a significant difference between hippuric acid concentration before and after fasting (p=0,016; p<I±); there was a significant correlation between hippuric acid concentration (non fasting) with smoking habit (p=0,022), coffee consuming habit (p=0,025); and between hippuric acid concentration (in fasting condition) with coffee consuming (p=0,039). Conclusion: Fasting, coffee consuming and smoking habit can increase urinary hippuric acid excretion. It is recommended for future researcher to control both coffee consumption and smoking when investigating the effects of fasting to urinary hippuric acid excretion to avoid biased results. Respondents are suggested to improve ventilation system in their workshops and use chemical cartridge respirator, apron and gloves while working. © 2019, Indian Journal of Forensic Medicine and Toxicology. All rights reserved.

Maternal obesity leads to long-term altered levels of plasma ceramides in the offspring as revealed by a longitudinal lipidomic study in children.

Maternal obesity is associated with increased risk of obesity and other symptoms of the metabolic syndrome in the offspring. Nevertheless, the molecular mechanisms and cellular factors underlying this enhanced disease susceptibility remain to be determined. Here, we aimed at identifying changes in plasma lipids in offspring of obese mothers that might underpin, and serve as early biomarkers of, their enhanced metabolic disease risk. We performed a longitudinal lipidomic profiling in plasma samples from normal weight, overweight, and obese pregnant women and their children that participated in the Prenatal Omega-3 Fatty Acid Supplementation, Growth, and Development trial conducted in Mexico. At recruitment women were aged between 18 and 35 years and in week 18-22 of pregnancy. Blood samples were collected at term delivery by venipuncture from mothers and from the umbilical cord of their newborns and from the same infants at 4 years old under non-fasting conditions. Lipidomic profiling was done using ultra-performance liquid chromatography high-resolution mass spectrometry. Analysis of the lipidomic data showed that overweight and obese mothers exhibited a significant reduction in the total abundance of ceramides (Cer) in plasma, mainly of Cer (d18:1/20:0), Cer (d18:1/22:0), Cer (d18:1/23:0), and Cer (d18:1/24:0), compared with mothers of normal body weight. This reduction was confirmed by the direct quantification of these and other ceramide species. Similar quantitative differences in the plasma concentration of Cer (d18:1/22:0), Cer (d18:1/23:0), and Cer (d18:1/24:0), were also found between 4-year-old children of overweight and obese mothers compared with children of mothers of normal body weight. Noteworthy, children exhibited equal daily amounts of energy and food intake independently of the BMI of their mothers. Maternal obesity results in long-lasting changes in plasma ceramides in the offspring suggesting that these lipids might be used as early predictors of metabolic disease risk due to maternal obesity.

Comparison of fasting and non-fasting blood lipid levels in children in Tianjin

Objective To compare the difference between fasting blood lipids and non-fasting blood lipids in children in Tianjin, and to explore the feasibility of non-fasting blood lipids detection in children. Methods A total of 223 child patients were enrolled in Department of Pediatrics, the Second Hospital of Tianjin Medical University from January 2017 to February 2018, fasting and 1-6 h post-dining blood samples were collected from each patient.Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured.Self-control methods were used.Wilcoxon signed rank test was used for statistical analysis. Results Compared with fasting lipids, non-fasting TC increased with 0.02 mmol/L, TG increased with 0.01 mmol/L, HDL-C increased with 0.03 mmol/L, while LDL-C decreased with 0.01 mmol/L, but non-high-density lipoprotein cholesterol did not change.Among them, only the difference in HDL-C between the fasting and non-fasting was statistically significant (Z=-2.870, P<0.05). The difference in the change rate of all indicators was <3%.According to the dyslipidemia group comparison, the differences in hypercholesterolemia (0.72 mmol/L, Z=-2.551, P=0.011), hypertriglyceridemia (0.73 mmol/L, Z=-3.846, P<0.001), low high-density lipoprotein cholesterolemia (-0.04 mmol/L, Z=-8.625, P<0.001) and normal level HDL-C (0.1 mmol/L, Z=-5.040, P<0.001)between non-fasting lipids and fasting blood lipids were statistically significant. Conclusions The change of children′s blood lipid profile in fasting and non-fasting conditions is little.Lipid testing in children does not require fasting.Blood tests can be performed at any appropriate time point in the normal diet. Key words: Non-fasting blood lipid; Blood lipid; Cardiovascular disease; Child

Capecitabine bioequivalence in healthy volunteers

Capecitabine is a prodrug and is selectively activated by tumor cells to its cytotoxic moiety, 5-fluorouracil, by thymidine phosphorylase, which is generally expressed at high levels in tumors. Clinical and pharmacokinetic studies of capecitabine have been performed in patients with cancer. This study aims to evaluate the bioequivalence of two capecitabine formulations (150-mg tablet) using healthy male subjects under nonfasting conditions. The study was conducted as an open, randomized, three-period, semi-replicated design with three sequences (RRT, RTR, TRR) with a 1-week washout interval. The subjects were selected for the study after having their health status previously assessed by a clinical evaluation and laboratory tests (biochemical and hematological parameters, and urinalysis). A single capecitabine tablet (150mg) was given in each occasion. Plasma capecitabine concentrations were analyzed by liquid chromatography coupled with tandem mass spectrometry (HPLC/MS/MS) with positive ion electrospray ionization using multiple reactions monitoring (MRM). The geometric mean and 90% confidence intervals (CI) of capecitabine/Xeloda® (T/R) percent ratio were 104.34% (98.74 - 110.25%) for AUClast, 103.06% (97.48 - 108.96%) for AUCinf, and 104.07% (88.13 - 122.90%) for Cmax. Since the 90% CI for Cmax, AUClast, and AUCinf ratios were all inside the 80 - 125% interval proposed by the US Food and Drug Administration Agency, it was concluded that the capecitabine formulation elaborated by Eurofarma Laboratórios Ltda. is bioequivalent to Xeloda® formulation for both the rate and the extent of absorption. The drug was well tolerated by the subjects, indicating that it is safe to perform capecitabine bioequivalence studies in healthy male subjects. .

Pas Kinase Deficiency Triggers Antioxidant Mechanisms in the Liver

Metabolic dysfunction in the liver is the cause of numerous pathologies, which are associated with an altered redox state. PASK (PAS Domain Kinase) is a nutrient and bioenergetic sensor. We contend that PASK could act as an oxidative stress sensor in liver and/or control the metabolic balance, playing a role in the mitochondrial homeostasis. Using PASK-deficient mice, we observed that PASK deficiency promotes antioxidant response mechanisms: a lower production of ROS/RNS under non-fasting conditions, overexpression of genes coding to ROS-detoxifying enzymes and mitochondrial fusion proteins (MnSod Gpx, Mfn1 and Opa1), coactivator Ppargc1a, transcription factors (Pparg and FoxO3a) and deacetylase Sirt1. Also, under fasting conditions, PASK deficiency induced the overexpression of Ppargc1a, Ppara, Pparg, FoxO3a and Nrf2 leading to the overexpression of genes coding to antioxidant enzymes such as MnSOD, Cu/ZnSOD, GPx, HO1 and GCLm. Additionally, inducing PINK1 involved in cell survival and mitophagy. These changes kept ROS steady levels and improved the regenerative state. We suggest a new role for PASK as a controller of oxidative stress and mitochondrial dynamics in the liver. In fact, antioxidant response is PASK dependent. PASK-targeting could therefore be a good way of reducing the oxidative stress in order to prevent or treat liver diseases.

Non-fasting lipid profile determination in presumably healthy children: Impact on the assessment of lipid abnormalities.

ObjectiveDespite the common use of non-fasting measurements for lipid profile in children it remains unclear as to the extent non-fasting conditions have on laboratory results of lipids measurements. We aimed to assess the impact of non-fasting lipid profile on the occurrence of dyslipidemia in children.Materials and methodsBasic lipid profile including: total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), as well as small, dense-LDL-C (sd-LDL-C), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB) and lipoprotein(a) [Lp(a)], were measured in 289 presumably healthy children aged 9–11 in both fasting and non-fasting condition. The clinical impact of non-fasting lipid profile was evaluated individually for each child with estimation of false positive (FP) and false negative (FN) results.ResultsThe highest percentage of FP results in non-fasting condition was observed for TG (42.3%) being significantly higher when compared to FN results (p = 0.003). In contrast, the highest percentage of FN results in a non-fasting state were shown for LDL-C (14.3%), but the difference was statistically insignificant when compared to FP results. When comparing fasting and non-fasting lipid profile a number of significant differences was shown for: TG (p<0.001), HDL-C (p = 0.002) LDL-C (p<0.001) and ApoAI (p<0.001), respectively. The occurrence of dyslipidemia, recognized on the basis of non-fasting lipids was significantly higher (p = 0.010) when compared to fasting lipid profile.ConclusionsA higher occurrence of dyslipidemia, based on the measurement of non-fasting lipids in children, is suggestive of possible disorders in lipid metabolism. However, accurate identification of dyslipidemia by assessment of non-fasting lipids requires the establishment of appropriate cut-off values for children.

Propafenone quantification in human plasma by high-performance liquid chromatography coupled with electrospray tandem mass spectrometry in a bioequivalence study .

Propafenone is an antiarrhythmic drug applied to ventricular arrhythmias, initially recognized as a sodium channel blocker. This study aims to evaluate the bioequivalence of two propafenone formulations (300mg tablet) in healthy subjects under non-fasting conditions. The study was conducted as an open, randomized, 2-period design with a 2-sequence (RT, TR) with a 1-week washout interval. The subjects were selected for the study after having their health status previously assessed by a clinical evaluation and laboratory tests (biochemical and hematological parameters, and urinalysis). Debrisoquine phenotype of healthy subjects was determined by analysis of urinary excretion of debrisoquine and its major metabolite, 4-hydroxydebrisoquine. A single propafenone tablet (300mg) was given in each occasion. Plasma propafenone concentrations were analyzed by liquid chromatography coupled to tandem mass spectrometry (HPLC/MS/MS) with positive ion electrospray ionization using multiple reactions monitoring (MRM). The geometric mean and 90% confidence intervals (CI) of propafenone/Ritmonorm^® (T/R) percent ratio were 100.44% (88.39-114.13%) for AUC_last, 99.84% (90.31-110.36%) for AUC_inf, and 99.30% (90.08-109.47%) for C_max. Since the 90% CI for C_max, AUC_last, and AUC_inf ratios were all inside the 80-125% interval proposed by the US Food and Drug Administration Agency, it was concluded that the propafenone formulation elaborated by Biolab Sanus Farmacêutica Ltda. is bioequivalent to Ritmonorm^® formulation for both the rate and the extent of absorption. The drug was well tolerated by the subjects, indicating that it is safe to perform propafenone bioequivalence studies in healthy subjects with intermediate/extensive metabolism. .

A Novel Spatiotemporal Longitudinal Methodology for Predicting Obesity Using Near Infrared Spectroscopy (NIRS) Cerebral Functional Activity Data

Globally, there has been a dramatic increase in obesity, with prevalence in males and females expected to increase to 18 and 21%, respectively (NCD Risk Factor Collaboration, Lancet 387(10026):1377–96, 2016). However, there are hardly any data-analytic calorie-based cognitive studies, especially using non-invasive near infrared spectroscopy (NIRS) data that predict obesity using predictive data mining. Obesity is linked with neurodegenerative diseases, diabetes, and cardiovascular diseases. Thus, understanding, predicting, preventing, and managing obesity have the potential to save the lives of millions. Behavioral studies suggest that overeating in obese individuals is triggered by exaggerated brain reward center (BRC) activity to high-calorie food stimuli (Shefer et al., Neurosci Biobehav Rev 37(10):2489–503, 2013). In this paper, details of a novel research methodology are presented for a 24-month longitudinal study using a 44-channel NIRS device with the subjects in a natural environment. The proposed methodology consists of using visual stimuli of low/high calorie food items under fasting and satiated conditions for three types of subjects. The experiments consist of block design, longitudinal plan, data smoothing, BRC activation mapping, stereotactic normalization, generating paired t-test maps under fasting and non-fasting conditions and subsequently using Naive Bayes modeling to generate obesity prediction maps for the control subjects. The simulated results consist of generation of Bayesian prediction maps using layers of paired t-test cerebral activity maps for the four BRC functional regions considered for three types of subjects, i.e., obese, control, and control subjects fed high calorie diet. We have demonstrated how cerebral functional activity data in response to visual food stimuli can be used to predict obesity in the non-obese, thus offering a non-invasive preventive measure.

Effect of diabetes mellitus type 2 on salivary glucose, immunoglobulin A, total protein, and amylase levels in adults: A systematic review and meta-analysis of case-control studies.

Background:Saliva is a fluid with the complex compound which can be used as diagnostic markers for type 2 diabetes (T2D). This meta-analysis evaluated salivary glucose, immunoglobulin A (IgA), total protein, and amylase levels in adult T2D compared with the controls as well as the correlation of salivary glucose levels with serum glucose and hemoglobin A1C (HbA1c) levels in both groups.Materials and Methods:Web of Science, Scopus, PubMed, and Cochrane Library databases were searched up to July 2017. A random-effects analysis was performed using the mean difference (MD) and 95% confidence intervals. The search terms were “T2D, IgA, amylase, total protein, or glucose” combination with “saliva.” The studied variables were the sample size, the percentage of male, the mean age, the condition of saliva sampling, and the salivary levels of mentioned factors.Results:A total of 25 studies were included in this meta-analysis with 1432 and 900 diabetic patients and healthy controls, respectively. MD of salivary glucose level in patients with T2D, compared with the healthy controls, in fasting and nonfasting conditions were 6.23 mg/dL (P = 0.0002) and 6.70 mg/dL (P < 0.00001), respectively. Furthermore, the fasting salivary total protein in the patients was significantly higher than the controls (MD = 167.96 mg/dL; P = 0.03). Non-fasting salivary amylase and secretory IgA levels were significantly lower in the patients (MD = −48.61 IU/mL; P < 0.00001) than in the controls (MD = −9.42 IU/mL; P = 0.0006), respectively. The pooled estimate showed a significant correlation between salivary and serum glucose in the patients (r = 0.765; P < 0.001) and the controls (r = 0.646; P < 0.001) and between salivary glucose and serum glycated hemoglobin in the patients (r = 0.721; P < 0.001).Conclusion:Measurement of these salivary factors can be helpful for diagnostic and monitoring purposes of T2D. In addition, salivary glucose as a diagnostic tool can evaluate serum glucose and HbA1c levels in the diabetic patients.

The “sweet” effect: Comparative assessments of dietary sugars on cognitive performance

In recent years there has been increasing interest in studying cognitive effects associated with sugar consumption. Neuro-cognitive research has confirmed that glucose, as a main energy substrate for the brain, can momentarily benefit cognitive performances, particularly for memory functioning. However, there is still limited understanding of relative effects of other common sugars (e.g., fructose and sucrose) on cognitive performance. The present study tested in 49 people the effects of three common dietary sugars against a placebo sweetener (i.e., sucralose), on performance of three well-studied cognitive tasks – simple response time, arithmetic, and Stroop interference, all of which are suggested to rely on the prefrontal lobe. A double-blind, placebo-controlled, cross-over experimental design was used. Results revealed that ingestion of glucose and sucrose led to poorer performances on the assessed tasks as opposed to fructose and the placebo (p<0.05); these effects were particularly pronounced under the fasting condition in comparison to the non-fasting condition (p<0.001). Overall, these results indicate that cognitive effects of sugar are unlikely to be mediated by the perception of sweetness. Rather, the effects are mediated by glucose. Further research should systematically assess effects of dietary sugars on other cognitive domains, such as memory, to give further insights on general cognitive effects of sugar consumption.

Effect of Fasting On Cognitive Functioning In Healthy Young Adults

Abstract Background and objective: Cognitive flexibility refers to the ability of the brain to switch from thinking about one concept to another simultaneously. The study was taken up to evaluate the effect of fasting on Cognitive Functioning In Healthy Young Adults. Methodology: A total of 20 healthy young adults participated in the study. Paper Stroop Color Test was employed to assess inhibition and cognitive flexibility. Participants were given 4 cards (word card color card and color-word card) and were instructed to read the card as told by the clinician. The total duration taken to complete each task and incorrect responses for each task was noted. The same experiment was done in fasting and non-fasting condition for each participant. Results: The results revealed no statistical significance between the 3 tasks between 2 conditions. Though our present study did not reveal statistical significance difference between 3 tasks and 2 conditions, it was found that the performance was better during the second condition i.e. after fasting condition in comparison to first condition i.e during fasting condition. Conclusion: The study justifies these findings to be reflected due to fluid deprivation, change in life style and sleep wake up cycles with in turn effects cognitive functioning. The study also highlights on the effectiveness of stroop task in identifying the changes in cognitive function due to fasting.

Not performing an OGTT results in significant underdiagnosis of (pre)diabetes in a high risk adult Caucasian population.

Type 2 diabetes (T2DM) is known to be underdiagnosed. Tests for diagnosis include fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) and HbA1c. HbA1c can be tested in non-fasting conditions. Therefore, general practitioners almost no longer execute OGTT's. We evaluated the performance of OGTT versus HbA1c in a population consisting of overweight and obese subjects, which can be considered a 'high risk' population. A total of, 1241 overweight and obese subjects without a history of diabetes (male/female: 375/866, age 44±13 years, body mass index 38.0±6.1 kg m-2) were tested for glucose tolerance status using FPG, OGTT and HbA1c. Exactly, 46.8% were found to have prediabetes and 11.9% were newly diagnosed with T2DM (male/female=18.9/8.9%) using ADA criteria. Testing only HbA1c would have resulted in 78 subjects being diagnosed with T2DM, but 47.3% of newly diagnosed patients would have been missed if OGTT would not have been done. Exactly 581 subjects were diagnosed with prediabetes, 1.4% subjects had impaired fasting glucose (IFG) 30.5% had impaired glucose tolerance (IGT), 5.1% subjects had a combined IFG+IGT, and 9.8% had an isolated elevated HbA1c (5.7-6.4%). Of the 581 subjects with prediabetes, 257 had an HbA1c <5.7%. Therefore, 44.2% subjects would have been missed when OGTT would not have been done. In a population with only overweight and obese adult subjects, 46.8% were diagnosed with prediabetes and 11.9% were newly diagnosed with diabetes. Exactly, 5.6 and 20.7% of total population met the diagnostic criteria of the OGTT for diabetes and prediabetes, respectively, but did not meet the diagnostic criteria of the HbA1c. These data suggest that not performing an OGTT results in significant underdiagnose of T2DM in an overweight and obese adult population.

Mixed biopolymer nanocomplexes conferred physicochemical stability and sustained release behavior to introduced curcumin

Beta-lactoglobulin (BLG)-sodium alginate (ALG) electrostatic nanocomplexes were utilized to encapsulate and deliver curcumin in clear acidic media. Relative viscosity measurements confirmed that ALG wrapping around the globular BLG molecules occurred in the aqueous biopolymer mixture upon acidification. Curcumin was efficiently entrapped within developed green delivery systems. The encapsulation efficiency (EE) of curcumin was around 98%. The carriers were efficiently able to retain the curcumin inside over time. The physical stability of hydrophobic curcumin toward precipitation in aqueous solution was significantly improved after introduction into nanostructures. Moreover, nanocomplexes conferred considerable protection to curcumin against heat-induced degradation. At the end of 15-day storage at 45 °C, the amounts of curcumin loaded in nanocomplexes were significantly (p < 0.05) larger than those loaded in blank samples. Non-significant changes in the particle size after high temperature short time (HTST) heat treatment indicated that the presence of polysaccharide shell around the protein core increased the thermal stability of BLG at acidic conditions. No release occurred in simulated fasting and non-fasting gastric conditions. However, a sustained release behavior (78.5% during 12 h) was observed in simulated intestinal fluid.

Reliability of pulse waveform separation analysis: effects of posture and fasting.

Oscillometric pulse wave analysis devices enable, with relative simplicity and objectivity, the measurement of central hemodynamic parameters. The important parameters are central blood pressures and indices of arterial wave reflection, including wave separation analysis (backward pressure component Pb and reflection magnitude). This study sought to determine whether the measurement precision (between-day reliability) of Pb and reflection magnitude: exceeds the criterion for acceptable reliability; and is affected by posture (supine, seated) and fasting state. Twenty healthy adults (50% female, 27.9 years, 24.2 kg/m) were tested on six different mornings: 3 days fasted, 3 days nonfasted condition. On each occasion, participants were tested in supine and seated postures. Oscillometric pressure waveforms were recorded on the left upper arm. The criterion intra-class correlation coefficient value of 0.75 was exceeded for Pb (0.76) and reflection magnitude (0.77) when participants were assessed under the combined supine-fasted condition. The intra-class correlation coefficient was lowest for Pb in seated-nonfasted condition (0.57), and lowest for reflection magnitude in the seated-fasted condition (0.56). For Pb, the smallest detectible change that must be exceeded in order for a significant change to occur in an individual was 2.5 mmHg, and for reflection magnitude, the smallest detectable change was 8.5%. Assessments of Pb and reflection magnitude are as follows: exceed the criterion for acceptable reliability; and are most reliable when participants are fasted in a supine position. The demonstrated reliability suggests sufficient precision to detect clinically meaningful changes in reflection magnitude and Pb.