Oral Sensitivity Research Articles

The Mediterranean Diet: Effects on Insulin Resistance and Secretion in Individuals with Overweight or Obesity.

High adherence to the Mediterranean Diet (MD) is associated with a lower risk of type 2 diabetes. However, it is less clear whether the different MD food items might influence specific biological functions related to glucose tolerance, i.e., insulin resistance (IR) and/or secretion (IS). Thus, this cross-sectional study aimed to investigate the relationship between adherence to MD and IR, insulin sensitivity, and IS in individuals with overweight/obesity. Participants (62 individuals; 7M/55F; mean age 49 ± 15 years; mean BMI 35.8 ± 6.7 kg/m²) underwent a 75 g oral glucose tolerance test (OGTT) to assess plasma glucose and insulin concentrations. These parameters were used for the calculation of validated IR indices (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Homeostatic Model Assessment for β-cell function (HOMA-β)), as well as insulin sensitivity indices (insulin sensitivity index (ISI), oral glucose insulin sensitivity (OGIS)). MD adherence was gauged using the PREDIMED questionnaire. Bivariate correlations were used to highlight the association between OGTT-derived indices and MD adherence (PREDIMED score) or specific foodstuffs related to MD. Despite there being no significant differences in BMI, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT), the high MD adherence group presented lower HOMA-IR (p = 0.022) and higher ISI (p = 0.033) compared to other groups. High MD adherence was inversely correlated with HOMA-IR (r = -0.400; p = 0.004) and directly correlated with ISI (r = 0.296, p = 0.039). Fish consumption, a key component of MD, exhibited significant associations: it was directly correlated to ISI (r = 0.394, p = 0.005) and inversely related to HOMA-IR (r = -0.327, p = 0.019) and β-cell function (r = -0.489, p < 0.001). In conclusion, a high MD adherence, and in particular the consumption of fish, is associated with a decreased IR in individuals with overweight/obesity.

A supervised learning regression method for the analysis of oral sensitivity of healthy individuals and patients with chemosensory loss

The gustatory, olfactory, and trigeminal systems are anatomically separated. However, they interact cognitively to give rise to oral perception, which can significantly affect health and quality of life. We built a Supervised Learning (SL) regression model that, exploiting participants’ features, was capable of automatically analyzing with high precision the self-ratings of oral sensitivity of healthy participants and patients with chemosensory loss, determining the contribution of its components: gustatory, olfactory, and trigeminal. CatBoost regressor provided predicted values of the self-rated oral sensitivity close to experimental values. Patients showed lower predicted values of oral sensitivity, lower scores for measured taste, spiciness, astringency, and smell sensitivity, higher BMI, and lower levels of well-being. CatBoost regressor defined the impact of the single components of oral perception in the two groups. The trigeminal component was the most significant, though astringency and spiciness provided similar contributions in controls, while astringency was most important in patients. Taste was more important in controls while smell was the least important in both groups. Identifying the significance of the oral perception components and the differences between the two groups provide important information to allow for more targeted examinations supporting both patients and healthcare professionals in clinical practice.

Accuracy of upper respiratory tract samples to diagnose Mycobacterium tuberculosis: a systematic review and meta-analysis

Pulmonary tuberculosis due to Mycobacterium tuberculosis can be challenging to diagnose when sputum samples cannot be obtained, which is especially problematic in children and older people. We systematically appraised the performance characteristics and diagnostic accuracy of upper respiratory tract sampling for diagnosing active pulmonary tuberculosis. In this systematic review and meta-analysis, we searched MEDLINE, Cinahl, Web of Science, Global Health, and Global Health Archive databases for studies published between database inception and Dec 6, 2022 that reported on the accuracy of upper respiratory tract sampling for tuberculosis diagnosis compared with microbiological testing of sputum or gastric aspirate reference standard. We included studies that evaluated the accuracy of upper respiratory tract sampling (laryngeal swabs, nasopharyngeal aspirate, oral swabs, saliva, mouth wash, nasal swabs, plaque samples, and nasopharyngeal swabs) to be tested for microbiological diagnosis of tuberculous (by culture and nucleic acid amplification tests) compared with a reference standard using either sputum or gastric lavage for a microbiological test. We included cohort, case-control, cross-sectional, and randomised controlled studies that recruited participants from any community or clinical setting. We excluded post-mortem studies. We used a random-effects meta-analysis with a bivariate hierarchical model to estimate pooled sensitivity, specificity, and diagnostics odds ratio (DOR; odds of a positive test with disease relative to without), stratified by sampling method. We assessed bias using QUADAS-2 criteria. This study is registered with PROSPERO (CRD42021262392). We screened 10 159 titles for inclusion, reviewed 274 full texts, and included 71, comprising 119 test comparisons published between May 13, 1933, and Dec 19, 2022, in the systematic review (53 in the meta-analysis). For laryngeal swabs, pooled sensitivity was 57·8% (95% CI 50·5-65·0), specificity was 93·8% (88·4-96·8), and DOR was 20·7 (11·1-38·8). Nasopharyngeal aspirate sensitivity was 65·2% (52·0-76·4), specificity was 97·9% (96·0-99·0), and DOR was 91·0 (37·8-218·8). Oral swabs sensitivity was 56·7% (44·3-68·2), specificity was 91·3% (CI 81·0-96·3), and DOR was 13·8 (5·6-34·0). Substantial heterogeneity in diagnostic accuracy was found, probably due to differences in reference and index standards. Upper respiratory tract sampling holds promise to expand access to tuberculosis diagnosis. Exploring historical methods using modern microbiological techniques might further increase options for alternative sample types. Prospective studies are needed to optimise accuracy and utility of sampling methods in clinical practice. UK Medical Research Council, Wellcome, and UK Foreign, Commonwealth and Development Office.

Effects of Quinine on the Glycaemic Response to, and Gastric Emptying of, a Mixed-Nutrient Drink in Females and Males.

Intraduodenal quinine, in the dose of 600 mg, stimulates glucagon-like peptide-1 (GLP-1), cholecystokinin and insulin; slows gastric emptying (GE); and lowers post-meal glucose in men. Oral sensitivity to bitter substances may be greater in women than men. We, accordingly, evaluated the dose-related effects of quinine on GE, and the glycaemic responses to, a mixed-nutrient drink in females, and compared the effects of the higher dose with those in males. A total of 13 female and 13 male healthy volunteers received quinine-hydrochloride (600 mg ('QHCl-600') or 300 mg ('QHCl-300', females only) or control ('C'), intraduodenally (10 mL bolus) 30 min before a drink (500 kcal, 74 g carbohydrates). Plasma glucose, insulin, C-peptide, GLP-1, glucose-dependent insulinotropic polypeptide (GIP) and cholecystokinin were measured at baseline, for 30 min after quinine alone, and then for 2 h post-drink. GE was measured by 13C-acetate breath-test. QHCl-600 alone stimulated insulin, C-peptide and GLP-1 secretion compared to C. Post-drink, QHCl-600 reduced plasma glucose, stimulated C-peptide and GLP-1, and increased the C-peptide/glucose ratio and oral disposition index, while cholecystokinin and GIP were less, in females and males. QHCl-600 also slowed GE compared to C in males and compared to QHCl-300 in females (p < 0.05). QHCl-300 reduced post-meal glucose concentrations and increased the C-peptide/glucose ratio, compared to C (p < 0.05). Magnitudes of glucose lowering and increase in C-peptide/glucose ratio by QHCl-600 were greater in females than males (p < 0.05). We conclude that quinine modulates glucoregulatory functions, associated with glucose lowering in healthy males and females. However, glucose lowering appears to be greater in females than males, without apparent differential effects on GI functions.

Dexamethasone solution and dexamethasone in Mucolox™ for the treatment of oral inflammatory ulcerative diseases: A phase II randomized clinical trial.

Mucolox™ is a mucosal drug delivery system that prolongs the contact time between the oral mucosa and topical corticosteroids, potentially reducing the need for multiple applications daily. This study aimed to assess the clinical efficacy and tolerability of dexamethasone 0.5 mg/5 mL solution in Mucolox™ for the management of oral inflammatory ulcerative diseases. Participants were randomly assigned to receive dexamethasone 0.5 mg/5 mL in Mucolox™ (Mucolox™ arm) or dexamethasone 0.5 mg/5 mL solution (standard arm) and instructed to swish/gargle for 5 min three times daily. Changes from pre- to posttreatment patient's sensitivity score (0-10 on a visual analog scale), reticulation/erythema/ulceration score, and oral health-related quality of life were evaluated at baseline and at the end of the study period. Twenty nine patients (75% females) with a median age of 58 years (range 18-79) were enrolled and randomly allocated to the Mucolox™ or standard arm. One subject was excluded. Although statistically significant in both arms, the pre- to posttreatment sensitivity score reduction was higher in the Mucolox™ arm (6.3 vs. 4.4-point reduction). Both arms showed a decrease in the reticulation/erythema/ulceration score between the two visits (7.2 vs. 4.7 [Mucolox™ arm]; 8.0 vs. 4.8 [standard arm]; p > 0.05). Mucolox™ in dexamethasone 0.5 mg/5 mL solution was better tolerated when taste and level of comfort were considered. Both treatments were effective in the management of oral inflammatory ulcerative diseases. Dexamethasone 0.5 mg/5 mL in Mucolox™ was better tolerated and was slightly better in controlling patients' oral sensitivity. Larger studies are needed to confirm these findings in oral inflammatory ulcerative diseases patients. ClinicalTrials.gov Identifier: NCT04540133.

Duodenal mucosal resurfacing with photodynamic therapy using methylene blue in a mouse model

BackgroundThe duodenum has emerged as a key player in metabolic diseases. The objective was to evaluate the safety and efficacy of intra-duodenal PDT using methylene blue in managing glycemic control and weight reduction. MethodsOptimal concentration of methylene blue and conditions for intra-duodenal PDT were determined through in vitro experiments. After injecting methylene blue into the duodenum, we performed intra-duodenal PDT. High-fat diet rats were used to assess the efficacy of intra-duodenal PDT through measures of oral glucose tolerance, insulin sensitivity, and weight change. Immunohistochemical staining was also conducted to examine GLP-1 and GIP-producing cells in the ileum and duodenum, respectively. ResultsIntroduodenal PDT reduced villous height of duodenum at 48 h, which was fully recovered at 30 days without complications. Rats treated with PDT showed significantly lower blood glucose levels with glucose loading and improved insulin sensitivity than rats in the sham-treatment group. The PDT group also had a significant reduction in body weight compared to the sham-treatment group at 30 days after intervention, although food intake was not significantly different between the two groups. Numbers of GLP-1 and GIP producing cells in the ileum and irradiated area were significantly higher in the PDT group than in the sham-treatment group. ConclusionsIntra-duodenal PDT using methylene blue showed a feasible therapeutic modality in improving metabolic parameters. However, large animal experiments and mechanism studies are needed to determine the clinical relevance. The possibility of repeating this treatment every 30 days and its accompanying complications should be further studied.

Factors explaining individual differences in the oral perception of capsaicin, l-menthol, and aluminum ammonium sulfate.

This research focused on the oral perception of naturally occurring chemical food compounds that are used in the pharma and food industries due to their pharmacological properties. They stimulate chemically sensitive receptors of the somatosensory system and are also chemesthetic compounds. Capsaicin is a naturally occurring alkaloid activating pungency perception. l-Menthol is a cyclic monoterpene working also as a medical cooling agent. Aluminum ammonium sulfate is used as a dehydrating agent and additive known to activate astringency in oral cavity. The objective of the study was to identify factors explaining individual differences in the perception of oral chemesthesis measured as sensitivity to chemesthetic compounds and their recognition. The subjects (N = 205) evaluated quality-specific prototypic compounds at five different concentration levels. Differences between gender were discovered in capsaicin sensitivity with men being less sensitive than women. Age was associated with the perception of capsaicin, l-menthol, aluminum ammonium sulfate, and the combined oral chemesthetic sensitivity. Quality-specific recognition ratings were also contributing to the sensitivity to chemesthetic compounds. A combined oral chemesthetic recognition score was created based on quality-specific recognition ratings. Increasing age generally indicated weaker recognition skills. Better recognizers had a higher combined oral chemesthetic sensitivity score than poorer recognizers. These results provide new information about chemesthesis. The results suggest that age and gender are important factors in explaining individual differences in sensitivity to capsaicin, l-menthol, and aluminum ammonium sulfate. In addition, recognition skills are associated with the sensitivity based on the quality-specific recognition scores.

Challenging Eating Behaviors in Young Children With Autism: An Investigation of the Role of Oral Sensitivity

Abstract Date Presented 04/22/2023 Children with autism have a high occurrence of challenging eating behaviors, which can lead to negative health consequences such as obesity and malnutrition. One of the underlying mechanisms implicated in these challenging eating behaviors is differences in oral sensory processing. Therefore, this study examined picky eaters with autism and compared child and parent mealtime behaviors between children with and without oral hypersensitivity. Primary Author and Speaker: Anna Wallisch Contributing Authors: Kelsey Thompson, Sallie Nowell, Jessica Meredith, Brian Boyd

1104-P: South Asian vs. White Adolescents Have Lower Insulin Sensitivity and Higher Insulin AUC

Background: T2D occurs at higher rates in South Asian (SA) adults, even at non-overweight/obese BMI. OGTT metrics were compared in SA vs White (W) adolescents to identify early contributors to increased T2D risk. Methods: Healthy SA and W adolescents, ages 12-21y, with BMI ≥80%ile (or ≥23kg/m2 if ≥18y) underwent 10-sample 180-min OGTT to determine incremental insulin AUC (iAUC), Oral Minimal Model insulin sensitivity (Si), and disposition index (DI: Si x insulin iAUC at 180min). Ancestry differences in OGTT outcomes were compared using linear regression adjusted for age, sex, and BMI. Results: For n=21, age [median (IQR) W: 20.1y (16.1, 21.3), SA: 21.0 (20.3, 21.6)], sex [W: 6F, SA: 4F], and BMI [W: 25.2kg/m2 (24.7, 31.4), SA: 24.6 (24.1, 27.9)] were not different for SA vs W. Fasting glucose [β=7.1, p=0.01; SA: 98.0mg/dL (92.0, 102.5), W: 89.0mg/dL (87.0, 93.5)], fasting insulin [β=7.0, p=0.005], insulin iAUC at 30min [β=1192, p=0.02], and log-transformed insulin iAUC at 180min [β=0.98, p=0.002] were higher, and log-transformed Si [β=-1.07, p=0.008] lower in SA than W. HbA1c, OGTT 1h and 2h glucose, and DI did not differ. Conclusions: Higher OGTT insulin in overweight SA adolescents contrast with reduced insulin found in SA adults and suggests reduced Si and insulin hyper-secretion are precursors to β-cell failure and T2D in SA adults. Understanding T2D mechanistic differences by ancestry may lead to improved T2D treatments. Disclosure T.A.Hitt: None. D.Stefanovski: None. S.Malina: None. C.X.D.Wang: None. B.S.Zemel: None. A.Kelly: None. S.N.Magge: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK115648); National Institutes of Health (UL1TR001878, UL1TR001079)

Improved Insulin Secretion Response and Beta-cell Function Correlated with Increased Prolactin Levels After Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients with Acanthosis Nigricans.

To explore insulin secretion patterns, β-cell function, and serum prolactin (PRL) concentrations in Chinese morbidly obese patients with Acanthosis nigricans (AN) and their alterations after laparoscopic sleeve gastrectomy (LSG). A total of 138 morbidly obese subjects undergoing LSG were categorized as simple obesity without AN (OB group, n = 55) and obesity with AN (AN group, n = 83). Oral glucose tolerance test (OGTT), PRL, and related metabolic indices were performed pre- and 12 months post-LSG. Insulin secretion patterns were derived from insulin secretion peak time during OGTT: type I (peak at 30 or 60 min) and type II (peak at 120 or 180 min). Preoperatively, AN group showed significantly higher proportions of type II insulin secretion pattern, fasting insulin (FINS), and homeostatic model assessment of insulin resistance (HOMA-IR) whereas lower oral glucose insulin sensitivity (OGIS), insulinogenic index (IGI), and disposition index (DI) than OB group, which were improved significantly at 12 months postoperatively in both groups, more pronounced in AN group. Intriguingly, serum PRL declined substantially in AN group than OB group at baseline whereas elevated only in the AN group post-LSG. After adjusting for confounding factors, elevated PRL correlated significantly with increased IGI and DI, and decreased HOMA-IR in both genders, as well as increased OGIS in females, which was detected only in the AN group CONCLUSION: Morbidly obese patients with AN presented delayed insulin secretion response, impaired insulin secretion, and β-cell dysfunction, which were significantly improved by LSG and might benefit from elevated PRL.

Probiotic Bacteria from Human Milk Can Alleviate Oral Bovine Casein Sensitization in Juvenile Wistar Rats.

This study aims to see if probiotic bacteria from human milk could ameliorate oral cow's milk sensitization. The probiotic potential of the SL42 strain isolated from the milk of a healthy young mother was first determined. Rats were then randomly gavaged with cow's milk casein without an adjuvant or assigned to the control group. Each group was further subdivided into three groups, with each receiving only Limosilactobacillus reuteri DSM 17938, SL42, or a phosphate-buffered saline solution. Body weight, temperature, eosinophils, serum milk casein-specific IgE (CAS-IgE), histamine, and serum S100A8/A9 and inflammatory cytokine concentrations were measured. The animals were sacrificed after 59 days; histological sections were prepared, and the spleen or thymus weights, as well as the diversity of the gut microbiota, were measured. On days 1 and 59, SL42 abridged systemic allergic responses to casein by dropping histamine levels (25.7%), CAS-specific IgE levels (53.6%), eosinophil numbers (17%), S100A8/9 (18.7%), and cytokine concentrations (25.4-48.5%). Analyses of histological sections of the jejunum confirmed the protective effect of probiotic bacteria in the CAS-challenged groups. Lactic acid bacteria and Clostridia species were also increased in all probiotic-treated groups. These findings suggest that probiotics derived from human milk could be used to alleviate cow's milk casein allergy.

Assessment of Patients' Experience and Perception Toward Dentinal Hypersensitivity for Its Diagnosis and Management: A Cross-Sectional Study.

Background Dentinal hypersensitivity (DH) is a common clinical finding that varies greatly in prevalence. An appropriate impulse that detonates noxious stimuli in the pulp/dentin boundary causes the typical DH pain, which is sudden, short, sharp, and of rapid onset. The objective of this research was to ascertain the incidence of DH in Keralites and evaluate some contributory factors, along with other initiating stimuli. Methodology Over three months, from June 2022 to August 2022, a cluster sampling technique was employed to conduct the study in 14 districts of Kerala. Patients from five clinics from each district who reported having DH and were aged 25 to 65 yearswere chosen at random. Using Google Survey forms, a 20-question, closed-ended survey was mailed to patients. The data were collected, evaluated, and analyzed using SPSS Version 23.0 (IBM Corp., Armonk, NY, USA). The statistical difference in the distribution of DH and the patient's age was determined using analysis of variance (ANOVA). A chi-square test was carried out to test the association between dentinal hypersensitivity, gender, and other parameters; P< 0.05 was considered to be statistically significant. Results Among the 2,520 persons to whom questionnaires were mailed, 2,321 responded, with an unresponsive rate of 7.89%. The study revealed a sensitivity predilection among females (54%), although statistically insignificant. Respondents aged 25 to 35 years (41.01%) were commonly reported to have DH, the age distribution of which was found to be highly significant statistically (P< 0.01). Teeth whitening resulted in 82.98% of the sensitivity, whereas 47.99% accepted poor oral hygiene as an additional contributory factor. DH was reported in 52.01% of the patients with gastritis and 63.03% of the patients with gingival recession. Further, blame for poor dental treatment (88.88%)and climate change (82.92%) were also found relevant. The quality of life was claimed to be afflicted in 90.99% of the patients. Desensitizing agents were used by 68.97% of the patients, with which68.03% reported satisfaction. Of the subjects who underwent professional treatment, 87.03% reported being satisfied. Oral prophylaxis-induced sensitivity was reported in 57.99%, indicating enhanced oral health awareness among Kerala residents. There was a statistically highly significant difference in the patient distribution based on the exposure to DH, and their perception of the causes and factors affecting DH (P< 0.01). Conclusions DH is afrequently and widely prevalent dental malady. Respondents demonstrated that they were conversant with DH. The quality of life and enjoyment of daily activities are both impacted by dentin hypersensitivity, and many patients are unaware that it is a treatable illness. Various desensitizing substances are also available and can be applied quickly to sensitive areas. Patients prefer this procedure as it is simpler to apply these agentsand the effects are pleasant and beneficial.

Single Airway Co-Exposure to Peanut and an Environmental Adjuvant Increases the Risk of Oral Peanut Sensitization

There is increasing evidence that environmental exposures to foods through the skin or respiratory tract cause allergic sensitization, whereas oral exposure results in tolerance. We previously reported that repeated airway co-exposures to peanut and environmental adjuvants could promote systemic allergic sensitization. Here we investigated if a single airway co-exposure to peanut with an environmental adjuvant was a risk factor for oral sensitization to peanut.

A specific tongue microbiota signature is found in patients displaying an improvement of orosensory lipid perception after a sleeve gastrectomy.

A preferential consumption of low-fat foods is reported by most of the patients after a vertical sleeve gastrectomy (VSG). The fact that a recent study shed light on a relationship between oral microbiota and fat taste sensitivity in obese patients prompted us to explore whether such a connection also exists in the context of a VSG. Thirty-two adult female patients with a severe obesity (BMI = 43.1 ± 0.7 kg/m2) and candidates for a VSG were selected. Oral microbiota composition surrounding the gustatory circumvallate papillae (CVP) and the lipid perception thresholds were explored before and 6 months after surgery. VSG was found to be associated both with a qualitative (compositional changes) and quantitative (lower gene richness) remodeling of the peri-CVP microbiota. Analysis of the lipid perception allowed us to distinguish two subgroups: patients with a post-operative improvement of the fat taste sensitivity (i.e., with a lower threshold, n = 14) and unimproved patients (n = 18). Specific peri-CVP microbiota signatures also discriminated these two subgroups, unimproved patient being characterized by higher levels of Porphyromonas, Fusobacterium, and Haemophilus genera associated with lower levels of Atopobium and Prevotella genera as compared to the lipid-improved patients. Collectively, these data raise the possibility that the microbial environment surrounding gustatory papillae might play a role in the positive changes of fat taste sensitivity observed in some patients after VSG.

Role of the immune response in age-related changes in oral mucosal Pain sensitivity

Role of the immune response in age-related changes in oral mucosal Pain sensitivity

Osteomatrix as a personalized 3D tissue-specific invasion test-bed for oral carcinoma.

The clinical challenge in the successful management of oral cancer malignancy remains in the inaccuracy of detecting regional invasion potential and inefficient treatment of recurrent tumors. The presence and extent of bone invasion by the oral tumor are of critical importance as they can influence the preoperative strategy altering the prognosis outcome. Here, we are examining the patient-specific osteotropism of oral carcinoma using a bone derived extracellular matrix. The extracellular matrix (ECM) was obtained from caprine bone by a combination of demineralization, delipidation and decellularization (D3) techniques. The bone D3-derived ECM (BdECM) tissue was characterized for analyzing the effective removal of cells, minerals, and lipids with an intact structure and chemical composition. The human adipose-derived stem cells (ADSCs) on the osteomatrix (BdECM derived hydrogel) exhibited excellent cell viability and early osteogenic differentiation capacity in vitro. Furthermore, the osteomatrix polarized monocytes towards an anti-inflammatory phenotype (M2 macrophage) indicating its low immunogenicity. In the second phase of this study, we isolated and established primary cancer cell cultures from patient-derived tissue exhibiting the cancer stem cell marker phenotype (EpCAM+/CD44high/CD24-). Moreover, the presence of side population (SP) cells confirmed a contributing factor for resistance to cancer therapy. The spheroid formed from primary cells embedded in the osteomatrix was used as a test-bed to monitor the invasion profile and screening of anti-cancer drugs. Our 3D test platform captured the inter-patient heterogeneity by displaying variation in the degree of invasion and response towards tested doses of anticancer drugs. Altogether, our data emphasize the necessity of a tissue-specific in vitro preclinical model for the evaluation of oral carcinogenesis and drug sensitivity.

Insulin-Like Growth Factor -1 (IGF-1) and Glucose Dysregulation in Young Adult Patients with β-Thalassemia Major: Causality or Potential Link?

Insulin-like growth factor-1 (IGF-1) has been shown to lower blood glucose through stimulating glucose transport to fat and muscle and inhibiting hepatic glucose output. Although previous cross-sectional reports reported an association between low circulating concentrations of IGF-1 and glucose dysregulation (GD), its role is still debated. The present retrospective study was designed to assess the circulating IGF-1 levels in β-thalassemia major (β -TM) patients with normal oral glucose tolerance test (NGT-OGTT) and (GD) referred for an endocrine evaluation to explore the potential link between low IGF-1 and GD. Our study included 34 young adult patients with β-TM; 12 patients with NGT after OGTT, 7 with impaired glucose tolerance (IGT), 9 with impaired fasting glucose (IFG) plus IGT, and 6 patients with β-TM-related diabetes mellitus (β-TM- DM). Twenty-two β-TM patients with GD or β-TM- DM and 1 patient with NGT had IGF-1 levels below the 2.5th percentile. Correlation of IGF-1 with fasting plasma glucose, HOMA-IR (homeostatic model assessment for insulin resistance) and OGIS (oral glucose insulin sensitivity) was found. Moreover, a negative correlation was documented between ALT and the Insulinogenic Index (IGI) and a positive correlation between serum ferritin and PG 2-h after OGTT. This study reports for the first time an association between low levels of IGF-1 and GD in β-TM patients. Despite some limitations, our study can serve to generate proposals for more convenient and efficient methods to identify and treat early GD in patients with β-TM, and to conduct more extensive studies. www.actabiomedica.it).

A new decontamination method for Bacillus subtilisin pasteurized milk: Thermosonication treatment

Thermosonication (TS) is a novel and viable technique employed to replace conventional thermal processing. TS treatment combined with pasteurization was used to kill the residual heat-resistant Bacillus in pasteurized milk and extend the shelf life of pasteurized milk and compared with High Temperture Shoort Time (HTST) pasteurization to study its decontamination effect on Bacillus subtilis and the quality of treated milk. The results showed that after 40 kHz, 240 W, 25 min ultrasonic treatment and 50 °C heating decontamination treatment, the number of B. subtilis in the medium and milk medium decreased by 4.17 log CFU/mL and 4.09 log CFU/mL respectively. The results of cell membrane permeability showed that the leakage of DNA and protein in the HTST-TS group increased by 52.3 % and 34 %, respectively, when compared to that in the HTST group. In addition, transmission electron microscopy (TEM) analysis showed that the bacterial cell membrane of the HTST-TS group swelled up, the cell wall was ruptured, and the cell content was accumulated in the cells. The results showed that HTST-TS treatment significantly inhibited the activities of ATPase (47 %), succinate dehydrogenase (SDH) (68.6 %), and malate dehydrogenase (MDH) (54.4 %). The physical and chemical sensory evaluation of milk treated with HTST-TS showed that HTST-TS treatment could improve the L* value (2.24 %), zeta potential (64.19 %), and colloidal particle size (14.49 %) of milk but had no significant effect on oral sensitivity. In conclusion, this study provides new insights, which may be helpful in implementing this new combined decontamination method in the dairy industry to improve the quality of pasteurized milk and extend the its shelf life.

Morbid obesity is associated with hypertrophic outward remodeling and increased stiffness of small conduit arteries: An ultra-high frequency ultrasound study

Background and aimsAlthough many studies have been published on the effect of obesity on large and small arteries, there are no data in the literature regarding the effect of obesity on medium-sized arteries, and in particular of small conduit arteries. The aim of the present study was to investigate whether patients with severe obesity presented structural or functional alterations in different arterial segments. Methods and results34 patients with severe obesity (BMI≥35 kg/m2) and 34 age-and sex-matched normal weight patients were recruited as controls. Aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid, radial and interdigital arteries were acquired for the assessment of wall-to-lumen ratio, wall cross-sectional area (WCSA), compliance, distensibility coefficient (DC) and Young's elastic modulus (Einc). Insulin sensitivity was calculated by oral glucose sensitivity index (OGIS). No differences between groups in carotid artery remodeling were found, while WCSA of the radial and interdigital arteries were higher in obese group than in controls. As regard the parameters of vascular elasticity, the DC of radial and interdigital arteries were lower (p = 0.025 and p = 0.001, respectively), as well as the Einc of radial arteries was higher (p = 0.021), in subject with obesity compared to controls. All these correlations were consistent after adjustment for the main covariates. Finally, in a multiple regression analysis OGIS was and independent determinant of interdigital artery DC (R2 = 0.29, p = 0.001). ConclusionsFor the first time, we describe an outward remodeling and increased stiffness in small conduit arteries in severe obesity.

PSUN299 GLP-1 Contribution to Insulin Secretory Response to Protein Ingestion and Insulin Kinetics Following Gastric Bypass and Sleeve Gastrectomy

Abstract Rapid passage of ingested nutrients to the gut after Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG) results in hyperinsulinemia after glucose ingestion, in part due to an enhanced glucagon-like peptide-1 (GLP-1)-induced insulin secretory response (ISR) and reduced metabolic clearance rate of insulin (MCRI). The effect of endogenous GLP-1 on insulin kinetics is unknown, and so is GLP-1 contribution to insulin secretory response to non-glucose nutrient ingestion. In non-surgical subjects, protein ingestion enhances insulin secretion and reduces MCRI. We hypothesized that protein ingestion enhances GLP-1-induced ISR and alters MCRI in proportion to changes in nutrient influx after GB and SG. To test this hypothesis ISR, β-cell sensitivity to glucose (BGS), MCRI, and oral glucose insulin sensitivity (OGIS) were measured on 3 days during 50 g glucose ingestion as well as 50 g protein ingestion with and without GLP-1R antagonist, exendin (9-39) [Ex-9] infusion. Ten GB-treated subjects, 9 SG-treated, and 7 non-operated controls (CN) were enrolled. The 3 non-diabetic groups were matched for age, BMI, fat-free mass, HbA1c; surgical groups were matched for weight loss and time post-surgery. Fasting glucose, insulin, and ISR were similar among the 3 groups and among the 3 studies but fasting MCRI was greater in surgical groups than CN (p&amp;lt;0.05). Compared to glucose, protein ingestion led to larger BGS in 3 groups despite smaller overall ISR response (AUCISR3h) (p&amp;lt;0.05). Blocking GLP-1R during protein ingestion decreased AUCISR3h only in surgical subjects (p&amp;lt;0.05 for interaction), whereas BGS was reduced similarly in 3 groups during Ex-9 infusion (p&amp;lt;0.05). OGIS was smaller during protein than glucose ingestion in 3 groups (p&amp;lt;0.05). GLP-1R blockade did not affect insulin sensitivity. Following nutrient ingestion in parallel with increase in insulin secretion MCRI was reduced to nadir values at 40 minutes, but then gradually increased approaching premeal values at different pace among surgical and non-surgical subjects (p&amp;lt;0.05). The slope of MCRI: Insulin (0-40 min) was smaller after protein ingestion than glucose, and after protein with Ex-9 infusion than without in 3 groups (p&amp;lt;0.05). Blocking GLP-1R had no effect on MCRI values in the latter phase of protein ingestion when insulin secretion reduced approaching premeal values. There was no association between parameters of insulin sensitivity and insulin clearance during glucose or protein ingestion. Our findings indicate that the regulation of insulin secretion and clearance during protein ingestion is altered after GB and SG. Further, endogenous GLP-1 contribution to insulin secretory response to protein ingestion after GB and SG is enhanced, but GLP-1 effect on insulin kinetics is trivial. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.