Postprandial Triglyceride Is Associated with Fasting Triglyceride and HOMA-IR in Korean Subjects with Type 2 Diabetes

Hwang

et al. 2014

J of Diabetes Invest

Self Cite

Aims/IntroductionType 2 diabetes is characterized by progressive deterioration of β‐cell function. Recently, it was suggested that the C‐peptide‐to‐glucose ratio after oral glucose ingestion is a better predictor of β‐cell mass than that during fasting. We investigated whether postprandial C‐peptide‐to‐glucose ratio (PCGR) reflects β‐cell function, and its clinical application for management of type 2 diabetes.Materials and MethodsWe carried out a two‐step retrospective study of 919 Korean participants with type 2 diabetes. In the first step, we evaluated the correlation of PCGR level with various markers for β‐cell function in newly diagnosed and drug‐naïve patients after a mixed meal test. In the second step, participants with well‐controlled diabetes (glycated hemoglobin <7%) were divided into four groups according to treatment modality (group I: insulin, group II: sulfonylurea and/or dipeptityl peptidase IV inhibitor, group III: metformin and/or thiazolidinedione and group IV: diet and exercise group).ResultsIn the first step, PCGR was significantly correlated with various insulin secretory indices. Furthermore, PCGR showed better correlation with glycemic indices than homeostatic model assessment of β‐cell function (HOMA‐β). In the second step, the PCGR value significantly increased according to the following order: group I, II, III, and IV after adjusting for age, sex, body mass index and duration of diabetes. The cut‐off values of PCGR for separating each group were 1.457, 2.870 and 3.790, respectively (P < 0.001).ConclusionsWe suggest that PCGR might be a useful marker for β‐cell function and an ancillary parameter in the choice of antidiabetic medication in type 2 diabetes.

Section: Methodsmentioning

confidence: 99%

Postprandial C‐peptide to glucose ratio as a predictor of β‐cell function and its usefulness for staged management of type 2 diabetes

Hwang

et al. 2014

J of Diabetes Invest

Self Cite

J Diabetes Metab Disord

“…The most interesting finding we observed one month after the treatment was a significant increase in serum triglyceride levels in patients with successfully eradicated H.pylori who received standard triple therapy; while no similar adverse effect was observed in patients who were treated alternatively with BSP, or received BSP as complementary treatment of standard triple therapy. Serum triglycerides have been identified as major contributing factor and independent predictor of coronary heart disease in patients with type 2 diabetes, and lowering triglyceride levels has always considered a main clinical target in these patients [ 18 ]; it has been suggested that even a temporary and short-term increase in triglyceride levels could be accompanied by development of insulin resistance, endothelial damage and dysfunction, especially in patients with diabetes, via increased levels of intracellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin, as well as oxidative stress [ 19 - 21 ]. Another important risk factor outcome observed following the H.pylori eradication was clinically considerable, but not statistically significant, elevated triglyceride to HDL-C ratio in the STT group; TG/HDL-C ratio is a main atherogenic lipid parameter that is directly related to lipoprotein particle size and especially small LDL-dense particles in the plasma [ 22 , 23 ]; patients with type 2 diabetes with high TG/HDL-C ratio are potentially at a higher risk for increased arterial stiffness and atherosclerosis [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

A comparative study of broccoli sprouts powder and standard triple therapy on cardiovascular risk factors following H.pylori eradication: a randomized clinical trial in patients with type 2 diabetes

Mirmiran

Bahadoran

Golzarand

et al. 2014

BackgroundIn this clinical trial we compared the effects of broccoli sprouts powder, as an alternative and complementary treatment, to those of standard triple therapy, as a common medical treatment, on cardiovascular risk factors following the H.pylori eradication in patients with type 2 diabetes.MethodsEighty-six type 2 diabetic patients with positive H.pylori stool antigen test (HpSAg) were randomized to receive one of the three following regimens: STT) Standard triple therapy (omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1000 mg, twice a day for 14 days), BSP) 6 g/d broccoli sprouts powder for 28 days, and combination of these as STT + BSP. After 4 weeks of treatment, H.pylori eradication rates were assessed by HpSAg. Anthropometric measures, blood pressure, serum lipids and lipoproteins as well as serum high sensitive- C reactive protein were also assessed at baseline and at the second examination.ResultsSeventy-seven participants completed the study [STT (n = 28), BSP (n = 25), STT + BSP (n = 24)]. The H.pylori eradication rates were 89.3%, 56.0% and 91.7% in STT, BSP and STT + BSP groups, respectively. After the treatment, both systolic and diastolic blood pressure significantly decreased in STT + BSP group (P < 0.05). Serum triglycerides and TG/HDL-C ratio increased in STT patients group (<0.05). Serum hs-CRP levels significantly decreased in the patients who were treated with BSP per se (3.0 ± 2.5 at baseline vs. 2.3 ± 2.1 after the treatment, P < 0.05).ConclusionCompared to standard triple therapy, BSP regimen in addition to considerable effects on H.pylori eradication had also favorable properties on cardiovascular risk factors following the H.pylori eradication.

“…15 In fact, several studies have demonstrated that fed state blood glucose and triglycerides values are more strongly associated with all-cause CV morbidity and mortality. 16 The OMTT, besides allowing the study of postprandial metabolism, is a closer approach, than oral glucose tolerance tests, to the actual food ingestion as the nutritional supplement contains proteins, carbohydrate and fats, rather than pure glucose.…”

Section: Discussionmentioning

confidence: 99%

Acute effects of an oral supplement of (−)-epicatechin on postprandial fat and carbohydrate metabolism in normal and overweight subjects

et al. 2014

Postprandial hyperglycemia, in particular when accompanied by excessive hypertriglyceridemia, is associated with increased cardiovascular risk, mainly in overweight or obese subjects, as it favors oxidative stress, systemic inflammation and endothelial dysfunction. Thus, treatments that favorably modulate metabolism by reducing steep increases in postprandial serum glucose and triglycerides, are of considerable interest. Evidence suggests that (−)-epicatechin (EPI) is responsible for reductions in cardiometabolic risk associated with chocolate consumption these effects may be associated with favorable effects of EPI on postprandial metabolism. The aims of this study were to assess the effects of EPI on postprandial metabolism in normal-weight and overweight/obese subjects. Twenty adult volunteers (normal and overweight) underwent oral metabolic tolerance tests in the absence and presence of oral EPI (1 mg/kg). Metabolic responses were examined using indirect calorimetry and determining blood glucose and triglycerides at 0, 2 and 4 hours after metabolic load ingestion. Results show that EPI increased postprandial lipid catabolism, as evidenced by a significant decrease in the respiratory quotient, which implies an increase in fat oxidation. The effect was associated with significantly lower postprandial plasma glucose and triglycerides concentrations. The effects were more prominent in overweight subjects. In conclusion, EPI modulates postprandial metabolism by enhancing lipid oxidation accompanied by reductions in glycemia and triglyceridemia.