Complementary measures for promoting insulin sensitivity in skeletal muscle

Non-alcoholic fatty pancreas disease: an updated review

Ectopic accumulation of fat can cause a variety of metabolic diseases, and the emerging non-alcoholic fatty pancreas disease (NAFPD) is increasingly being recognized by clinicians as a cause for concern. NAFPD is a disease caused by abnormal accumulation of adipose tissue in the pancreas, which is related to obesity. The main feature of NAFPD is death of acinar cells, which are then replaced by adipose cells. However, the underlying molecular mechanisms have not been fully explored. Obesity, aging, and metabolic syndrome are independent risk factors for the occurrence and development of NAFPD. Studies have shown that NAFPD leads to insulin resistance and pancreatic dysfunction, increases the risk of diabetes mellitus, worsens the severity of pancreatitis, and is significantly correlated with pancreatic cancer and postoperative pancreatic fistula. There is no standard treatment for NAFPD; exercise, a balanced diet, and lifestyle can help reduce pancreatic fat; however, other treatment modalities such as drugs and bariatric surgery are still being explored. The specific pathological mechanism of NAFPD remains unclear, and its potential association with various clinical diseases requires further study. This review summarizes the etiology, diagnosis, clinical consequences, and potential therapeutic strategies of NAFPD.

Non-alcoholic fatty pancreas disease - practices for clinicians

Obesity is a growing health burden worldwide, increasing the risk for several diseases featuring the metabolic syndrome - type 2 diabetes mellitus, dyslipidemia, non-alcoholic fatty liver disease and cardiovascular diseases. With the increasing epidemic of obesity, a new pathologic condition has emerged as a component of the metabolic syndrome - that of non-alcoholic fatty pancreas disease (NAFPD). Similar to non-alcoholic fatty liver disease (NAFLD), NAFPD comprises a wide spectrum of disease - from deposition of fat in the pancreas - fatty pancreas, to pancreatic inflammation and possibly pancreatic fibrosis. In contrast with NAFLD, diagnostic evaluation of NAFPD is less standardized, consisting mostly in imaging methods. Also the natural evolution of NAFPD and its association with pancreatic cancer is much less studied. Not least, the clinical consequences of NAFPD remain largely presumptions and knowledge about its metabolic impact is limited. This review will cover epidemiology, pathogenesis, diagnostic evaluation tools and treatment options for NAFPD, with focus on practices for clinicians.

The effects of omega-3 plus vitamin E and zinc plus vitamin C supplementation on cardiovascular risk markers in postmenopausal women with type 2 diabetes

BACKGROUND

We investigate the effects of omega-3 plus vitamin E and vitamin C plus zinc supplementations on cardiovascular risk markers in postmenopausal women with type 2 diabetes.

METHODS

In this double-blind placebo-controlled clinical trial, 75 postmenopausal women with type 2 diabetes were randomly assigned to one of three groups to take, daily, for 12 weeks: (1) 1.8 g omega-3 fatty acids plus 400 mg vitamin E; (2) 5 mg zinc plus 300 mg vitamin C; or (3) a placebo.

RESULTS

Although the cardiovascular risk markers variations decreased at the end of intervention, we did not find any significant differences in cardiovascular risk markers between therapeutic groups and the control group. Results of repeated measures analysis of variance (ANOVA) of markers showed that total cholesterol, low-density lipoprotein (LDL) cholesterol, Apo A1 and Apo B100 in two time periods were significant (p = 0.001). The level of total and LDL cholesterol decreased significantly (p = 0.05) in patients diagnosed with diabetes equal or less than 7 years in the group receiving omega-3 plus vitamin E. However, decreased LDL cholesterol (p = 0.003) and increased high-density lipoprotein (HDL) cholesterol (p = 0.03) were predominant in patients who had been diagnosed with diabetes equal or less than 7 years in the group receiving zinc plus vitamin C.

CONCLUSION

The effectiveness of nutraceutical supplementation was varied on biochemical biomarkers based on the kind of supplement or supplement pharmacogenomics, duration of diabetes affected and other pathophysiologic status in studied groups.

The Role of Consumption of Alpha-Linolenic, Eicosapentaenoic and Docosahexaenoic Acids in Human Metabolic Syndrome and Type 2 Diabetes- A Mini-Review

The human metabolic syndrome and its frequent sequela, type 2 diabetes are epidemic around the world. Alpha-linolenic acid (ALA, 18:3 n-3), eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid (DHA, 22:6 n-3) consumption ameliorates some of these epidemics' features thus leading one to question if consumption of EPA and DHA, and their metabolic precursor ALA reduce the conversion of metabolic syndrome to type 2 diabetes and reduce the major cause of death in the metabolic syndrome and type 2 diabetes-myocardial infarction. Contributing to myocardial infarction are metabolic syndrome's features of dyslipidemia (including elevated total cholesterol and LDL-c), oxidation, inflammation, hypertension, glucose intolerance, overweight and obesity. Inflammation, glucose and lipid levels are variously influenced by disturbances in various adipocytokines which are in turn positively impacted by n-3 polyunsaturated fatty acid consumption. Type 2 diabetes has all these features though elevated total cholesterol and LDL-c are rarer. It is concluded that EPA and DHA consumption significantly benefits metabolic syndrome and type 2 diabetes primarily in terms of dyslipidemia (particularly hypertriglyceridemia) and platelet aggregation with their impact on blood pressure, glucose control, inflammation and oxidation being less established. There is some evidence that EPA and/or DHA consumption, but no published evidence that ALA reduces conversion of metabolic syndrome to type 2 diabetes and reduces death rates due to metabolic syndrome and type 2 diabetes. ALA's only published significance appears to be platelet aggregation reduction in type 2 diabetes.

The effect of dietary fish oil supplementation on exercising horses

Ten horses of Thoroughbred or Standardbred breeding were used to study the effects of dietary fish oil supplementation on the metabolic response to a high-intensity incremental exercise test. Horses were assigned to either a fish oil (n = 6) or corn oil (n = 4) treatment. The fish oil (Omega Protein, Hammond, LA) contained 10.6% eicosapentaenoic acid and 8% docosahexaenoic acid. Each horse received timothy hay and a textured concentrate at a rate necessary to meet its energy needs. The supplemental oil was top-dressed on the concentrate daily at a rate of 324 mg/kg BW. Horses received their assigned diet for 63 d, during which time they were exercised 5 d/wk in a round pen or on a treadmill. During wk 1, horses exercised for 10 min at a trot. After wk 1, exercise time and intensity were increased so that at wk 5, exercise time in the round pen increased to 30 min (10 min of cantering and 20 min of trotting) per day. Starting at wk 6, horses were exercised 3 d/wk in the round pen for 30 min and 2 d/wk on a treadmill for 20 min. After 63 d, all horses performed an exercise test consisting of a 5-min warm-up at 1.9 m/s, 0% grade, followed by a step test on a 10% grade at incremental speeds of 2 to 8 m/s. Blood samples were taken throughout exercise. During exercise, horses receiving fish oil had a lower heart rate (treatment x time interaction; P < 0.05) and tended to have lower packed cell volume (treatment effect; P = 0.087). Plasma lactate concentrations were not affected by treatment. Plasma glucose concentrations were not different between groups during exercise but were lower (treatment x time interaction; P < 0.01) for the fish oil group during recovery. Serum insulin tended to be lower in fish oil horses throughout exercise (treatment effect; P = 0.064). There was a tendency for glucose:insulin ratios to be higher for fish oil-treated horses throughout exercise (treatment effect; P = 0.065). Plasma FFA were lower (treatment x time interaction; P < 0.01) in horses receiving fish oil than in horses receiving corn oil during the initial stages of the exercise test. Serum glycerol concentrations also were lower in fish oil-treated horses (P < 0.05). Serum cholesterol concentrations were lower in horses receiving fish oil (treatment effect; P < 0.05), but serum triglycerides were not affected by treatment (P = 0.55). These data suggest that addition of fish oil to the diet alters exercise metabolism in conditioned horses.