Dewan Shivani - Academia.edu (original) (raw)

Papers by Dewan Shivani

Research paper thumbnail of P0595 CABERGOLINE AND CARDIAC VALVULOPATHY – A UNIT REVIEW

European Journal of Internal Medicine, 2009

Introduction: Growth hormone (GH) deficiency results in postprandial hyperlipidemia wich can be c... more Introduction: Growth hormone (GH) deficiency results in postprandial hyperlipidemia wich can be corrected by GH suppletion. It is unknown if GH activity affects postprandial lipemia in subjects with normal GH levels. Objectives: To evaluate the relationship between IGF1 concentrations and postprandial lipemia in subjects with normal GH production. Materials and methods: 158 subjects with a normal IGF1 levels (219,2±90,9 ng/mL; x±SD) measured their daytime capillary triglycerides (cTG) during three days in order to construct daytime TG profiles representing postprandial lipemia in a real life, physiological situation. The area under the curve (AUC) was used as total daytime triglyceridemia. Participants kept nutrition diaries, fasting venous plasma samples were obtained once and body composition was measured by body impedance. Results: The association between IGF1 and postprandial lipemia estimated as cTG-AUC after correction of fasting cTG was weak (Pearson's r=0,20; P=0,02). In contrast, fasting plasma GH levels were significantly associated to cTG-AUC (r=-0,42, P<0.001). The subjects in the highest IGF1 50-percentile had a mean±SD IGF1 of 290,2±80,7 ng/mL, were younger (30,8±12,4 yrs old) and showed the highest postprandial triglyceridemia corrected for fasting TG 16±5,10 mM.h) compared to those in the lower IGF1 percentile (44,7±12,8 yrs [P<0.001], 158,2±41,4 ng/mL [P<0.001] and 4,32±4,70 mM.h [P=0 ,02], respectively). There were no differences in insulin sensitivity between the groups by HOMA ratio, neither did fasting capillary TG differ between the groups. The major determinat of IGF1 was age (r=-0.68; P<0.001) followed by fasting plasma glucose (r=-0,43; P<0.001). Parameters related to insulin sensitivity, showed only weak correlations with postprandial lipemia, but body composition was closely associated to cTG-AUC with relative fat mass as an important determinant (r=0,41, P<0.001). Conclusion: GH activity on the long term does not affect postprandial lipemia in a real life situation in GH sufficient subjects. Body composition seems to be a major determinant of daytime TG profiles in subjects with normal GH production.

Research paper thumbnail of Effects of insulin-induced hypoglycaemia on energy intake and food choice at a subsequent test meal

Diabetes-metabolism Research and Reviews, 2004

Background and aimsHypoglycaemia is assumed to increase food intake, but there is little data on ... more Background and aimsHypoglycaemia is assumed to increase food intake, but there is little data on the magnitude or qualitative nature of this effect. We have therefore investigated the effects of insulin-induced hypoglycaemia on food intake at a test meal.Hypoglycaemia is assumed to increase food intake, but there is little data on the magnitude or qualitative nature of this effect. We have therefore investigated the effects of insulin-induced hypoglycaemia on food intake at a test meal.MethodsSixteen healthy men (age 29.8 ± 11 years; mean ± SD) were studied; either insulin (0.05 units/kg) or saline was given intravenously in a double-blind crossover design. Blood glucose was monitored at regular intervals. Participants were given an ad libitum breakfast 20 min after injections and food intake and appetite scores were recorded.Sixteen healthy men (age 29.8 ± 11 years; mean ± SD) were studied; either insulin (0.05 units/kg) or saline was given intravenously in a double-blind crossover design. Blood glucose was monitored at regular intervals. Participants were given an ad libitum breakfast 20 min after injections and food intake and appetite scores were recorded.ResultsBlood glucose was unchanged following saline (4.3 ± 0.4 to 4.4 ± 0.3 mmol/L). There was a transient decline in blood glucose after insulin with a nadir at 20 min (4.31 ± 0.34 to 2.41 ± 0.45 mmol/L, p < 0.0001), which returned to baseline at 40 min. Total energy intake was 17% higher (1701.1 ± 895.3 kcal vs 1427.7 ± 815 kcal, p = 0.026) following insulin administration compared to that following saline. Macronutrient analysis revealed a significant increase in high-fat foods (muffins) (69.2 ± 54.1 vs 29 ± 42.3 g, p = 0.009) after insulin. Appetite scores were similar after saline and insulin despite these changes in food intake.Blood glucose was unchanged following saline (4.3 ± 0.4 to 4.4 ± 0.3 mmol/L). There was a transient decline in blood glucose after insulin with a nadir at 20 min (4.31 ± 0.34 to 2.41 ± 0.45 mmol/L, p < 0.0001), which returned to baseline at 40 min. Total energy intake was 17% higher (1701.1 ± 895.3 kcal vs 1427.7 ± 815 kcal, p = 0.026) following insulin administration compared to that following saline. Macronutrient analysis revealed a significant increase in high-fat foods (muffins) (69.2 ± 54.1 vs 29 ± 42.3 g, p = 0.009) after insulin. Appetite scores were similar after saline and insulin despite these changes in food intake.ConclusionsTransient insulin-induced hypoglycaemia increases energy intake. Participants consumed more fat after insulin compared to that after saline. High-fat foods can lead to passive overconsumption and have a low glycaemic index, which may prolong hypoglycaemia. Both factors could ultimately promote weight gain in individuals with recurrent hypoglycaemia. Copyright © 2004 John Wiley & Sons, Ltd.Transient insulin-induced hypoglycaemia increases energy intake. Participants consumed more fat after insulin compared to that after saline. High-fat foods can lead to passive overconsumption and have a low glycaemic index, which may prolong hypoglycaemia. Both factors could ultimately promote weight gain in individuals with recurrent hypoglycaemia. Copyright © 2004 John Wiley & Sons, Ltd.

Research paper thumbnail of P0595 CABERGOLINE AND CARDIAC VALVULOPATHY – A UNIT REVIEW

European Journal of Internal Medicine, 2009

Introduction: Growth hormone (GH) deficiency results in postprandial hyperlipidemia wich can be c... more Introduction: Growth hormone (GH) deficiency results in postprandial hyperlipidemia wich can be corrected by GH suppletion. It is unknown if GH activity affects postprandial lipemia in subjects with normal GH levels. Objectives: To evaluate the relationship between IGF1 concentrations and postprandial lipemia in subjects with normal GH production. Materials and methods: 158 subjects with a normal IGF1 levels (219,2±90,9 ng/mL; x±SD) measured their daytime capillary triglycerides (cTG) during three days in order to construct daytime TG profiles representing postprandial lipemia in a real life, physiological situation. The area under the curve (AUC) was used as total daytime triglyceridemia. Participants kept nutrition diaries, fasting venous plasma samples were obtained once and body composition was measured by body impedance. Results: The association between IGF1 and postprandial lipemia estimated as cTG-AUC after correction of fasting cTG was weak (Pearson's r=0,20; P=0,02). In contrast, fasting plasma GH levels were significantly associated to cTG-AUC (r=-0,42, P<0.001). The subjects in the highest IGF1 50-percentile had a mean±SD IGF1 of 290,2±80,7 ng/mL, were younger (30,8±12,4 yrs old) and showed the highest postprandial triglyceridemia corrected for fasting TG 16±5,10 mM.h) compared to those in the lower IGF1 percentile (44,7±12,8 yrs [P<0.001], 158,2±41,4 ng/mL [P<0.001] and 4,32±4,70 mM.h [P=0 ,02], respectively). There were no differences in insulin sensitivity between the groups by HOMA ratio, neither did fasting capillary TG differ between the groups. The major determinat of IGF1 was age (r=-0.68; P<0.001) followed by fasting plasma glucose (r=-0,43; P<0.001). Parameters related to insulin sensitivity, showed only weak correlations with postprandial lipemia, but body composition was closely associated to cTG-AUC with relative fat mass as an important determinant (r=0,41, P<0.001). Conclusion: GH activity on the long term does not affect postprandial lipemia in a real life situation in GH sufficient subjects. Body composition seems to be a major determinant of daytime TG profiles in subjects with normal GH production.

Research paper thumbnail of Effects of insulin-induced hypoglycaemia on energy intake and food choice at a subsequent test meal

Diabetes-metabolism Research and Reviews, 2004

Background and aimsHypoglycaemia is assumed to increase food intake, but there is little data on ... more Background and aimsHypoglycaemia is assumed to increase food intake, but there is little data on the magnitude or qualitative nature of this effect. We have therefore investigated the effects of insulin-induced hypoglycaemia on food intake at a test meal.Hypoglycaemia is assumed to increase food intake, but there is little data on the magnitude or qualitative nature of this effect. We have therefore investigated the effects of insulin-induced hypoglycaemia on food intake at a test meal.MethodsSixteen healthy men (age 29.8 ± 11 years; mean ± SD) were studied; either insulin (0.05 units/kg) or saline was given intravenously in a double-blind crossover design. Blood glucose was monitored at regular intervals. Participants were given an ad libitum breakfast 20 min after injections and food intake and appetite scores were recorded.Sixteen healthy men (age 29.8 ± 11 years; mean ± SD) were studied; either insulin (0.05 units/kg) or saline was given intravenously in a double-blind crossover design. Blood glucose was monitored at regular intervals. Participants were given an ad libitum breakfast 20 min after injections and food intake and appetite scores were recorded.ResultsBlood glucose was unchanged following saline (4.3 ± 0.4 to 4.4 ± 0.3 mmol/L). There was a transient decline in blood glucose after insulin with a nadir at 20 min (4.31 ± 0.34 to 2.41 ± 0.45 mmol/L, p < 0.0001), which returned to baseline at 40 min. Total energy intake was 17% higher (1701.1 ± 895.3 kcal vs 1427.7 ± 815 kcal, p = 0.026) following insulin administration compared to that following saline. Macronutrient analysis revealed a significant increase in high-fat foods (muffins) (69.2 ± 54.1 vs 29 ± 42.3 g, p = 0.009) after insulin. Appetite scores were similar after saline and insulin despite these changes in food intake.Blood glucose was unchanged following saline (4.3 ± 0.4 to 4.4 ± 0.3 mmol/L). There was a transient decline in blood glucose after insulin with a nadir at 20 min (4.31 ± 0.34 to 2.41 ± 0.45 mmol/L, p < 0.0001), which returned to baseline at 40 min. Total energy intake was 17% higher (1701.1 ± 895.3 kcal vs 1427.7 ± 815 kcal, p = 0.026) following insulin administration compared to that following saline. Macronutrient analysis revealed a significant increase in high-fat foods (muffins) (69.2 ± 54.1 vs 29 ± 42.3 g, p = 0.009) after insulin. Appetite scores were similar after saline and insulin despite these changes in food intake.ConclusionsTransient insulin-induced hypoglycaemia increases energy intake. Participants consumed more fat after insulin compared to that after saline. High-fat foods can lead to passive overconsumption and have a low glycaemic index, which may prolong hypoglycaemia. Both factors could ultimately promote weight gain in individuals with recurrent hypoglycaemia. Copyright © 2004 John Wiley & Sons, Ltd.Transient insulin-induced hypoglycaemia increases energy intake. Participants consumed more fat after insulin compared to that after saline. High-fat foods can lead to passive overconsumption and have a low glycaemic index, which may prolong hypoglycaemia. Both factors could ultimately promote weight gain in individuals with recurrent hypoglycaemia. Copyright © 2004 John Wiley & Sons, Ltd.