Effect of protein restriction on sulfur amino acid catabolism in insulin-dependent diabetes mellitus (original) (raw)
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The Metabolic Response of Subjects with Type 2 Diabetes to a High-Protein, Weight-Maintenance Diet
The Journal of Clinical Endocrinology & Metabolism, 2003
In a randomized, crossover 5-wk study design, we recently reported that a weight-maintaining diet in which the percentage of total food energy as protein was increased from 15-30% resulted in a decrease in postprandial glucose and glycohemoglobin in people with untreated type 2 diabetes without a significant change in insulin. Protein was substituted for carbohydrate in the diet. The fat content remained unchanged. In this publication, we present data on other hormones and metabolites that were considered to potentially be affected by substitution of protein for carbohydrate in the diet.
Urinary sulphate excretion and progression of diabetic nephropathy in Type 1 diabetes
Diabetic Medicine, 2013
AimsHydrogen sulphide levels are reduced in many disease states, including diabetes and end‐stage renal disease. We aimed to determine whether urinary sulphate excretion, as a proxy for hydrogen sulphide, was associated with progression of diabetic nephropathy.MethodsWe conducted a post‐hoc study of a prospective, randomized, controlled trial on the effect of a low vs. normal protein diet for 4 years, on decline of renal function in patients with Type 1 diabetes and diabetic nephropathy. We excluded patients with less than three measurements of glomerular filtration rate assessed by 51Cr‐EDTA plasma clearance (GFR) and less than 1 year of follow‐up (n = 10), leaving 72 patients eligible for analyses. We studied both association of rate of decline in GFR and association of the combined endpoint of end‐stage renal disease and death with baseline 24‐h urinary sulphate excretion.ResultsSulphate excretion was significantly associated with the slope of GFR (rs = –0.28, P = 0.02). In a mul...
The Journal of nutrition, 2003
We showed previously that 64% of the total dietary sulfur amino acid (SAA) requirement could be supported by dietary cysteine (Cys). However, the observation of such a sparing effect may be affected by the dietary intakes of SAA provided. The aim of this study was to compare methionine (Met) metabolism and transsulfuration (TS) in five healthy men fed three different diets (in random order) for 3 d each, with varying combinations of Met and Cys: 24 mg Met/(kg. d) and no Cys (diet A); 13 mg Met/(kg. d) and 11 mg Cys/(kg. d) (diet B); and 5 mg Met/(kg. d) and 19 mg Cys/(kg. d) (diet C). On d 3, Met kinetics and TS were assessed using orally administered L-[1-(13)C, methyl-(2)H(3)]methionine. Met demethylation (transmethylation, TM) significantly decreased as the dietary Met to Cys ratio decreased. Met TS was significantly lower during diets B [2.8 +/- 0.4 micro mol/(kg. h)] and C [1.5 +/- 0.5 micro mol/(kg. h)] than during diet A [7.8 +/- 2.9 micro mol/(kg. h)] (P < 0.05). The resu...
Insulin resistance of amino acid and protein metabolism in type 2 diabetes
Clinical Nutrition, 2011
Although insulin resistance in T2DM (type 2 diabetes mellitus) is usually referred to glucose and lipid metabolism, the question whether such a resistance affects also amino acid and protein metabolism is both relevant and not easy to be answered. Available data indicate a reduced response to insulin in the inhibition of proteolysis at low, near basal hormone levels, whereas such a response appears to be normal at high physiological doses. In most studies in T2DM subjects the stimulation of whole-body protein synthesis in the presence of hyperinsulinemia and euaminoacidemia appears to be normal, although one single study reported lower rates in male T2DM subjects with obesity. The response to insulin of plasma protein synthesis (albumin and fibrinogen) is also normal. However, some metabolic steps of amino acids related to vascular complications (methionine and arginine) exhibit a defective response to insulin in T2DM subjects with nephropathy. In summary, although gross alterations in the response of whole-body protein turnover are not evident in T2DM, specific investigations reveal subtle abnormalities in metabolic steps of selected amino acids. Furthermore, the effects of interaction between diabetes (with the associated insulin resistance) and older age in the pathogenesis of sarcopenia in the elderly deserve more specific studies.
Amino Acid Plasma Concentrations and Urinary Excretion in Young Diabetics
InTech eBooks, 2018
The aim of this study is to analyze amino acid plasma profile in a group of young diabetics and to evaluate its application as markers of metabolic control of the disease, as well as to analyze the urinary excretion of amino acids in these patients. A clinical assessment and metabolic study (amino acid serum concentrations and urinary excretion of amino acids) was accomplished in a group of 49 children diagnosed with diabetes, and a group of 48 healthy children (control group). The plasma levels of total amino acids as well as branchedchain, glucogenic and ketogenic amino acids were significantly higher (p < 0.05) in the diabetic group with respect to the control group. Total as well as branched-chain, glucogenic and ketogenic amino acids urinary levels were significantly lower (p < 0.05) in the diabetic group compared to the control group. The study of the amino acid plasma in the young diabetic reflect disturbances in protein/amino acid metabolism and, consequently, in metabolic control of the disease. The study of amino acid urinary excretion might have interest not only in the context of diabetic nephropathy, but also in the revealing of partial aspects of amino acid metabolism and, probably, in the metabolic control of the disease.
Insulin Resistance of Protein Metabolism in Type 2 Diabetes and Impact on Dietary Needs: A Review
Canadian Journal of Diabetes, 2013
Mots clés: vieillissement protéine alimentaire résistance à l'insuline métabolisme des protéines diabète de type 2 a b s t r a c t Evidence shows that the metabolism of protein is altered in type 2 diabetes mellitus and insulin resistance not only applies to glucose and lipid but protein metabolism as well. Population surveys report greater susceptibility to loss of lean tissue and muscle strength with aging in diabetes. Prevention of sarcopenia requires that protein receives more attention in dietary prescriptions. Protein intake of 1e1.2 g/kg of body weight (with weight at a body mass index of 25 kg/m 2)/day may be distributed equally among 3 meals a day, including breakfast, to optimize anabolism. Adopting a dietary pattern that provides a high plant-to-animal ratio and greater food volume favouring consumption of vegetables, legumes, fruits, complemented with fish, low fat dairy and meat (preferably cooked slowly in moisture), soy and nuts may assist with metabolic and weight control. Depending on the magnitude of energy restriction, usual protein intake should be maintained or increased, and the caloric deficit taken from fat and carbohydrate foods. Exercise before protein-rich meals improves skeletal muscle protein anabolism. Because high levels of amino acids lower glucose uptake in individuals without diabetes, the challenge remains to define the optimal protein intake and exercise regimen to protect from losses of muscle mass and strength while maintaining adequate glucose control in type 2 diabetes. Ó 2013 Canadian Diabetes Association r é s u m é Les données scientifiques montrent que le métabolisme des protéines est altéré lors du diabète sucré de type 2 et que la résistance à l'insuline ne s'applique pas seulement au glucose et aux lipides, mais aussi au métabolisme des protéines. Les enquêtes en population rapportent une plus grande disposition à la perte de tissu maigre et de force musculaire lors du vieillissement chez les personnes souffrant de diabète. La prévention de la sarcopénie exige qu'une attention accrue soit portée sur les protéines lors des recommandations diététiques. Un apport protéique de 1-1,2 g/kg de poids corporel (selon un indice de masse corporelle de 25 kg/m 2)/jour pourrait être réparti également entre les 3 repas quotidiens, incluant le petit-déjeuner, pour optimiser l'anabolisme. L'adoption d'habitudes alimentaires fournissant un ratio élevé « allant du végétal à l'animal » et une plus grande quantité d'aliments favorisant la consommation de légumes, de légumineuses et de fruits, complétée par le poisson, les produits laitiers faibles en matière grasse et la viande (préférablement cuite lentement à la vapeur), le soya et les noix peuvent aider à la maîtrise du métabolisme et du poids. Selon l'importance de la restriction énergétique, l'apport protéique habituel devrait être maintenu ou augmenté, et la carence énergétique comblée par les aliments riches en matières grasses et en glucides. L'exercice avant des repas riches en protéines améliore l'anabolisme protéique du muscle squelettique. Puisque les concentrations élevées d'acides aminés abaissent le captage tissulaire de glucose chez les individus n'ayant pas le diabète, le défi est de définir l'apport protéique optimal et le programme d'exercices pour protéger de la perte de masse et de force musculaires tout en maintenant une maîtrise adéquate du glucose lors de diabète de type 2.
Determinants of whole-body protein metabolism in subjects with and without type 2 diabetes
Diabetes care
Whole-body protein metabolism is abnormal in suboptimally controlled type 2 diabetes and obesity. We hypothesized that glycemia, insulin resistance, and waist circumference modulate these alterations in type 2 diabetes and, to a lesser extent, in individuals without type 2 diabetes. In 88 lean and obese subjects without and 40 with type 2 diabetes on an inpatient protein-controlled isoenergetic diet for 7 days, whole-body protein turnover was measured using the fed-fasted 60-h oral (15)N-glycine method. Nitrogen flux was determined from urinary (15)N urea and protein synthesis, breakdown and net balance calculated. Indexes of diabetes control, resting energy expenditure (REE), and body composition were assessed. Higher protein turnover in obese subjects was further increased, and net balance was lower in type 2 diabetes. Waist-to-hip ratio and ln homeostasis model assessment of insulin resistance (HOMA-IR) explained 40% of the variance in flux in type 2 diabetes; fat-free mass and l...
Muscle protein breakdown in uncontrolled diabetes as assessed by urinary 3-methylhistidine excretion
Diabetologia, 1982
In an attempt to evaluate muscle protein catabolism in patients with uncontrolled diabetes, urinary excretion of 3-methylhistidine was measured in eight diabetic subjects, during poor control and after achievement of satisfactory control. The results were compared with the excretion values of ten healthy subjects fed a similar amount of meat. In the diabetic patients in poor metabolic control, 3-methylhistidine excretion was significantly increased compared with the healthy subjects, and returned to normal when a satisfactory glycaemic control was achieved. No significant differences were observed between ketonuric and non-ketonuric uncontrolled patients. Improved glycaemic control reduced 3-methythistidine excretion in both insulin-dependent and non-insulin-dependent diabetes. These results suggest increased protein catabolism causing muscle protein loss and negative nitrogen balance in diabetic patients with poorly controlled disease.
Sulfur amino acid metabolism in Zucker diabetic fatty rats
Biochemical pharmacology, 2015
The present study was aimed to investigate the metabolomics of sulfur amino acids in Zucker diabetic fatty (ZDF) rats, an obese type 2 diabetic animal model. Plasma levels of total cysteine, homocysteine and methionine, but not glutathione (GSH) were markedly decreased in ZDF rats. Hepatic methionine, homocysteine, cysteine, betaine, taurine, spermidine and spermine were also decreased. There are no significant difference in hepatic S-adenosylmethionine, S-adenosylhomocysteine, GSH, GSH disulfide, hypotaurine and putrescine between control and ZDF rats. Hepatic SAH hydrolase, betaine-homocysteine methyltransferase and methylene tetrahydrofolate reductase were up-regulated while activities of gamma-glutamylcysteine ligase and methionine synthase were decreased. The area under the curve (AUC) of methionine and methionine-d4 was not significantly different in control and ZDF rats treated with a mixture of methionine (60mg/kg) and methionine-d4 (20mg/kg). Moreover, the AUC of the increa...
Low protein diet in uremia: Effects on glucose metabolism and energy production rate
Kidney International, 1997
Low protein diet in uremia: Effects on glucose metabolism and energy production rate. Low-protein diets (LPD) increase insulin-mediated glucose disposal in chronic renal failure (CRF), but the fate of the better utilized glucose and the effect on energy production rate are unknown. Using a two-step (1 and 5 mU kg1 min ')euglycemic hyperinsulinemic clamp combined with indirect calorimetry, we studied the effects of a LPD (0.3 g kg1 day1, supplemented with essential amino acids and ketoanalogs) in six patients suffering from chronic renal failure. After three months of diet, no significant change was observed concerning glomerular filtration rate, body wt, or arterial pH. In the postabsorptive state, plasma glucose and insulin levels were significantly lower, and energy production rose from 15.72 0.48 to 17.16 0.67 Cal -kg min1 (P < 0.05). Insulin-stimulated glucose oxidation (2.36 0.29 vs.