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Body composition changes induced by bilio pancreatic diversion
CBS appears to be as accurate as that resulting from the radio-sulphate dilution technique with the advantage of obviating the need for using
P.141 Oxidation and turnover rate of disodium eebecate in man
tiiSOtOpes.
R.M. Tacchino’,G. M&one,
E. Arcieri Matromattei, A.V. Greco, F. March’, E. Finotti, hf. C&Magneto’ lstituto di Clinica Medica and ‘Istituto di Clinka Chirurgica, Centro CM? per lo sfudio della fisiopatdogia delta shock, Univefsit~ Cattoiica S. &ore, Rome
This study has been supported by grant nr. go/O214 from the Fond0 de lnvestgaciones Sanitarias de la Seguridad Social.
P.199 Bodycompositionchanges inducedby bilk pancreatkdiwsion RobMa ht. Tacchino, Frartcesco Marina, Giuseppe Nanni, Geffrude Mingrone, Esmerahia Caprisio, Luciana Auger, Marco Castagneto L@artmenr of Surgery - Catholic University, Rome, ltaly Bcdy composition changes induced by bilio-pancreatic diversion (BPD) for obesity were studied sequentially in 30 subjects. BP0 achieves weight loss by a combined mechansim of temporary reduction of intake and a permanent selective fat and starch malabsorption. Body composition was evaluated by 24h creatinine excretion and electrical impedance. The results of the two methods were in good agreement (LBMlmp = 3.369 + 1.061 [LBM,d ? = 0.66). The patients had an increased lean body mass (LBM Kg) preoperatively but mostly an increase fat content. The two body components were strictly related as an increase in fat was followed by an increase in LBM (LBM = 13.6 t 27.01 [log FAT] ? = 0.76 p < 0.0001). The changes induced by the surgical procedure consisted of a marked decrease of fat both as absolute values and as relative composition. LBM decreased slightiy but remained above expected values for height. The contribution of LBM to weight loss was evaluated as dLBM/d Weight ratio that was demonstrated to depend only on initial body fat content. The decrease of LBM was that expected for decreased body weight. In conclusiun weight loss induced by BPD is achieved without protein wasting and the stable patient approaches normal body composition.
P.140 Change of body compoeitkn and energy expendiiure reMions in cancer bearing rate and in proteicmalnutrition D.L. W&zberg, T. Yamada, EL Goqalves, M.% Aur~ctzio, G.A. Bevhcqua, F.S. Goffi Dept. of Swgery, S80 Pa&, University Medical School, S. Pa&, &xi/
Fmd*kaW# 29,*
tg)
Bodv~msssrsr EtlEgyLvwdiire (Kcav14M Kc&24hUBCM
P.142 Correlation of fat weight calculated by biiectrkal impedancewith glucose and insulinresponseto oral glucose tolerance test 0. Raptis,E. Ganotakis, D. Platanisictis, A. Mitrakou, Sd. Raptis 2nd DqxtrtrrMof Infernal Medicine-Propaedeu~ic, Evangelismos Hospital Ufliversity ofAthens, A&ens, Greece.
Weight loss in cancer can be attributed to anorexia with decrease of body composition parameters and/or increased energy expendiiure. In order to understand the contributions of these variables 46 Wistar rats were randomly distributed in 4 groups: M (12) fed with an aproteic diet, T (11) bearing Walker 256carcinossarcoma, fed with regular chow, PF (11) pair fed with T group animals and C (12) as controls fed with regular chow. Food intake was measured daily. Indirect calorimetry was done sequentially each 4 days. Body composition studies were perfoned after 3 weeks of tumor growing. There was significant reduction of carcass weight in M, T and PF groups compared to C group (p < 0.05) but not between T and PF animals. There was reduction of body cell mass (BCM) in M, T animals compared to C group. Total body fat did not change in T and PF rats. Energy expenditure was reduced in M and T groups. The ratio between energy expenditure and bcdy cell mass didn’t change between T and C groups. In conclusion: Walker carcinossarcoma is an anoretical and h&metabolic tumor. Ths weight loss is due mainly to body cell mass reduction which apparently consumes the same energy than control rats. ormp
In order to better ascertain its possible use as an alternative fuel substrate in total parenteral nutrition, sebacate (Sb) metabolism was studied in 7 overnight tasting healthy male volunteers, who received iv. 209 of disodium sebacate over 6hrs. Sb turnover and oxidation were measured using an isotopic sebacate (disodic salt of (l-10) “‘C-sebacic acid) infusion (0.416 uCVmin over 4 hrs) during constant blood concentration of cold sebacate. Excreted radioactivity (uCiimin) was determined by bubbling the expired air into an apparatus containing 3mEq hyamine to trap COP from 20L-Douglas bag. Twenty-four hours nitrogen excretion with urine was obtained. COP production and O2 consumption were measured at 2,4 and 6 hrs after starting the infusion. Resting energy expenditure, RQ and the percent of calories derived from lipid oxidation were calculated by indirect calorimetry. Blood samples were collected during and after sebacate infusion at intervals of 20-30mins and Sb serum concentrations were analyzed by high performance liquid chromatography. The Sb serum level at the plateau phase was 917 ?I 143.6ug/ml. The Sb turnover rate was 15.02 ? 2.6umoVkg.min”; the Sb fractional removal rate was 0.69 + 0.21 min-‘; the Sb oxidation was 1.02 + 0.4 umoVkg.min-’ and thefraction of CO? derivedfrom sebacateoxidation was 14.9 + 4.3%.At the end of sebacate infusion RQ dropped to 0.639 f 0.043 and the calories derived from lipids increased to 40.00 + 16.30%. These data show that sebacate is well utilized by human tissues as an energy fuel substrate with atumover rate similarto that of l14C palmitateas reported in the literature.
C 1.9W.O.16 257.6Y316 33.9t10.2 143.if25.0
M 2.56to.66 ml+_14 17.4+&3 76.526.7
1 0.73+0.64 217.6f24.0 33.5t9.0 1097i12.0'
PF 0.75TO.M 2990+21.s 333t12.0 117.4+14.0
62.2?164 0.55io.13
52.1t7.7 0.71to.7
57.0t21.3 0.5410.24
74.2tll.O 0.66zo.14
73
The relative importance of absolute fat weight in predicting alterations in fasting and stimulated glucose and insulin response was investigated in 54 individuals, matched for body mass index and percent body fat, with fasting plasma glucose < 140mg/dl which entered our department for evaluation of glucose homeostasis. Two-hour glucose tolerance tests (759) were performed on the subjects. They were further divided into three groups. Group A: 14 subjects with normal response(N), Group 8: 20 subjects with impaired response (IGTj and 20 subjects with non insulin dependent diabetes (NIDDM). Bioelectrical impedance measurement with a BES-2002 Biological Ohm Meter provided estimates for fat-free body mass, absolute fat weight and total body weight. A mean value of 4 consequent measurements was entered for composition analysis. Test-retest correlation coefficient was 0.99 for a single impedance measurement. fat weight showed a statistically significant difference among the three groups (N: 16.37 & 1.6kg, IGT: 16.44 ?r 1.6, NIDDM: 21.59 i 1.1, pi 0.05) regardless the similar percent body fat. A correlation was established between fat weight and fasting insulin levels (r = 0.510, p < 0.01). fat weigM andglucose increaseexpressed as areaunder thecurveir = 0.480, p < 0.01) and fat weight and insulin increase (r = 0.420. p < 0.06). In conclusion, the estimation of fat weight by bicelectrical impedance establishes a predictive measure of glucose and insulin response to oral glucose tolerance ted.
P.141 Oxidation and turnover rate of disodium eebecate in man
tiiSOtOpes.
R.M. Tacchino’,G. M&one,
E. Arcieri Matromattei, A.V. Greco, F. March’, E. Finotti, hf. C&Magneto’ lstituto di Clinica Medica and ‘Istituto di Clinka Chirurgica, Centro CM? per lo sfudio della fisiopatdogia delta shock, Univefsit~ Cattoiica S. &ore, Rome
This study has been supported by grant nr. go/O214 from the Fond0 de lnvestgaciones Sanitarias de la Seguridad Social.
P.199 Bodycompositionchanges inducedby bilk pancreatkdiwsion RobMa ht. Tacchino, Frartcesco Marina, Giuseppe Nanni, Geffrude Mingrone, Esmerahia Caprisio, Luciana Auger, Marco Castagneto L@artmenr of Surgery - Catholic University, Rome, ltaly Bcdy composition changes induced by bilio-pancreatic diversion (BPD) for obesity were studied sequentially in 30 subjects. BP0 achieves weight loss by a combined mechansim of temporary reduction of intake and a permanent selective fat and starch malabsorption. Body composition was evaluated by 24h creatinine excretion and electrical impedance. The results of the two methods were in good agreement (LBMlmp = 3.369 + 1.061 [LBM,d ? = 0.66). The patients had an increased lean body mass (LBM Kg) preoperatively but mostly an increase fat content. The two body components were strictly related as an increase in fat was followed by an increase in LBM (LBM = 13.6 t 27.01 [log FAT] ? = 0.76 p < 0.0001). The changes induced by the surgical procedure consisted of a marked decrease of fat both as absolute values and as relative composition. LBM decreased slightiy but remained above expected values for height. The contribution of LBM to weight loss was evaluated as dLBM/d Weight ratio that was demonstrated to depend only on initial body fat content. The decrease of LBM was that expected for decreased body weight. In conclusiun weight loss induced by BPD is achieved without protein wasting and the stable patient approaches normal body composition.
P.140 Change of body compoeitkn and energy expendiiure reMions in cancer bearing rate and in proteicmalnutrition D.L. W&zberg, T. Yamada, EL Goqalves, M.% Aur~ctzio, G.A. Bevhcqua, F.S. Goffi Dept. of Swgery, S80 Pa&, University Medical School, S. Pa&, &xi/
Fmd*kaW# 29,*
tg)
Bodv~msssrsr EtlEgyLvwdiire (Kcav14M Kc&24hUBCM
P.142 Correlation of fat weight calculated by biiectrkal impedancewith glucose and insulinresponseto oral glucose tolerance test 0. Raptis,E. Ganotakis, D. Platanisictis, A. Mitrakou, Sd. Raptis 2nd DqxtrtrrMof Infernal Medicine-Propaedeu~ic, Evangelismos Hospital Ufliversity ofAthens, A&ens, Greece.
Weight loss in cancer can be attributed to anorexia with decrease of body composition parameters and/or increased energy expendiiure. In order to understand the contributions of these variables 46 Wistar rats were randomly distributed in 4 groups: M (12) fed with an aproteic diet, T (11) bearing Walker 256carcinossarcoma, fed with regular chow, PF (11) pair fed with T group animals and C (12) as controls fed with regular chow. Food intake was measured daily. Indirect calorimetry was done sequentially each 4 days. Body composition studies were perfoned after 3 weeks of tumor growing. There was significant reduction of carcass weight in M, T and PF groups compared to C group (p < 0.05) but not between T and PF animals. There was reduction of body cell mass (BCM) in M, T animals compared to C group. Total body fat did not change in T and PF rats. Energy expenditure was reduced in M and T groups. The ratio between energy expenditure and bcdy cell mass didn’t change between T and C groups. In conclusion: Walker carcinossarcoma is an anoretical and h&metabolic tumor. Ths weight loss is due mainly to body cell mass reduction which apparently consumes the same energy than control rats. ormp
In order to better ascertain its possible use as an alternative fuel substrate in total parenteral nutrition, sebacate (Sb) metabolism was studied in 7 overnight tasting healthy male volunteers, who received iv. 209 of disodium sebacate over 6hrs. Sb turnover and oxidation were measured using an isotopic sebacate (disodic salt of (l-10) “‘C-sebacic acid) infusion (0.416 uCVmin over 4 hrs) during constant blood concentration of cold sebacate. Excreted radioactivity (uCiimin) was determined by bubbling the expired air into an apparatus containing 3mEq hyamine to trap COP from 20L-Douglas bag. Twenty-four hours nitrogen excretion with urine was obtained. COP production and O2 consumption were measured at 2,4 and 6 hrs after starting the infusion. Resting energy expenditure, RQ and the percent of calories derived from lipid oxidation were calculated by indirect calorimetry. Blood samples were collected during and after sebacate infusion at intervals of 20-30mins and Sb serum concentrations were analyzed by high performance liquid chromatography. The Sb serum level at the plateau phase was 917 ?I 143.6ug/ml. The Sb turnover rate was 15.02 ? 2.6umoVkg.min”; the Sb fractional removal rate was 0.69 + 0.21 min-‘; the Sb oxidation was 1.02 + 0.4 umoVkg.min-’ and thefraction of CO? derivedfrom sebacateoxidation was 14.9 + 4.3%.At the end of sebacate infusion RQ dropped to 0.639 f 0.043 and the calories derived from lipids increased to 40.00 + 16.30%. These data show that sebacate is well utilized by human tissues as an energy fuel substrate with atumover rate similarto that of l14C palmitateas reported in the literature.
C 1.9W.O.16 257.6Y316 33.9t10.2 143.if25.0
M 2.56to.66 ml+_14 17.4+&3 76.526.7
1 0.73+0.64 217.6f24.0 33.5t9.0 1097i12.0'
PF 0.75TO.M 2990+21.s 333t12.0 117.4+14.0
62.2?164 0.55io.13
52.1t7.7 0.71to.7
57.0t21.3 0.5410.24
74.2tll.O 0.66zo.14
73
The relative importance of absolute fat weight in predicting alterations in fasting and stimulated glucose and insulin response was investigated in 54 individuals, matched for body mass index and percent body fat, with fasting plasma glucose < 140mg/dl which entered our department for evaluation of glucose homeostasis. Two-hour glucose tolerance tests (759) were performed on the subjects. They were further divided into three groups. Group A: 14 subjects with normal response(N), Group 8: 20 subjects with impaired response (IGTj and 20 subjects with non insulin dependent diabetes (NIDDM). Bioelectrical impedance measurement with a BES-2002 Biological Ohm Meter provided estimates for fat-free body mass, absolute fat weight and total body weight. A mean value of 4 consequent measurements was entered for composition analysis. Test-retest correlation coefficient was 0.99 for a single impedance measurement. fat weight showed a statistically significant difference among the three groups (N: 16.37 & 1.6kg, IGT: 16.44 ?r 1.6, NIDDM: 21.59 i 1.1, pi 0.05) regardless the similar percent body fat. A correlation was established between fat weight and fasting insulin levels (r = 0.510, p < 0.01). fat weigM andglucose increaseexpressed as areaunder thecurveir = 0.480, p < 0.01) and fat weight and insulin increase (r = 0.420. p < 0.06). In conclusion, the estimation of fat weight by bicelectrical impedance establishes a predictive measure of glucose and insulin response to oral glucose tolerance ted.