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Biomedical subjects

D Mott

Publications and source records attributed to D Mott.

12 recordsLinked to original sources

Impaired insulin-stimulated muscle glycogen synthase activation in vivo in man is related to low fasting glycogen synthase phosphatase activity.

Insulin-mediated glycogen synthase activity in skeletal muscle correlates with the rate of insulin-mediated glycogen deposition and is reduced in human subjects with insulin resistance. To assess the role of glycogen synthase phosphatase as a possible mediator of reduced glycogen synthase activity, we studied 30 Southwestern American Indians with a broad range of insulin action in vivo. Percutaneous biopsies of the vastus lateralis muscle were performed before and during a 440-min euglycemic clamp at plasma insulin concentrations of 89 +/- 5 and 1,470 +/- 49 microU/ml (mean +/- SEM); simultaneous glucose oxidation was determined by indirect calorimetry. After insulin stimulation, glycogen synthase activity was correlated with the total and nonoxidative glucose disposal at both low (r = 0.73, P less than 0.0001; r = 0.68, P less than 0.0001) and high (r = 0.75, P less than 0.0001; r = 0.74, P less than 0.0001) plasma insulin concentrations. Fasting muscle glycogen synthase phosphatase activity was correlated with both total and nonoxidative glucose disposal rates at the low (r = 0.48, P less than 0.005; r = 0.41, P less than 0.05) and high (r = 0.47, P less than 0.05; r = 0.43, P less than 0.05) plasma insulin concentrations. In addition, fasting glycogen synthase phosphatase activity was correlated with glycogen synthase activity after low- (r = 0.47, P less than 0.05) and high- (r = 0.50, P less than 0.01) dose insulin stimulations. These data suggest that the decreased insulin-stimulated glucose disposal and reduced glycogen synthase activation observed in insulin resistance could be secondary to a low fasting glycogen synthase phosphatase activity.

Adult

Dynamic low-dose three-dimensional computed tomography: a preliminary study.

Three-dimensional (3D) computed tomographic reformations have been used successfully as an adjunct to standard axial computed tomography (CT) in the evaluation of disorders affecting areas of complex anatomy. The basic requirements for high-quality 3D reformations are an absence of patient movement and narrow-width transaxial sections. Speed of examination is an important factor in optimizing image quality. One hundred examinations were performed on an IGE CT 9800 scanner. For bone studies, 80 mAs and, for certain soft tissues, 140 or 200 mAs were employed with 120 kVp. The advantages of such a "low-dose" technique are significant reduction in patient skin dose and a faster examination. The main disadvantage is a reduction in signal-to-noise ratio. The image quality obtained in 3D presentations has nevertheless been sufficient to enable all bony abnormalities to be identified. Three-dimensional examinations are now being performed routinely using a dynamic mode and this "low-dose" technique.

Female

Regulation of glycogen synthase and phosphorylase activities by glucose and insulin in human skeletal muscle.

We examined the insulin dose-response characteristics of human muscle glycogen synthase and phosphorylase activation. We also determined whether increasing the rate of glucose disposal by hyperglycemia at a fixed insulin concentration activates glycogen synthase. Physiological increments in plasma insulin but not glucose increased the fractional activity of glycogen synthase. The ED50: s for insulin stimulation of whole body and forearm glucose disposal were similar and unaffected by glycemia. Glycogen synthase activation was exponentially related to the insulin-mediated component of whole body and forearm glucose disposal at each glucose concentration. Neither insulin nor glucose changed glycogen phosphorylase activity. These results suggest that insulin but not the rate of glucose disposal per se regulates glycogen synthesis by a mechanism that involves dephosphorylation of glycogen synthase but not phosphorylase. This implies that the low glycogen synthase activities found in insulin-resistant states are a consequence of impaired insulin action rather than reduced glucose disposal.

Adult

Free fatty acid metabolism and obesity in man: in vivo in vitro comparisons.

We have examined the relationship of free fatty acid (FFA) turnover and lipid oxidation rates in vivo to the size of body triglyceride stores and compared these findings with the in vitro lipolytic rates of isolated abdominal fat cells. The studies were performed in 20 Pima Indian women 18 to 35 years of age, both lean and obese. FFA turnover rate was measured using a 1-14C-palmitate infusion, lipid oxidation rate by indirect calorimetry using a ventilated hood, body composition by underwater weighing with correction for residual lung volume, and fat cell lipolytic rates in vitro by published methods. Both FFA turnover and lipid oxidation rates, expressed per kg of body fat, decreased with increasing degree of obesity (as measured by percent body fat) (r = -0.90, and r = -0.75, P less than or equal to 0.0001, respectively). In contrast, the rate of lipolysis determined in vitro, expressed per kg of fat, increased with increasing degree of obesity (r = 0.58, P less than 0.01). A ratio of FFA turnover/lipolysis, which directly compares these in vivo and in vitro measurements, decreased significantly with increases in the degree of obesity (r = -0.81, P less than or equal to 0.0001). Furthermore, there were no positive correlations between the measures of in vivo FFA metabolism and in vitro lipolysis when both were expressed per fat mass, per fat cell number, or per fat cell surface area. The in vivo data also demonstrated that lipid oxidation could only account for 50% of the FFA disappearance rate. While lipid oxidation rate adjusted to the metabolic size increased with increasing plasma FFA concentration (r = 0.75, P less than 0.0003), the nonoxidative component of the FFA turnover failed to increase with increases in plasma FFA concentration (P = 0.5). We conclude that FFA is not available in vivo in proportion to the size of the triglyceride stores. The reason for this is not due to an inability of fat cells to release their stored triglyceride as assessed in vitro. Hence, in vitro measurements of fat cell lipolysis cannot be used to directly predict in vivo FFA metabolism. The large nonoxidative FFA disposal is likely to be important in the regulation of plasma FFA concentrations.

Adipose Tissue

Increased resting metabolic rates in obese subjects with non-insulin-dependent diabetes mellitus and the effect of sulfonylurea therapy.

Obese subjects with non-insulin-dependent diabetes mellitus (NIDDM) lose weight soon after diagnosis and tend to gain weight during hypoglycemic therapy. One explanation for these weight shifts is the change in caloric loss from glycosuria. We compared 24 obese Pima Indians with NIDDM to 24 Pima Indians with normal glucose tolerance to determine whether resting metabolic rate changes may be an additional factor influencing the weight shifts. The diabetic and nondiabetic subjects were equally obese, body fat 38 +/- 1% versus 37 +/- 1% (mean +/- SEM), respectively, as determined by densitometry. In the morning after an overnight fast, resting metabolic rate (RMR) was measured by indirect calorimetry. The mean RMR of the diabetic subjects, 32.9 +/- 0.5 kcal/day X kg fat-free mass (FFM), was 5% higher than that of the nondiabetic subjects, 31.4 +/- 0.5 kcal/day X kg FFM (P less than 0.05). In nine of the diabetic subjects, 6 wk of tolazamide therapy was associated with reductions in mean FPG, 253 +/- 16 to 144 +/- 14 mg/dl (P less than 0.01), mean daily urine glucose loss, 128 +/- 26 to 11 +/- 4 g (P less than 0.01), and mean RMR, 31.9 +/- 0.8 to 30.2 +/- 0.6 kcal/day X kg FFM (P less than 0.04). Weight of the subjects was maintained constant from beginning to end of therapy (106.5 +/- 9.6 versus 108.1 +/- 9.9 kg) by decreasing daily calorie intake from 3070 +/- 103 to 2784 +/- 163 kcal (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

The effects of short-term overfeeding on adipocyte metabolism in Pima Indians.

The effects on adipocyte metabolism of increasing daily caloric intake by approximately 60% for 14 days was studied in seven nondiabetic moderately obese southwestern Native American Indians. Mean body weight increased by 3.0 +/- 0.3 kg, without any change in average size of isolated abdominal adipocytes. Overfeeding resulted in a 58% increase (P less than 0.01) in mean fasting plasma insulin concentration, whereas fasting plasma glucose concentration remained constant. Basal and maximum (8 nmol/L) insulin-stimulated glucose transport rates by isolated adipocytes increased by 83% (P less than 0.02) and 110% (P less than 0.01), respectively, after overfeeding, associated with an increase of 118% (P less than 0.01) in the incremental response to maximal insulin stimulation. However, no differences in either the sensitivity (ED50 of insulin for the stimulation of glucose transport) or the responsiveness (percent stimulation by insulin) of glucose transport were seen in isolated adipocytes as a result of overfeeding. Maximum insulin-stimulated total glucose utilization rates by isolated adipocytes incubated at 5.5 mmol/L glucose were 63% greater after overfeeding, due to increases in lactate formation, triglyceride synthesis, and CO2 production. Mono125I-(Tyr A14)-insulin binding per cell and per cell surface area was similar before and after overfeeding. The lipolytic rate of isolated adipocytes, in the absence and presence of 25 nmol/L and 2 mumol/L isoproterenol, was decreased by 75% (P less than 0.02), 45% (P less than 0.05), and 27% (P less than 0.05), respectively, after overfeeding. However, overfeeding did not result in a significant difference in the sensitivity of antilipolysis to insulin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue

Evidence for reduced thermic effect of insulin and glucose infusions in Pima Indians.

Several authors have reported a reduced thermic effect of food in obese subjects. The hyperinsulinemic-euglycemic clamp technique has been used to measure one component of the thermic effect of food, insulin and insulin-mediated glucose disposal. We used this technique to measure the thermic responses to insulin and glucose infusions in 120 glucose-tolerant Pima Indians, a population with a high prevalence of obesity. During high-dose insulin infusions (400 mU/m2 per min) the measured increase in energy expenditure (MEE), 150 +/- 6 cal/min, was greater than the predicted increase in energy expenditure (PEE), 72 +/- 2 cal/min, for glucose storage as glycogen. During low-dose insulin infusions (40 mU/m2 per min) the mean MEE, 6 +/- 5 cal/min, was not significantly different from zero and was not greater than the mean PEE, 9 +/- 1 cal/min. These data were in contrast to results obtained from Caucasians by others and suggested a markedly reduced thermic effect of low-dose insulin and glucose infusions in Pima Indians. We also studied 23 glucose-tolerant male Caucasians and compared their results with the results from male Indians matched for glucose storage rates and obesity. The results showed that the thermic response to insulin and glucose infusions was similar in the two racial groups during high-dose insulin infusions but was markedly reduced in the Indians compared with the Caucasians during low-dose insulin infusions.

Adolescent

Impedance plethysmography: evaluation of a simplified system of electrodes for the measurement of blood flow in the lower limb.

Venous occlusion plethysmography was used to measure the flow of blood into the lower limbs of 30 normal volunteers. An impedance plethysmograph, using disposable point electrodes, was compared with a mercury in Silastic strain gauge plethysmograph in 20 subjects. The effect of changes in the configuration of the point electrodes was studied in 10 subjects. Impedance plethysmography was shown to be reproducible, and one particular configuration of point electrodes was shown to be superior to the others.

Blood Flow Velocity