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Biomedical subjects

E Muls

Publications and source records attributed to E Muls.

At least 37 records · Page 2Linked to original sources
PubMed1997

The effectiveness of long-term fibre supplementation on weight maintenance in weight-reduced women.

OBJECTIVE: To investigate whether fibre supplementation is effective in weight-reduced subjects for maintenance of weight-loss in the long-term. DESIGN: Longitudinal, randomly assigned intervention study with supplementation of 20 g of water soluble fibre (guar gum) daily for 14 months after an energy-restricted period of two months (VLCD). SUBJECTS: Thirty-one female, obese subjects (age: 41.4 +/- 7.4 y: BMI 33.2 +/- 3.7 kg/m-2); 20 subjects were supplemented with fibre and 11 subjects served as the control group. MEASUREMENTS: Body weight (BW), blood lipids and blood pressure, anthropometry, and eating behaviour were measured before the VLCD (0), after VLCD (2), and at 4, 10, and 16 months. RESULTS: The fibre group with at least 80% compliance (group A) and the control group showed the same weight regain response after VLCD. The fibre consuming group with 50-80% compliance (group B) differed with respect to relapse. The rate and amount of BW regain was significantly higher for group B. After 14 months group B had returned to baseline levels, whereas group A and the control group showed a tendency to a lower BW than at baseline (P = 0.09). No effect of fibre supplementation was found on blood lipids, blood pressure and energy intake. Eating behaviour characteristics changed during the intervention and might explain differences in weight maintenance. CONCLUSIONS: No effect of 14 months fibre supplementation was found on weight maintenance in weight-reduced subjects. Guar gum intake did not result in reduction of blood pressure or cholesterol, or in suppression of energy intake.

Adult↗
PubMed1995

Is weight cycling detrimental to health? A review of the literature in humans.

Weight cycling has been hypothesized to have deleterious metabolic, behavioral and health consequences. The majority of clinical studies in humans do however not support the hypothesis that weight cycling per se influences the amount of velocity of subsequent weight loss. Both natural and experimental weight cycling studies have failed to demonstrate permanent alterations of body composition or body fat distribution. Studies found little evidence that weight cycling affects resting energy expenditure. Further research on postulated effects of weight cycling on other components of energy expenditure is needed. A history of weight cycling is not related to alterations in fat mobilization or in cardiovascular risk factors such as blood pressure and serum lipids, but weight variability may be associated with decreases in glucose tolerance over time. The potential impact of weight cycling on dietary preference for fat, on psychological adjustment or on disordered eating behavior, including binge eating, deserves further investigation. The data from large epidemiological databases suggesting a link between body weight fluctuation and excess mortality are sufficiently provocative to encourage further research into the association, but do not override the potential benefits of weight loss in obese patients.

Body Composition↗
PubMed1993

The effects of weight loss and apolipoprotein E polymorphism on serum lipids, apolipoproteins A-I and B, and lipoprotein(a).

Serum levels of lipoprotein(a) [Lp(a)], an independent risk factor for coronary heart disease, are strongly influenced by genetic factors. To evaluate the effect of weight loss on serum Lp(a), 54 normolipidemic obese women were examined before and after a two-month weight reduction programme. A mean weight loss of 10.1 kg was associated with decreases of serum triglycerides, total cholesterol (TC), LDL-C, HDL-C, apo B and apo A-I (P = 0.0001 for all variables), but not Lp(a). However, initial Lp(a) values were related to Lp(a) responses during dietary intervention (P = 0.0001). In subjects with pre-treatment Lp(a) values above 30 mg/dl, a mean 26.3% decrease was observed with weight loss, while no change was found in subjects with low Lp(a) values at baseline (P = 0.007 for group comparison). Apo E polymorphism contributes to the variation in lipid levels in the general population and in the obese. The relative contributions of the apo E locus to the total variance of TC, LDL-C and Lp(a) at baseline in these obese women were estimated to be 3.3, 1.7 and 3.2%, respectively, which are less than previously reported in healthy adults. Pre-treatment TC was increased in subjects with the apo E 3/4 phenotype compared to those with the common apo E 3/3 phenotype (P = 0.03). Apo E polymorphism did not affect Lp(a) levels at baseline nor the changes in lipoprotein variables, including Lp(a), during weight loss. In conclusion, short-term substantial weight loss in normolipidemic obese women resulted in a lowering of Lp(a) only in individuals with pre-treatment Lp(a) levels above 30 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis.

The effect of three doses of erythromycin on interdigestive gastrointestinal motility and on plasma motilin levels was studied in healthy volunteers and patients with diabetic gastroparesis. Abnormalities of interdigestive motility were observed in 40% of the patients. In healthy volunteers, 40 mg erythromycin elicited a premature phase 3 that started in the stomach. In contrast to the spontaneous gastric phase 3, this erythromycin-induced phase 3 was not accompanied by a motilin peak. In patients with diabetic gastroparesis, 40 mg erythromycin induced a premature phase 3 in three patients, no response in one patient, and a burst of antral contractions in another patient. Doses of 200 and 350 mg erythromycin elicited a burst of antral phase-3-like contractions in both volunteers and patients, which was not accompanied by a motilin peak. This phase-3-like activity did not migrate to the small intestine and was not followed by a phase 1, but by a prolonged period of antral contractile activity. The number and amplitude of antral contractions after 200 or 350 mg erythromycin were significantly higher than after 40 mg. The motor patterns induced by different doses of erythromycin offer potential therapeutic applications.

Adult↗
PubMed1992

Effect of motilin on gastric emptying in patients with diabetic gastroparesis.

Erythromycin markedly accelerates gastric emptying, possibly because it acts as a motilin agonist. In the present study, the effect of an equipotent dose of motilin was tested. In six patients with severe diabetic gastroparesis, gastric emptying of liquids and solids was examined scintigraphically after motilin or placebo in a double-blind crossover study. Motilin (10 pmol.kg-1.min-1) or saline was infused over a 90-minute period starting 5 minutes before breakfast. Motilin markedly accelerated emptying. For liquids, the half-emptying time was reduced from 51 +/- 6 to 22 +/- 11 minutes (P less than 0.01) and for solids from 111 +/- 4 to 51 +/- 12 minutes (P less than 0.01). The mean increase in plasma motilin levels was 1315 +/- 342 pg/mL, corresponding to an effective infusion rate of about 4 pmol.kg-1.min-1. In the control experiments, basal motilin levels (173 +/- 17 pg/mL) were within the normal range but increased steadily postprandially, reaching 321 +/- 25 pg/mL at the end of the study period, probably reflecting gastric distension. The postprandial increase in pancreatic polypeptide level was blunted compared with accepted normal values but was more pronounced during motilin infusion, i.e., 650 +/- 217 vs. 279 +/- 66 pg/mL (P less than 0.01), probably because of the improved emptying. Our data show that motilin accelerates gastric emptying in diabetic gastroparesis and support the hypothesis that erythromycin's effect is mediated through motilin receptors.

Diabetic Neuropathies↗
PubMed1990

Improvement of gastric emptying in diabetic gastroparesis by erythromycin. Preliminary studies.

Erythromycin mimics the effect of the gastrointestinal polypeptide motilin on gastrointestinal motility, probably by binding to motilin receptors and acting as a motilin agonist. Erythromycin may thus have clinical application in patients with disturbances of gastroduodenal motility, such as diabetic gastroparesis. To examine this possibility, we studied the effect of erythromycin on gastric emptying in 10 patients with insulin-dependent diabetes mellitus and gastroparesis. We studied the emptying of liquids and solids simultaneously on separate days after the intravenous administration of erythromycin (200 mg) or placebo, using a double-isotope technique and a double-blind, crossover design. Erythromycin shortened the prolonged gastric-emptying times for both liquids and solids to normal. For example, 120 minutes after the ingestion of a solid meal, mean (+/- SE) retention was 63 +/- 9 percent with placebo and 4 +/- 1 percent with erythromycin, as compared with 9 +/- 3 percent in 10 healthy subjects. The corresponding values 120 minutes after the ingestion of a liquid meal were 32 +/- 4, 9 +/- 3, and 4 +/- 1 percent, respectively. Gastric emptying also improved, but to a lesser degree, in the 10 patients after four weeks of treatment with oral erythromycin (250 mg three times a day). These preliminary results suggest that erythromycin may have therapeutic value in patients with severe diabetic gastroparesis.

Adult↗
PubMed1990

The efficacy and safety of pravastatin, compared to and in combination with bile acid binding resins, in familial hypercholesterolaemia.

Forty patients with familial hypercholesterolaemia (FH) were treated with 40 mg pravastatin once daily. Pravastatin decreased serum total and low density lipoprotein cholesterol (LDL) after 8 weeks of treatment by 28% and 33%, respectively, while high density lipoprotein cholesterol increased by 8% and triglycerides decreased by 14%. In 30 patients LDL cholesterol had not decreased below 5.0 mmol l-1 after 8 weeks of treatment, and in these patients resins were added to pravastatin, resulting in an additional decrease in total and LDL cholesterol of 8% and 12%, respectively. A control group of 22 FH patients was treated with placebo for 10 weeks, after which time resins were added, and they induced a decrease in total and LDL-cholesterol of 17% and 22%, respectively. Our results over a 24-week treatment period indicate that 40 mg pravastatin is more effective than 3 packets of resins in lowering LDL cholesterol, whereas the combination is most effective of all and can be used safely.

Anticholesteremic Agents↗
PubMed1985

Lipoprotein distribution and composition in the human nephrotic syndrome.

Plasma lipoprotein profiles were quantitated in 9 patients with the nephrotic syndrome. Six subjects were studied both during an active proteinuric phase and during a remission phase without proteinuria. During the proteinuric phase, the plasma triglyceride, cholesterol and apo B levels were markedly increased, whereas the HDL cholesterol, apo A-I, and apo A-II concentrations were normal. Analysis of the distribution and composition of the lipoprotein subclasses, separated by isopycnic ultracentrifugation, showed typical patterns characterized by: (1) elevated apo B-rich VLDL and LDL fractions, (2) the presence of a denser LDL subfraction, floating at d 1.053 g/ml, which contained about 35% of LDL cholesterol and apo B and (3) a redistribution among HDL subclasses. The HDL2b (d 1.063-1.100 g/ml) fraction was markedly decreased, while the HDL2a + 3a (d 1.100-1.150 g/ml) and HDL3b + 3c (d 1.150-1.210 g/ml) subclasses were moderately elevated. The decreased cholesterol and apo A-I contents of HDL2b therefore counterbalanced their increase in HDL2a + 3a and HDL3b + 3c, resulting in normal plasma HDL cholesterol and apo A-I concentrations. When reinvestigated during a remission phase without proteinuria, the nephrotic patient's overall lipoprotein distribution and composition were similar to those in healthy controls. The combination of several factors such as the presence of elevated apo B-rich VLDL, IDL and LDL, together with decreased HDL2 cholesterol and HDL2 apo A-I suggests that nephrotic patients are at increased risk for atherosclerosis.

Adolescent↗
PubMed1985

Changes in the distribution and composition of high-density lipoproteins in primary hypothyroidism.

The distribution and composition of high-density lipoprotein (HDL) subclasses were investigated in 14 women with severe hypothyroidism who were studied before and during treatment. The plasma concentrations of triglycerides, total cholesterol, HDL cholesterol, and of the apoproteins (apo) A-I, B, and E were increased in the hypothyroid state, while the apo A-II levels did not change significantly. After normalization of the thyroid function tests, the lipid and apoprotein levels were similar to those of normal individuals. Isopycnic ultracentrifugation in the density range 1.020 to 1.210 g/mL showed increases of both cholesterol and apo B in very-low-density lipoprotein (VLDL) and in low-density lipoprotein (LDL). The distribution of the HDL subclasses was modified in the hypothyroid subjects; both the less dense HDL fraction (d 1.063 to 1.100 g/mL; HDL2b), and the denser subclass (d 1.150 to 1.210 g/mL; HDL3b+3c) were increased, while the intermediate density subfraction (d 1.100 to 1.150 g/mL; HDL2a+3a) did not vary significantly. This redistribution of the HDL subfractions was associated with increased concentrations of cholesterol, phospholipid, and apo A-I in HDL2b, and of phospholipid and apo A-I in HDL3b+3c. Treatment of hypothyroidism decreased the concentrations of these fractions, and HDL2a+3a became the major HDL subclass in the euthyroid state. The particle sizes within HDL subfractions, measured by polyacrylamide gradient gel electrophoresis, were identical in the untreated and treated patients. The increased mass of protein and lipid within HDL2b and HDL3b+3c could therefore be attributed to an accumulation of identical-sized particles. The overall lipid and protein composition of the HDL lipoproteins was similar before and during treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Hyperthyroidism influences the distribution and apolipoprotein A composition of the high density lipoproteins in man.

Hyperthyroidism has a different influence on the major high density lipoprotein (HDL) components cholesterol, apoprotein (apo) A-I, and apo A-II. To characterize in greater detail the alterations induced by hyperthyroidism within the HDL subclasses, we investigated HDL distribution and composition in 11 hyperthyroid women before and during treatment. The plasma concentrations of total cholesterol, HDL cholesterol, phospholipids, apo A-I, and apo B were decreased when the patients were hyperthyroid compared with the values during treatment. Apo A-II and apo C-III levels were only slightly lower in the hyperthyroid state. Triglyceride and apo E concentrations did not change significantly during therapy. Analysis of lipoprotein subclasses separated by isopycnic ultracentrifugation revealed 1) marked decreases in low density lipoprotein (LDL) cholesterol, phospholipids, and apo B; 2) less pronounced reductions in the very low density lipoprotein (VLDL) lipid and apo B concentrations; and 3) a consistent decrease in the HDL2b (density, 1.063-1.100 g/ml) fraction in the hyperthyroid patients. The reduction in HDL2b mass was associated with lower concentrations of HDL2b cholesterol, phospholipids, and apo A-I. The HDL2b apo A-II levels remained constant during treatment. Hyperthyroidism, therefore, modified the apo A composition of the HDL2b particles and resulted in a decreased molar apo A-I to apo A-II ratio within HDL2b. Further analysis of HDL particles differing in their apo A composition; i.e. HDL particles containing apo A-I only [(A-I)HDL] or containing both apo A-I and A-II [(A-I + A-II)HDL], by immunological procedures suggested that hyperthyroidism influenced the apo A content of HDL2b mainly by changing the proportions of (A-I)HDL and (A-I + A-II)HDL and the amount of apo A-I associated with (A-I)HDL. Treatment reversed the preferential decrease in (A-I)HDL within the HDL2b subclass. The particle sizes within HDL subfractions, measured by polyacrylamide gradient gel electrophoresis, were similar in the untreated and treated patients. Consequently, the decreased mass of apo A-I and lipids within HDL2b in the hyperthyroid patients could be attributed to a reduced number of identically sized particles within this fraction. These data demonstrate that the thyroid hormones are important regulators of HDL metabolism through their influence on the concentration and distribution of apo A-I.

Adolescent↗
PubMed1984

Serum lipids and apolipoproteins A-I, A-II and B in primary hypothyroidism before and during treatment.

Serum lipids and apolipoproteins (apo) A-I, A-II, and B were measured in twenty-four patients with severe primary hypothyroidism (Thyrotropin above 40 mU/l), before and during 1-thyroxine treatment. Apo A-I, A-II, and B were assayed by immunonephelometry, using monospecific antisera. The serum levels of total cholesterol (TC), of low-density lipoprotein cholesterol (LDLc), and of the major LDL apoprotein, apo B, were markedly increased in the untreated hypothyroid patients compared to the values during therapy (TC: mean +/- SD, 8.87 +/- 2.9 v. 5.48 +/- 1.6 mmol/l; LDLc: 6.66 +/- 2.6 v. 3.78 +/- 1.4 mmol/l; apo B: 1.66 +/- 0.48 v. 1.14 +/- 0.37 g/l; P less than 0.00001 for all variables). High-density lipoprotein cholesterol (HDLc) was slightly higher before than during therapy (1.58 +/- 0.7 v. 1.31 +/- 0.4 mmol/l; P less than 0.05), while the main HDL apoprotein, apo A-I, was significantly elevated (1.49 +/- 0.42 v. 1.13 +/- 0.27 g/l; P less than 0.0002). The increase of the second major HDL apoprotein, apo A-II, was less pronounced (0.33 +/- 0.1 v. 0.30 +/- 0.08 g/l; P less than 0.022). The apo A-I to apo A-II ratio, which reflects the relative concentrations of the HDL subfractions HDL2 and HDL3, was significantly higher before than during treatment (P less than 0.0006). Serum triglyceride levels were moderately elevated in the untreated hypothyroid patients (1.34 +/- 0.6 v. 0.95 +/- 0.4 mmol/l; P less than 0.002). The small decrease in body weight during therapy did not correlate with the changes of the various lipid and apoprotein parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Etiology of hypercalcemia in a patient with Addison's disease.

A case is reported of a hypercalcemic patient with primary Addison's disease. A combination of increased calcium input into the extracellular space and reduced calcium removal by the kidney accounted for the hypercalcemia. The mechanisms responsible for the reduction in calcium removal were decreased glomerular filtration and increased tubular calcium reabsorption. Both renal factors were secondary to volume depletion and improved rapidly during rehydration with saline infusion. The enhanced calcium mobilization was probably of skeletal origin. It persisted irrespective of volume status until hydrocortisone treatment was instituted. Serum 1,25-dihydroxyvitamin D3 levels were below 10 pg/ml, even after normalization of the glomerular filtration rate, but returned slowly to the normal range during corticosteroid substitution. Serum 25-hydroxyvitamin D3 and parathyroid hormone levels were within the normal range. Our case report therefore demonstrates that physiological amounts of glucocorticoids reduce bone resorption, normalize serum calcium, and restore the production of 1,25-dihydroxyvitamin D3.

Addison Disease↗
PubMed1982

Serum lipids and apolipoproteins A-I, A-II, and B in hyperthyroidism before and after treatment.

The serum concentrations of total cholesterol (TC), triglycerides (RG), high density lipoprotein-cholesterol (HDLc), low density lipoprotein-cholesterol (LDLc), and the apolipoproteins (apo) A-I, A-II, and B were measured in 33 hyperthyroid patients before and after treatment. The results were compared with those of healthy controls. Apo A-I, A-II, and B were assayed by immunonephelometry. The serum levels of TC (mean +/- SD, 167 +/- 36 mg/dl, HDLc (40.8 +/- 12 mg/dl), and LDLc (108 +/- 35 mg/dl) were decreased in the untreated hyperthyroid patients compared to both the values after treatment (TC: 215 +/- 54 mg/dl; P less than 0.001; HDLc: 52 +/- 14 mg/dl; P less than 0.001; LDLc: 146 +/- 47 mg/dl; P less than 0.001) and the control values (TC: 206 + 39 mg/dl; P less than 0.001; HDLc: 47.4 +/- 10 mg/dl; P les than 0.01; LDLc: 145 +/- 38 mg/dl; P less than 0.001). TG levels were not statistically different before and after treatment. The apo A-I concentrations (116 +/- 24 mg/dl) were lower before than after treatment (131 +/- 28 mg/dl; P less than 0.01), but they were not statistically different from those in the control group (115 +/- 19 mg/dl). The apo A-II levels were identical in all groups (before treatment, 35 +/- 7 mg/dl; after treatment, 37 +/- 9 mg/dl; control group, 36 +/- 9 mg/dl). The apo B levels were lower in the untreated hyperthyroid patients (86 +/- 23 mg/dl) compared to those in controls (103 +/- 19 mg/dl; P less than 0.001) and patients after therapy (103 +/- 25 mg/dl; P less than 0.001). The increase in HDLc relative to the major HDL apo A-I and A-II during treatment for hyperthyroidism was associated with changes in body weight. The apo A-I to apo A-II and LDLc to apo B ratios, however, were significantly lower before compared to those after treatment, when the influence of increasing body weight during therapy was accounted for. This study emphasizes the important regulating role of thyroid hormones on lipid and apolipoprotein metabolism.

Apolipoprotein A-I↗
PubMed1980

Influence of thyroid function on the serum concentration of 1,25-dihydroxyvitamin D3.

The serum concentrations of parathyroid hormone, 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 were measured in patients with untreated thyroid disorders. The serum concentration of parathyroid hormone was decreased in hyperthyroidism [20 +/- 10 mU/liter, (mean +/- SD); n =23; P < 0.01] and increased in hypothyroidism (53 +/- 17 mU/liter; n = 12; P < 0.001) compared to that in normal subjects (26 +/- 9 mU/liter; n = 81). The concentration of 25-hydroxyvitamin D3 was not altered, but the concentration of 1,25-dihydroxyvitamin D3 was significantly lower in the serum of hyperthyroid patients (28 +/- 11 ng/liter) than in the serum of normal subjects (42 +/- 13 ng/liter). On the contrary, an increased concentration of 1,25-dihydroxyvitamin D3 was observed in the serum of hypothyroid patients (73 +/- 28 ng/liter; P < 0.001 vs. normal subjects). The abnormal serum concentrations of 1,25-dihydroxyvitamin D3 in thyroid disorders cannot be explained by differences in serum binding because the serum vitamin D-binding protein was unaltered in hyperthyroid subjects and only slightly increased (+17%) in hypothyroid subjects. These changes in the serum concentration of 1,25-dihydroxyvitamin D3 are compatible with previous data on altered intestinal calcium absorption in thyroid disorders.

Calcifediol↗
PubMed1976

Hormonal and biochemical changes in patients successfully operated for primary hyperparathyroidism.

Six patients with primary hyperparathyroidism were studied during the first seven days after the operative removal of the parathyroid adenoma with special emphasis on biochemical and hormonal changes during the first 24 h. Serum parathyroid hormone (PTH) levels fell abruptly after the parathyroidectomy and normalized within 3 h. The half-life of the biologically inert c-terminal PTH-fragment (M.W. 7000-7500) was calculated to be about 180 min. No significant changes in serum calcitonin levels were found. The serum phosphorus levels, which were already low pre-operatively, decreased transiently but significantly during the first 90 min after the removal of the parathyroid adenoma. This fall in serum phosphorus preceded a slow decrease of the calcaemia. During the first post-operative week the calcaemia continued to decline, while serum phosphorus levels increased. The pre-operative cholesterol levels were low compared to age-paired normal Belgians. During the first post-operative week the cholesterolaemia decreased even more, whereas at long term follow-up a clearcut increase of the serum cholesterol levels has to be expected.

Adult↗