Biomedical subjects
K Niedermann
Publications and source records attributed to K Niedermann.
Loss of abdominal fat and improvement of the cardiovascular risk profile by regular moderate exercise training in patients with NIDDM.
Non-insulin-dependent diabetes mellitus (NIDDM) is associated with an increased cardiovascular risk. Glycaemic control alone is often insufficient to control diabetic dyslipidaemia and other cardiovascular risk factors associated with NIDDM. The present trial was designed to evaluate the effects of physical activity as an adjunct to standard diabetes therapy on the lipid profile, blood pressure, glycaemic control, weight and body fat. Sixteen well-controlled (HbA1c 7.5%) patients with NIDDM participated in a regular aerobic exercise training programme at 50-70% maximal effort over 3 months. Thirteen age- and sex-matched patients with NIDDM served as a control group. The 3-month intervention with an increase in physical activity from 92 (mean +/- SD) +/- 79 to 246 +/- 112 min per week (p < 0.001) by means of a structured activity programme resulted in significant improvement of plasma lipids with a 20% decrease in triglycerides (p < 0.05), unchanged total cholesterol and increases in high-density lipoprotein and high-density lipoprotein-3 subfraction of 23% (p < 0.001) and 26% (p < 0.001), respectively. Systolic and diastolic blood pressure decreased significantly from 138 +/- 16 to 130 +/- 17 mm Hg (p < 0.05) and 88 +/- 10 to 80 +/- 10 mmHg (p < 0.001), respectively. Resting heart rate decreased from 81 +/- 13 to 74 +/- 14 beats per minute (p < 0.001), waist-hip circumference ratio decreased from 0.96 +/- 0.11 to 0.92 +/- 0.10 (p < 0.001) and body fat decreased from 35.3 +/- 7.2 to 33.0 +/- 8.0% (p < 0.001). These effects occurred independently of changes in body weight and glycaemic control, which did not change during the study. This study shows that improvement in physical fitness by introducing regular physical exercise as part of the treatment programme in patients with NIDDM results in a significant amelioration of their cardiovascular risk profile.
Effect of dopamine on hepatosplanchnic blood flow.
Hepatosplanchnic blood flow (EHBF) was estimated with the single-injection method using indocyanine green in 10 patients without cardiac failure before and after 20 min of an intravenous infusion of dopamine. Five patients received 4 microgram/kg/min and another 5 patients 8 microgram/kg/min. The cardiac index (CI) was determined according to the Fick principle, and the arterio-hepatovenous oxygen difference (AV DO2 AO/HV) was measured. The mean increase in EHBF in the 10 patients was from 640 +/- 46 ml/min/m2 to 831 +/- 56 ml/min/m2 (p less than 0.001). The percentage of EHBF to CI increased from 24.1 +/- 2.0% to 26.4 +/- 1.6% (p less than 0.05). The mean AV DO2 AO/HV dropped from 49.6 +/- 3.8 ml/liter to 40.4+/- 2.9 ml/liter (p less than 0.005). We conclude that dopamine given at rates of 4 and 8 microgram/kg/min to patients whose hearts are well compensated increases hepatosplanchnic flow. Thus, the large increase in renal blood flow which occurs with dopamine is not at the expense of hepatosplanchnic blood flow.
[Liver circulation during dopamine therapy].
Intravenous dopamine (4 and 8 microgram/kg/min) causes an increase of hepatic flow and cardiac index, while the ratio hepatic flow:cardiac index remains unchanged. The increase of renal flow after dopamine therefore does not occur at the expense of hepatic flow.