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P Ritz

Publications and source records attributed to P Ritz.

67 records · Page 4Linked to original sources

Measurements of 2H and 18O in body water: analytical considerations and physiological implications.

Measurement of energy expenditure with doubly-labelled water and of body composition and breast milk output with 2H or 18O requires accurate and precise techniques for measuring isotopic enrichments. The possibility of an inaccuracy in measurements of 2H and 18O isotopic enrichment arising from the matrix in biological fluids was investigated (1) by simulating a dilution experiment in both water and urine samples and (2) by reconstituting urine samples, ranging from 10 to 60 g/kg in solid concentration, from freeze-dried urinary solids mixed with either natural abundance or doubly-labelled water. Current techniques involved in measuring 2H and 18O isotopic enrichments were used (reduction of the samples to H2 gas with either Zn or U, and CO2/H2O equilibration or direct measurement of mass 20:18 ratios on water vapour for 18O analysis). All four methods accurately measured serial dilutions in both urine and water. Dilution space calculated from isotopic enrichments, compared with the water content of urine (determined by freeze-drying and accounting for exchangeable isotopes) was overestimated by about 2.4% by the Zn technique whereas other methods were accurate. The urinary solids content of a water solution was related to that inaccuracy. The use of the Zn technique with biological samples is likely to create biases in 2H distribution space. Examination of recent literature supports this view. Caution should therefore be used when physiological conclusions have to be made from the relative size of 2H and 18O distribution spaces.

Body Water↗

Revision of calculations in the doubly labeled water method for measurement of energy expenditure in humans.

In the doubly labeled water (DLW) method for the measurement of energy expenditure in humans, the basis of the calculation for CO2 production is the difference between the products of the rate constants for the disappearance of 18O and 2H from body water (KO, and KD, respectively) and the matching isotope dilution spaces (NO and ND, respectively). Thus, omitting corrections for isotope fractionation, CO2 production = 0.5 (KONO-KDND). In this calculation, it is also customary to normalize observed NO and ND values to a fixed value for ND/NO. The increasing use of the method has resulted in the generation of substantially more information on the normal value for ND/NO than existed at the time the method was first developed, and recent work has suggested that revisions of the originally used value of 1.03 may now be deemed appropriate. Values of 1.034 or 1.0427 have recently been suggested, but when applied in energy expenditure studies these estimates would lead to significantly different expenditure measurements. It can, however, be shown from published work and direct experimental study that ND/NO values are method dependent, and for these reasons the lower revised value of 1.034 appears to be more acceptable. The possibility that particular populations may ultimately be shown to be different from 1.034 should not, however, be dismissed entirely, and for this reason we suggest that information derived in individual experiments could be used in a Bayesian fashion to generate new ND/NO estimates. The appropriate techniques are described.

Body Water↗

Effects of colonic fermentation on respiratory gas exchanges following a glucose load in man.

Colonic fermentation produces short-chain fatty acids (SCFA). In humans, the amount of energy produced from the oxidation of these compounds is unknown and could modify the metabolic utilization of energetic fuels (eg, carbohydrates and lipids). If it were so, the equations used to evaluate the oxidation of nutrients from indirect calorimetry data should include the contribution of SCFA, which is not usually the case. Indeed, this fermentation process is usually considered as a minor and neglected energetic pathway. In this study, we have addressed the reliability of this assumption. Six normal subjects received orally either 50 g glucose or 50 g glucose plus 20 g lactulose. Their respiratory gas exchanges, breath hydrogen, methane, and 13CO2 concentrations, and plasma glucose, insulin, and free fatty acid (FFA) concentrations were monitored for 8 hours. CO2 production and breath hydrogen concentration were significantly greater with lactulose. No differences in oxygen consumption, breath 13CO2 production, or plasma concentrations of blood glucose, FFA, and insulin could be found between the two experiments. This suggests that the fermentation process induced by lactulose generates extra fuels going through an oxidation pathway. Therefore, the classic equations used to calculate carbohydrate and lipid oxidation and energy expenditure (EE) from indirect calorimetry data are probably not valid when fermentation is taking place. Indeed, in this experiment we could have overestimated glucose oxidation (12.5%) if the fermentation process were not considered. In conclusion, colonic fermentation in humans of nondigestible carbohydrates produces energetic substrates that could be used and oxidized as energetic fuels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Effects of a combination of bedtime intermediate-acting insulin and glibenclamide in type 2 (non-insulin-dependent) diabetic patients with secondary failure to respond to oral hypoglycaemic agents.

The effect of a subcutaneous injection of an intermediate-acting insulin at bedtime combined with glibenclamide has been evaluated in 16 non-insulin-diabetic patients with secondary failure to respond to oral agents. The patients showed poor metabolic control (HbA1 greater than 11%) after two months on diet and glibenclamide treatment (15 mg.day-1). For 3 months the glibenclamide was continued together with an injection of an intermediate-acting insulin at bedtime in order to maintain fasting blood glucose under 120 mg.dl-1. A significant reduction in fasting blood glucose and HbA1 (15.50 vs 10.35%) and fructosamine (2.03 vs 1.69 mmol.l-1) was observed (230 to 141 mg.dl-1) at a mean insulin dose of 0.28 U.kg-1. The peak blood glucose after a standard test meal was also significantly improved (290 vs 203 mg.dl-1). Two months after the bedtime insulin injection had been withdrawn, only one patient was still being treated with oral agents alone. Except for another patient who dropped out, all the others had to be treated again with insulin because their fasting blood glucose exceeded 180 mg.dl-1. It is concluded that a single subcutaneous injection of an intermediate-acting insulin at bedtime combined with glibenclamide improved fasting and post-meal blood glucose concentrations in non-insulin-dependent patients resistant to diet and oral hypoglycaemic treatment. Almost all of the patients relapsed after insulin was withdrawn.

Administration, Oral↗

Effect of nifedipine on glucose potentiation of the acute insulin response to arginine in non-insulin-dependent diabetics.

The effect of 7-days of nifedipine treatment on insulin secretion has been analyzed in hypertensive patients with non-insulin-dependent mellitus (NIDDM). Pancreatic beta-cell function was assessed as insulin release following stimulation with arginine after potentiation by hyperglycaemia. Two groups of 5 patients with NIDDM (fasting blood glucose 139.2 mg.dl-1), on the same controlled diet, were compared; one was treated with nifedipine 30 mg per d and the other was the control. The mean blood pressure in the nifedipine group decreased (110 vs 102 mm Hg). Fasting blood glucose and basal plasma insulin were not affected by nifedipine. The acute insulin response (AIR) to 5 g arginine after potentiation by hyperglycaemia (clamped at 240 and 350 mg/dl for 30 min) was significantly (P less than 0.05) decreased, as well as the potentiation slope (line relating AIR and plasma glucose level) in those patients, and were unchanged in the control group. Thus, nifedipine may impair insulin secretion at high glucose levels in patients with NiDDM.

Aged↗

Comparative continuous-indirect-calorimetry study of two carbohydrates with different glycemic indices.

Six healthy young men were studied by indirect calorimetry for 6 h after eating a meal composed of glucose or manioc starch (equivalent to 50 g dextrose). Blood was drawn every 30 min for 6 h to measure plasma glucose, free fatty acid (FFA), and insulin concentrations. The glycemic index of the starch was 57%. Plasma insulin and glucose concentrations were significantly higher from 150 to 210 min and FFA concentrations remained significantly lower from 210 to 360 min after starch than after glucose. Carbohydrate oxidation rose from a similar initial concentration for glucose and starch, to a constant concentration until 200 min before becoming significantly higher for the starch load until the end of the test. Total glucose oxidation was significantly higher with starch. Total fat oxidation did not differ after the two loads. A negative correlation was found between glucose oxidation and plasma FFA concentrations. Use of low-glycemic-index carbohydrates increases carbohydrate oxidation because of lower plasma FFA concentrations and fat oxidation.

Absorption↗

Plasma vitamin A and E in type 1 (insulin-dependent) and type 2 (non-insulin-dependent) adult diabetic patients.

Vitamin A and E status was studied in 35 type 1 (insulin-dependent) and 35 type 2 (non-insulin-dependent) diabetic patients and in 30 control subjects. Vitamin A blood concentration was significantly decreased in type 1 and increased in type 2 diabetic patients as compared to control subjects. No correlation was found between vitamin A blood concentration and blood glucose control as evaluated with HbA1c. Blood Vitamin E concentrations were significantly increased in both groups of diabetic patients and were statistically correlated with blood cholesterol, apoprotein B and triglycerides, but not with HbA1c.

Adolescent↗

[Vegetative neuropathy and pressure regulation in diabetics].

UNLABELLED: The present study was undertaken to evaluate the effects of autonomic cardiovascular neuropathy (ACN) on blood pressure control in diabetic patients. METHODS: a nyctohemeral blood pressure (BP) monitoring (Spacelabs 5200) and an assessment of ACN, graded with a scoring system depending on usual test (Valsalva maneuver, heart response to deep breathing, blood pressure response to standing up and sustained handgrip) were performed in 90 normotensive male subjects. Thirty controls, age: 49 +/- 13 years, weight: 72 +/- 12 kg, height: 174 +/- 6 cm and 60 diabetic patients, type 1 or 2, age: 52 +/- 13 years, weight: 75 +/- 12 kg, height: 174 +/- 6 cm were recruited. RESULTS: mean BP levels recorded on 24 hours (control: 117 +/- 13/75 +/- 9 mmHg, diabetic: 119 +/- 12/74 +/- 7 mmHg), BP variability measured with the coefficient of variation (SD/mean) (control: syst = 13 +/- 4, diast = 15 +/- 4; diabetic: syst = 12 +/- 3, diast = 14 +/- 4), differences between mean BP on day-time (9 a.m. - 8:30 p.m.) and mean BP on night-time (10:30 p.m. - 7:30 a.m.) (control: syst = 16 +/- 10 mmHg, diast = 11 +/- 8 mmHg; diabetic: syst = 13 +/- 10 mmHg, diast = 10 +/- 7 mmHg) are not statistically different. It is the same with heart rate. Two control and 11 diabetic subjects have impaired ACN tests. Among diabetic subjects, impairment of autonomic nervous cardiovascular system is correlated with abnormal BP pattern (loss of nocturnal fall, paradoxical nocturnal rise seen in 15 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Sipple's syndrome associated with a large prolactinoma.

A 26-year-old male presented with the symptoms and signs of acute congestive heart failure and hypertension. The left ventricle was shown to be thickened and displayed reversible hypokinesia. Further investigations revealed the underlying pathology of a phaeochromocytoma, bilateral medullary thyroid carcinoma (MTC), parathyroid adenoma and macro-prolactinoma. There was a family history of MTC. The echocardiographic features of catecholamine-induced cardiomyopathy were important in this diagnosis. Our research revealed no previous report of Sipple's syndrome associated with a macroprolactinoma. This case, along with the other 13 reports of mixed (type I and II) multiple endocrine neoplasia (MEN), are not within the classical subsets of MEN.

Adenoma↗

Antigenic relationships between plasma membrane ATPases of two different yeasts, Candida tropicalis and Schizosaccharomyces pombe.

Antibodies raised against purified plasma membrane ATPase from the yeast S. pombe inhibit the plasma membrane-bound ATPase of another yeast, C. tropicalis. The kinetic constants, Vm and Km, of the ATPases are both modified by the antibodies. These results show antigenic relationships between the plasma membrane ATPases belonging to the two yeast genera.

Adenosine Triphosphatases↗

Physical activity at 9-12 months and fatness at 2 years of age.

Previous research has shown that physical activity in early infancy does not predict later fatness, whereas in preschool children, such a relationship is found. The objective of this study was to investigate whether total energy expenditure (TEE) and behavior in late infancy are related to subcutaneous and total fatness in early childhood. Twenty-six infants were studied at 9-12 months and followed up at 2 years of age. Anthropometry, body composition, TEE, and behavior were measured in late infancy; skinfold thicknesses and total body fat were measured at 2 years of age. Infant TEE adjusted for fat-free mass was not related to later fatness. Infant behavior was related to later subcutaneous fatness, but not to total body fatness. Lower levels of infant activity were associated with greater skinfold thicknesses in childhood. Thus, by late infancy, physical activity level is related to subsequent skinfold thickness. Particular aspects of infant behavior appear to be more important than the sum of energy expended on activity. However, the relationship did not extend to total body fat.

Adipose Tissue↗