OBJECTIVETo investigate the electrogastrogram (EGG) characteristics of healthy neonates.

METHODSTwenty healthy neonates born at 37-39 weeks of gestation (11 males and 9 females, Apagar's score 9.3 +/- 0.4) were enrolled in this study. EGG recordings were performed for half an hour pre- and postprandially at an interval of a week from birth until age 4 weeks. The EEG variables measured included the percentage of normal gastric rhythm, the percentage of tachygastria and bradygastria, the fed-to-fasting ratio of the EEG dominant power, as well as the EEG dominant frequency and its instability coefficient. The paired sample t test (95% CI) was used to compare the recordings.

RESULTSBetween birth and age 28 days, the percentage of normal gastric rhythm ranged from 38.2 +/- 4.9% to 39.7 +/- 3.5% of recorded time, tachygastria was observed in the range of 23.7 +/- 5.4% to 23.5 +/- 4.3% of recorded time, and bradygastria was shown to be in the range of 38.1 +/- 5.5% to 36.8 +/- 3.9% of recorded time in the 20 neonates before meal. Statistically significant differences were not seen in neonates with different ages as well as during pre- and postprandial periods. The EEG dominant frequency of neonates before meal was 2.38 +/- 0.5, 2.43 +/- 0.2, 2.54 +/- 0.3, 2.57 +/- 0.2 and 2.59 +/- 0.1 cpm at birth and at postnatal age of 7, 14, 21 and 28 days respectively. There were no significant differences in the dominant frequency and the coefficient of instability of the dominant frequency during pre- and postprandial periods. The EEG dominant frequency at postnatal age of 14, 21 and 28 days during pre- and postprandial periods was significantly higher than that at birth and at postnatal age of 7 days (P < 0.05). The coefficient of instability of the dominant frequency at postnatal age of 21 and 28 days was significantly lower than that at birth and at postnatal age of 7 and 14 days (P < 0.05). There were no statistically significant differences in the fed-to-fasting ratio of EGG dominant power in neonates with different ages.

CONCLUSIONSThe pattern of electrical activity in the normal neonatal stomach appears to be different from that demonstrated in adults and children. The percentage of normal gastric rhythm is lower, and tachygastria and bradygastria are more frequently seen. The EEG dominant frequency increases with postnatal age in neonates.

Age Factors ; Electrodiagnosis ; Female ; Humans ; Infant, Newborn ; physiology ; Male ; Postprandial Period ; Stomach ; physiology

AIMTo investigate the level of postprandial triglycerides (TG)s in elderly men with subnormal testosterone level (< or = 11.0 nmol/L) compared to men with normal testosterone level (> 11.0 nmol/L).

METHODSThirty-seven men with subnormal and 41 men with normal testosterone aged 60-80 years underwent an oral fat load and TG levels were measured fasting and 2, 4, 6 and 8 h afterwards.

RESULTSMen with subnormal testosterone had significantly higher body mass index (BMI) and waist circumference (P < 0.001) than men with normal testosterone. They had significantly higher area under curve (AUC, P = 0.037), incremental area under curve (AUCi, P = 0.035) and TG response (TGR, P = 0.014) for serum-TG and significantly higher AUC (P = 0.023), AUCi (P = 0.023) and TGR (P = 0.014) for chylomicron-TG compared to men with normal testosterone level. Adjusting for waist circumference erased the significant differences between the groups in postprandial triglyceridemia.

CONCLUSIONMen with subnormal testosterone have increased postprandial TG levels indicating an impaired metabolism of postprandial TG-rich lipoproteins (TRL), which may add to an unfavourable lipid profile and promote development of atherosclerosis.

Aged ; Aged, 80 and over ; Body Mass Index ; Case-Control Studies ; Humans ; Lipid Metabolism ; physiology ; Male ; Middle Aged ; Postprandial Period ; physiology ; Testosterone ; deficiency ; Time Factors ; Triglycerides ; metabolism

BACKGROUNDThe accurate and comprehensive assessment of glycemic control in patients with diabetes is important for optimizing glycemic management and for formulating personalized diabetic treatment schemes. This study aimed to analyze the correlation between 1,5-anhydroglucitol (1,5-AG) and glycemic excursions in type 2 diabetic patients.

METHODSSeventy-one outpatients with type 2 diabetes mellitus were randomly recruited from Chinese People's Liberation Army General Hospital. Using a continuous glucose monitoring system (CGMS), these patients' blood glucose levels were monitored for three consecutive days to obtain mean blood glucose (MBG) data. Intraday glycemic excursions were evaluated using the mean amplitude of glycemic excursions (MAGE), the largest amplitude of glycemic excursions (LAGE), standard deviation of blood glucose (SDBG) and the M-value. Interday glycemic excursion was assessed by absolute mean of daily difference (MODD). Postprandial glycemic fluctuations were evaluated using postprandial glucose excursions (PPGE) and postprandial incremental area under the curve (iAUC). Fasting venous blood samples were collected to measure serum 1,5-AG, whole-blood hemoglobin A1c (HbA1c) and serum glycated albumin (GA). Clinical markers of glycemia and parameters of glycemic excursions from CGMS were analyzed using the Pearson correlation coefficient and multivariate stepwise regression.

RESULTSPearson correlation analysis revealed that 1,5-AG was significantly correlated with MAGE, SDBG, M-value, LAGE, PPGE and iAUC (r values were -0.509, -0.430, -0.530, -0.462, -0.416 and -0.435, respectively, P < 0.01), especially in moderately and well-controlled patients, based on defined HbA1c levels. Multivariate stepwise regression analysis revealed a negative correlation between 1,5-AG and the above parameters, but not HbA1c and GA. Finally, HbA1c and GA were positively correlated with MBG and fasting blood glucose (FBG).

CONCLUSIONS1,5-AG was much better than HbA1c and GA as a marker of glycemic excursions in type 2 diabetic patients. Based on these results 1,5-AG is the best metric for assessing postprandial glucose levels in moderately and well-controlled patients, while HbA1c and GA were superior to 1,5-AG for monitoring MBG and FBG.

Aged ; Blood Glucose ; metabolism ; Deoxyglucose ; blood ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; pathology ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Male ; Middle Aged ; Postprandial Period ; physiology

BACKGROUNDThe debate over the overall benefits of self-monitoring of blood glucose in type 2 diabetes patients is still continuing. We aimed to assess the difference in glycaemic control and coronary heart disease (CHD) risk levels of experimental type 2 diabetes patients provided with facilities for self-monitoring blood glucose and their counterparts without such facilities.

METHODSSixty-one patients who had no prior experience in using glucometers were studied as intervention (n = 30) and control (n = 31) groups. The intervention group was trained in self-monitoring of blood glucose and documentation. Baseline blood glucose and fasting blood glucose were measured and the intervention patients were provided with glucometers and advised to self-monitor their fasting and postprandial blood glucose over six months. The 10-year CHD risk levels were determined with the United Kingdom Prospective Diabetes Study-derived risk engine calculator.

RESULTSThe age and diabetes duration were similar in the two groups (P > 0.05). The majority of the patients were unemployed or retired females with only a primary level education. After 3 months, the haemogolbin A 1C (HbA 1c) levels of the control patients remained unchanged ((7.8 ± 0.3)% vs. (7.9 ± 0.4)%, P > 0.05) whereas the HbA 1c levels of the intervention patients were significantly reduced from the baseline at three ((9.6 ± 0.3)% vs. (7.8 ± 0.3)%, P < 0.001) and six ((9.2 ± 0.4)% vs. (7.5 ± 0.3)%, P < 0.001) months. Interestingly, while the 10-year CHD risk level of the control group remained unchanged after three months, that of the intervention group was remarkably reduced at three and six months from the baseline level ((7.4 ± 1.3)% vs. (4.5 ± 0.9)%, P = 0.056).

CONCLUSIONSelf-monitoring of blood glucose in type 2 diabetes patients significantly improved glycaemic control and the CHD risk profile, suggesting that type 2 diabetes patients will potentially benefit from inclusion of glucose meters and testing strips in their health-care package.

Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; methods ; Coronary Disease ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; Fasting ; blood ; Female ; Humans ; Male ; Middle Aged ; Postprandial Period ; physiology

BACKGROUNDThe conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population.

METHODSNine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A1c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis.

RESULTSAmong 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P < 0.001). For estimation of 2 h-PG ≥ 7.8 mmol/L and 2 h-PG ≥ 11.1 mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI ]: 0.738-0.806) and 0.885 (95% CI: 0.850-0.921), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 mmol/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity for detecting glucose abnormalities (84.1% vs. 73.7%, P < 0.001) and diabetes (82.7% vs. 48.1%, P < 0.001).

CONCLUSIONFPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.

Aged ; Asian Continental Ancestry Group ; Blood Glucose ; metabolism ; Diabetes Mellitus ; blood ; diagnosis ; urine ; Fasting ; blood ; Female ; Glucose Tolerance Test ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Postprandial Period ; physiology

OBJECTIVETo determine the relationships of Met416Val and XbaI polymorphism of muscle glycogen synthase (GYS1) gene and Trg64Arg variant of the beta(3)-adrenergic-receptor (beta(3)-AR) gene with type 2 diabetes mellitus (DM) and its intermediate phenotypes in the Chinese population.

METHODSPolymerase chain reaction-oligonucleotide ligation assay and restriction fragment length polymorphism assay were used to evaluate the GYS1 and beta(3)-AR gene polymorphisms in 102 pairs of case-control Chinese spouses.

RESULTSSubjects with Met416Val variant had a significantly higher 2-hour post-glucose level than subjects without this variant had in diabetic group (P = 0.032). The Met416Val polymorphism of GYS1 gene was not significantly associated with the risk of type 2 DM (adjusted OR = 1.67; 95% CI: 0.73 - 3.81, P = 0.223). Subjects with Trp64Arg variant had a significantly higher serum uric acid level than subjects without this variant had in diabetic group (P = 0.034). The combination of BMI and Arg64 allele carrier of the beta(3)-AR gene increased the diabetic risk over four-fold (adjusted OR = 4.00; 95% CI: 1.53 - 10.45, P = 0.005).

CONCLUSIONSIn the Chinese population, Met416Val polymorphism is identified in a subgroup of diabetic subjects with high 2-hour post-glucose. It will explain why some diabetic patients appear to be genetically predisposed to developing high postpradial glucose level. The presence of the Arg64 allele in the beta(3)-AR gene may predispose patients to higher serum uric acid level.

Adult ; Aged ; Alleles ; Body Mass Index ; Diabetes Mellitus, Type 2 ; blood ; genetics ; Glycogen Synthase ; genetics ; Humans ; Hyperglycemia ; genetics ; Middle Aged ; Polymorphism, Genetic ; Postprandial Period ; physiology ; Receptors, Adrenergic, beta-3 ; genetics ; Uric Acid ; blood

No abstract available.
Dyspepsia/physiopathology/*radionuclide imaging ; Fundoplication ; Human ; Obesity/physiopathology/*radionuclide imaging ; Observer Variation ; Postprandial Period/*physiology ; Sodium Pertechnetate Tc 99m/diagnostic use ; Stomach/physiopathology/*radionuclide imaging/surgery ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Tomography, Emission-Computed, Single-Photon/*methods

BACKGROUNDPostprandial hypotension (PPH) occurs frequently in elderly people and may lead to syncope, falls, dizziness, weakness, angina pectoris, and stroke. Some studies suggest that the magnitude of the postprandial fall in blood pressure (BP) is influenced by the rate at which glucose enters the small intestine. We hypothesized that acarbose (alpha-glucosidase inhibitor), a hypoglycemic agent that decreases the rate of glucose absorption in the small intestine, would attenuate PPH in the elderly, and would be safe in the treatment.

METHODSForty-three elderly in-patients with PPH were recruited. All of them were in relatively stable conditions. They had semi-liquid standard meals without and with acarbose for the two following days: screening day and intervention day. Blood pressure and heart rate (HR) were recorded at baseline and every 15 minutes for 120 minutes using a non-invasive ambulatory blood pressure monitoring system during the study, and ejection fraction (EF) and fractional shortening (FS) were measured by two dimensional echocardiography.

RESULTSCompared with the screening day, the falls in systolic, diastolic and mean arterial blood pressure (SBP, DBP, MAP) (all P < 0.05) were significantly attenuated after taking acarbose during breakfast, so were MAP (P < 0.05) during lunch, DBP (P < 0.05) and MAP (P < 0.05) during supper. The change of HR was not statistically significant after taking acarbose in three meals. EF and FS were positively correlated with the relief rate. The effective power was 63%, and the incidence of adverse drug reaction (ADR) was 9%.

CONCLUSIONAcarbose is effective and safe in the treatment of elderly patients with PPH.

Acarbose ; adverse effects ; therapeutic use ; Aged ; Aged, 80 and over ; Blood Pressure ; drug effects ; Enzyme Inhibitors ; therapeutic use ; Female ; Heart Rate ; drug effects ; Humans ; Hypoglycemic Agents ; therapeutic use ; Hypotension ; drug therapy ; Male ; Postprandial Period ; physiology

BACKGROUND/AIMS: Postprandial symptoms of fullness and abdominal discomfort are common after fatty meals. Gastric lipases hydrolyze 10% to 20% of dietary triglycerides during the stomach trituration period of digestion. The aim of this study was to evaluate the effects of acid-resistant lipase on upper gastrointestinal symptoms, including fullness and bloating, as well as on gastric myoelectrical activity after healthy subjects ingested a high-fat, liquid meal. METHODS: This study utilized a double-blind, placebo-controlled, crossover design with 16 healthy volunteers who ingested either a capsule containing 280 mg of acid-resistant lipase or a placebo immediately before a fatty meal (355 calories, 55% fat). Participants rated their stomach fullness, bloating, and nausea before and at timed intervals for 60 minutes after the meal. Electrogastrograms were obtained to assess the gastric myoelectrical activity. RESULTS: Stomach fullness, bloating, and nausea increased significantly 10 minutes after ingestion of the fatty meal (p<0.01), whereas normal gastric myoelectrical activity decreased and tachygastria increased (p<0.05). With lipase, reports of stomach fullness were significantly lower compared with placebo (p<0.05), but no effect on gastric myoelectrical activity or other upper gastrointestinal symptoms was observed. CONCLUSIONS: The high-fat meal induced transient fullness, bloating, nausea, and tachygastria in healthy individuals, consistent with post-prandial distress syndrome. Acid-resistant lipase supplementation significantly decreased stomach fullness.
Abdominal Pain/etiology/psychology ; Adult ; Cross-Over Studies ; Diet, High-Fat/*adverse effects/psychology ; *Dietary Supplements ; Double-Blind Method ; Dyspepsia/etiology/*prevention & control/psychology ; Female ; Gastrointestinal Motility/drug effects/physiology ; Healthy Volunteers ; Humans ; Lipase/*administration & dosage ; Male ; Meals ; Middle Aged ; Myoelectric Complex, Migrating ; Nausea/etiology/psychology ; Postprandial Period ; Stomach/*drug effects/physiology ; Young Adult

PURPOSE: The aim of this study was to identify the most precise and clinically practicable parameters that predict future oral hypoglycemic agent (OHA) failure in patients with type 2 diabetes, and to determine whether these parameters are valuable in various subgroups. MATERIALS AND METHODS: We took fasting blood samples from 231 patients for laboratory data and standard breakfast tests for evaluation of pancreatic beta-cell function. Hemoglobin A1c (HbA1c) levels were tested, and we collected data related to hypoglycemic medications one year from the start date of the study. RESULTS: Fasting C-peptide, postprandial insulin and C-peptide, the difference between fasting and postprandial insulin, fasting beta-cell responsiveness (M0), postprandial beta-cell responsiveness (M1), and homeostasis model assessment-beta (HOMA-B) levels were significantly higher in those with OHA response than in those with OHA failure. The area under the curve (AUC) of the receiver operating characteristic (ROC) measured with postprandial C-peptide to predict future OHA failure was 0.720, and the predictive power for future OHA failure was the highest of the variable parameters. Fasting and postprandial C-peptide, M0, and M1 levels were the only differences between those with OHA response and those with OHA failure among diabetic subjects with low body mass index, high blood glucose level, or long-standing diabetes. CONCLUSION: In conclusion, postprandial C-peptide was most useful in predicting future OHA failure in type 2 diabetic subjects. However, these parameters measuring beta-cell function are only valuable in diabetic subjects with low body mass index, high blood glucose level, or long-standing diabetes.
Administration, Oral ; Adolescent ; Aged ; Blood Glucose/analysis ; Body Mass Index ; C-Peptide/blood ; Child ; Child, Preschool ; Diabetes Mellitus, Type 2/*blood/drug therapy/*metabolism/physiopathology ; Fasting/blood ; Female ; Humans ; Hypoglycemic Agents/administration & dosage/therapeutic use ; Insulin/blood ; Insulin-Secreting Cells/*metabolism/*physiology ; Male ; Middle Aged ; Postprandial Period