Dr. Ron’s Research Review – March 2, 2011

This week’s research review has two recent articles: Trace elements for glucose metabolism, and Impaired glucose tolerance in healthy men with low body weight.

Trace elements in glucometabolic disorders: an update

            (Wiernsperger and Rapin 2010)

Impaired glucose tolerance in healthy men with low body weight

         (Jauch-Chara, Schmoller et al. 2010)

In the News

Cooking with Coconut Oil (which contains lauric acid, a saturated fat and MCT)

NY Times

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Dr. Ron


Articles

Trace elements in glucometabolic disorders: an update

            (Wiernsperger and Rapin 2010) Download

ABSTRACT: Many trace elements, among which metals, are indispensable for proper functioning of a myriad of biochemical reactions, more particularly as enzyme cofactors. This is particularly true for the vast set of processes involved in regulation of glucose homeostasis, being it in glucose metabolism itself or in hormonal control, especially insulin. The role and importance of trace elements such as chromium, zinc, selenium, lithium and vanadium are much less evident and subjected to chronic debate. This review updates our actual knowledge concerning these five trace elements. A careful survey of the literature shows that while theoretical postulates from some key roles of these elements had led to real hopes for therapy of insulin resistance and diabetes, the limited experience based on available data indicates that beneficial effects and use of most of them are subjected to caution, given the narrow window between safe and unsafe doses. Clear therapeutic benefit in these pathologies is presently doubtful but some data indicate that these metals may have a clinical interest in patients presenting deficiencies in individual metal levels. The same holds true for an association of some trace elements such as chromium or zinc with oral antidiabetics. However, this area is essentially unexplored in adequate clinical trials, which are worth being performed.

Impaired glucose tolerance in healthy men with low body weight

         (Jauch-Chara, Schmoller et al. 2010) Download

ABSTRACT: BACKGROUND: Impaired glucose tolerance (IGT) and high body mass index (BMI) are recognized risk factors for type 2 diabetes mellitus (T2DM). However, data suggest that also underweight predisposes people to develop T2DM. Here, we experimentally tested if already moderate underweight is associated with impaired glucose tolerance as compared to normal weight controls. Obese subjects were included as additional reference group. METHOD: We included three groups of low weight, normal weight, and obese subjects comprising 15 healthy male participants each. All participants underwent a standardized hyperinsulinemic-euglycemic glucose clamp intervention to determine glucose tolerance. In addition, insulin sensitivity index (ISI) was calculated by established equation. RESULTS: ISI values were higher in low and normal weight than in obese subjects (P < 0.010) without any difference between low and normal weight groups (P = 0.303). Comparable to obese participants (P = 0.178), glucose tolerance was found decreased in low weight as compared with normal weight subjects (P = 0.007). Pearson's correlation analysis revealed a positive relationship between glucose tolerance and BMI in low (P = 0.043) and normal weight subjects (P = 0.021), an effect that was found inverse in obese participants (P = 0.028). CONCLUSION: Our study demonstrates that not only obese but also healthy people with moderate underweight display glucose intolerance. It is therefore suggested that all deviations from normal BMI may be accompanied by an increased risk of developing T2DM in later life indicating that the maintenance of body weight within the normal range has first priority in the prevention of this disease.

References

Jauch-Chara, K., A. Schmoller, et al. (2010). "Impaired glucose tolerance in healthy men with low body weight." Nutr J 10(1): 16.

Wiernsperger, N. and J. Rapin (2010). "Trace elements in glucometabolic disorders: an update." Diabetol Metab Syndr 2: 70.