Anti-inflammatory effects of diet and caloric restriction in metabolic syndrome.

BACKGROUND: Weight loss in patients with metabolic syndrome has positive effects on cardiovascular and type 2 diabetes risks, but its effects on peripheral cytokines and lipid profiles in patients are still unclear. AIM: To determine the effects of diet-induced weight loss on metabolic parameters, lipids and cytokine profiles. METHODS: Eighteen adult males with metabolic syndrome (defined according to IDF 2009) and Body Mass Index (BMI) between 25 and 35 kg/m2 were subjected to a balanced hypocaloric diet for 6 months to reach at least a 5% body weight loss. RESULTS: After weight loss, a significant improvement in BMI, waist circumference, insulin, fasting blood glucose and HOMA-IR (homeostasis model assessment of insulin resistance) was observed. The analysis of LDL (low-density lipoprotein cholesterol) and HDL (high-density lipoprotein cholesterol) lipoproteins showed a change in their composition with a massive transfer of triacylglycerols from HDL to LDL. This was associated with a significant reduction in peripheral pro-inflammatory cytokines such as IL-6, TNF-α, IL-8 and MIP-1ß, leading to an overall decreased inflammatory score. An interesting positive correlation was also observed among peripheral cytokines levels after diet and peripheral levels of CETP (cholesteryl ester transfer protein), an enzyme with a key role in lipid change. CONCLUSION: Weight loss through caloric restriction is associated with an improvement in peripheral lipid and cytokine profiles that may play a major role in improving cardiovascular risk.

Beta-glucan- or rice bran-enriched foods: a comparative crossover clinical trial on lipidic pattern in mildly hypercholesterolemic men.

BACKGROUND/OBJECTIVES: There has been growing interest in using dietary intervention to improve the lipid profile. This work aims at analyzing the effects and the comparison of the enrichment of a diet with beta-glucans or rice bran in mildly hypercholesterolemic men. SUBJECTS/METHODS: The subjects initially consumed a 3-week Step 1 American Heart Association diet with rice bran-enriched foods. After this adaptation period, volunteers were randomly assigned to follow a crossover, controlled trial that consisted of two treatment with beta-glucan- or rice bran-enriched foods, each of 4 weeks, with a 3-week wash-out, like the adaptation period, between periods. Fasted blood samples were collected on days 0, 21, 49, 70 and 98 in both study arms for measuring low-density lipoprotein (LDL)-cholesterol (primary outcome), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, apolipoprotein (apo) A-I, apo B and glucose levels. RESULTS: Twenty-four men (mean age: 50.3±5.3, mean body mass index: 24.9±1.9) completed the 14-week trial. Subjects in the 3-week adaptation period experienced significant reductions in the mean level of LDL cholesterol, total cholesterol, total cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol, apo A-I, apo A-I/apo B and glucose. During the intervention diet periods, a difference was found between treatment groups for the mean change in LDL (0.21 (95% confidence interval (CI): 0.02-0.40), P=0.033) and total cholesterol (0.34 (95% CI: 0.20-0.47), P<0.001). Other parameters evaluated were not significantly affected by the diet consumed. CONCLUSIONS: The results of the present crossover clinical trial showed that beta-glucan-enriched foods are more effective in lowering serum LDL levels, compared with rice bran-enriched foods.

Increased lipid peroxidation in adult GH-deficient patients: effects of short-term GH administration.

OBJECTIVE: Adult GH deficiency (GHD) syndrome is characterized by increased risk of atherosclerosis and hence of cardio- and cerebrovascular mortality. Oxidative stress appears to play an important role in early atherogenesis. Oxidized LDL represents an important predictor of cardiovascular risk and is mainly responsible for oxidative damage of the endothelium. Its concentrations are increased in GHD, but the association between this abnormality and oxidative stress is still unclear, due to the discordant results yielded by the few available studies. DESIGN AND METHODS: In 13 GHD patients, plasma lipid peroxide concentrations were measured before and after a 4-month treatment with recombinant human GH (rhGH) and compared with those of 13 age- and sex-matched controls. In the same subjects, the so-called "lag-time", an index of anti-oxidant activity and thus of plasma oxidative balance, was also measured using a fluorescence kinetics method. RESULTS: Before treatment, peroxide levels were significantly higher in patients than in controls (374.0+/-31.52 vs 268.0+/-8.51 U.C., p<0.01), whereas the lag-time was significantly lower (113.0+/-10.70 vs 168.0+/-7.80 min, p<0.01). RhGH administration to patients resulted both in a significant decrease in lipid peroxide levels (from 374.0+/-31.52 to 336.0+/-33.17 U.C., p<0.01) and a significant prolongation of lag-time (from 113.0+/-10.70 to 144.0+/-15.00 min, p<0.01). After treatment, both parameters were no longer significantly different in patients and controls. Lag-time and peroxide levels at baseline did not show any correlation with IGF-I concentrations in GHD patients. After replacement therapy, however, lag-time was positively (r2= 0.62, p<0.01), and peroxide levels negatively (r2=0.41, p<0.05), correlated with IGF-I levels. CONCLUSIONS: These data support the view that adult GHD syndrome is characterized by an unbalance between pro- and anti-oxidant factors with marked preponderance of the former. This abnormality, likely contributing to the increased atherogenic risk of GHD patients, is corrected by short-term GH administration at a dose able to increase, although not to fully normalize, IGF-I levels.

Erythrocyte membrane alterations during ageing affect beta-D-glucuronidase and neutral sialidase in elderly healthy subjects.

In this study, a comparison between elderly (>70 years) and young subjects reveals that elder people are subject to a higher oxidative stress, which causes an increase in plasma hydroperoxide levels (18%) and a decrease in antioxidant defenses (25%). Moreover, the marked decrease of the erythrocyte membrane fluidity observed in elderly subjects was likely to affect the behavior of some membrane glycohydrolases. In fact, a significant decrease of beta-d-glucuronidase and neutral sialidase (30 and 50%, respectively) was detected. Activity differences were also observed when erythrocytes were further distinguished according to their biological age. Striking differences between young and elderly subjects were observed for beta-d-glucuronidase and neutral sialidase in young and senescent erythrocytes, respectively. Overall beta-d-glucuronidase decreases with the subjects' age, while neutral sialidase levels are higher in the elderly. This is presumably due to the localization of these enzymes in distinct plasma membrane micro-domains, which are differently peroxidized. A possible role of these enzymes in signaling praecox membrane alterations has also been evidenced.

Biochemical assessments of oxidative stress, erythrocyte membrane fluidity and antioxidant status in professional soccer players and sedentary controls.

BACKGROUND: Physical exercise is characterized by an increase in oxygen consumption by the whole body. This leads to a decrease in antioxidant levels that could promote both an increase in the markers of lipoprotein peroxidation and damage to the erythrocyte membrane with consequent modification of membrane fluidity. MATERIALS AND METHODS: Different markers of oxidative stress, erythrocyte membrane fluidity and antioxidant status were determined in 20 professional soccer players and 20 sedentary controls. Plasma lipoperoxides and kinetics of Cu-stimulated plasma peroxidation were measured together with hydrosoluble (albumin, uric acid and vitamin C), liposoluble (vitamin E and bilirubin) and enzymatic (superoxide dismutase and glutathione peroxidase) serum antioxidants. Erythrocyte membrane rigidity was determined by measuring fluorescence anisotropy (rs) of the fluorescent probe 1, 3, 5 diphenylexatriene. RESULTS: The sportsmen showed higher levels of the following plasmatic antioxidants: ascorbic acid (P<0.0001), uric acid (P<0.0001), alpha-tocopherol (P=0.03) and superoxide dismutase activity (P=0.0001). According to this evidence, the lipoperoxide levels (P=0.0158), the duration of the latency phase of plasma peroxidation (P=0.0123) and erythrocytes membrane fluidity (P=0.0152) were found to be significantly higher in the soccer players. DISCUSSION: Athletes undergoing regular and adequate training show improved antioxidant status together with a more fluid membrane status, which could contribute to improving both peripheral resistance to insulin and all the functional metabolic interchanges in the cellular membrane.

[Membrane fluidity and obesity: the correct food approach]. / Fluidità di membrana e obesità (il corretto approccio alimentare).

Modifications in dietary fat profile have shown to affect body weight gain and adiposity. This may occur through the changes of cell membrane fluidity, in particular of the peripheral muscle tissue. The decreased availability of diet polyunsaturated fatty acids (in particular of the to-3 series), that are able to induce membrane fluidification, together with an excessive intake of both saturated fatty acids and cholesterol, that on the contrary are able to rigidify the same membranes, promoter both a progressive immobilization of membrane proteins and a consequent decrease in their functional rate of liver lipoproteins VLDL, enriched in saturated fats and cholesterol. This lipoprotein increase promotes both the fat deposition in the adipose tissues and a further increase in the muscle membrane rigidity that is followed by a further enhancement in the peripheral resistance to insulin. A diert rich both in polyunsaturated fatty acids and antioxidants (vitamin and oligoelements), and in essential amino acids together with a preferential choice of complex carbohydrates (amylose, amylopectine, etc) in comparison to simple sugars (glucose, fructose, saccharose, lactose, etc) may significantly contribute to the maintenance of the correct degree of membrane fluidity and, as a consequence, to the physiologically correct body weight.

[Dietary restriction and oral administration of antioxidant and omega-3: what are the effects on the clinical variables in a group of obese women?]. / La dietoterapia ipocalorica bilanciata personalizzata ed il trattamento con integratori a base di antiossidanti e omega-3 (quali gli effetti sulle variabili cliniche di outcome in un gruppo di donne in sovrappeso?)

BACKGROUND: Obesity is now recognized as a major risk factor for many pathologies. The state of obesity is associated with an increase in reactive oxygen species; persistent overconsumption of calories in the obese may be exposing them to excessive damage besides maintaining the state of obesity. It is possible that dietary modification and association with assumption of antioxidant and omega-3 oral integration contributes to a reduction in reactive oxygen species generation and a corresponding reduction in indexes of oxidative damage, including lipid peroxidation. METHODS: Given this back-ground, the pro/anti-oxidant balance, biochemical parameters and the body composition were studied in two groups of obese women: a first group of 10 obese women were studied before and after eight weeks of dietary restriction and a second group of 12 obese women were studied before and after eight weeks of dietary restriction and oral administration of antioxidant and omega-3. RESULTS: In summary, as regards the preliminary results of clinical outcome parameters, interestingly enough the glycemic levels fall markedly in association with both dietary restriction and oral integration with antioxidant and omega-3. Another important finding of this study is that of calcium levels and phase angle (measured by impedenzometry) increase in the group treated with dietary restriction and oral administration of antioxidant and omega-3. CONCLUSIONS: Studies that aimed to explore whether oxidative status predicts clinical outcome would provide important details on the putative link between oxidative status and state of obesity.

[The hypocaloric balanced diet therapy and the supplementation with antioxidant and omega-3: what are the effects on the oxidative balance and erythrocytes membrane fluidity status?]. / La dietoterapia ipocalorica bilanciata personalizzata ed il trattamento con integratori a base di antiossidanti e omega-3: quali gli effetti sullo stato della bilancia ossidativa e della fluidità delle membrane eritrocitarie in un gruppo di donne in sovrappeso?

BACKGROUND: To investigate the effects of a hypocaloric balanced diet therapy and a supplementation with antioxidant and omega-3 polyunsaturated fatty acids on the oxidative balance and erythrocytes membrane fluidity status. METHODS: A randomised, double-blind, placebo-controlled study of the association between a hypocaloric balanced diet therapy and a supplementation with antioxidant and omega-3 was done on 40 women with 25 < BMI < 33. The inclusion criteria were the following: absence of dismetabolic pathologies, of previous hypocaloric diet therapy and/or supplementation and of hormonal treatments. Each subjects consumed a balanced diet with a daily caloric intake equal to: Kcal of basal metabolism (determined by indirect calorimetry) x LAF (1.64) 800 Kcal. At the start and after two months of treatment, the blood chemistry and anthropometrics parameters, the plasmatic reactive oxygen species (ROS) and antioxidant defence levels and erythrocyte membrane fluidity status were measured. RESULTS: The preliminary results of this study show that the weight loss, found in both groups investigated, determines a significant decrease of ROS. Furthermore, the association of the hypocaloric diet with antioxidant and omega-3 polyunsaturated fatty acids caused a significant increase of both plasmatic antioxidant defences and erythrocytes membrane fluidity status. CONCLUSIONS: The correlations found between the above parameters and the blood chemistry and anthropometrics variables suggest that the supplementation with antioxidant and omega-3 polyunsaturated fatty acids could ameliorate the effects of hypocaloric diet on the obesity treatment and may give some clinical benefit through the decrease of the values of atherosclerosis risk factors.

Adipose tissue and cytokines.

Adipose tissue is not simply a storage depot for excess energy intake, it is also able to produce and release several substances with local (autocrine) and systemic (endocrine) actions. An up-to-date review of our knowledge in this area is given here. Several of the compounds deriving from adipose tissue have been shown to play a role in obesity-related health complications. The production of cytokines, such as Tumor Necrosis Factor-alpha (TNF-alpha), IL-6, and leptin, is implicated in the development of several disorders. Insulin resistance is one of the most clinically significant.

A fluorescence method for the determination of plasma susceptibility to lipid peroxidation.

OBJECTIVE: We propose a fluorescence kinetics method for monitoring plasma susceptibility to peroxidation. DESIGN AND METHOD: Plasmatic peroxidation was induced by CuSO4 (500 microM), and fluorescence was measured every 30 min. Kinetics were represented by a sigmoidal curve from which it was possible to calculate the latency time (lag-time) and the propagation velocity (slope) of plasma peroxidation. RESULTS: The lag-time monitored by the fluorescence kinetics method corresponded to the formation of thiobarbituric acid reactive substances, and to progressive depletion of polyunsaturated fatty acids and alpha-tocopherol. The mechanism of reaction appeared to be dependent upon plasmatic hydroperoxides, and independent of oxygen radicals. Plasma storage is possible for at least two months at -80 degrees C, and reproducibility of the method is very good. CONCLUSIONS: Fluorescence kinetics provide a highly comprehensive picture of plasma susceptibility to peroxidation in comparison with the conventional measurements of anti- and pro-oxidant ratios.

Variability in alpha-tocopherol antioxidant activity in the core and surface layers of low- and high-density lipoproteins.

The effect of alpha-tocopherol enrichment of low- and high-density lipoproteins on Cu(2+)-catalyzed lipid peroxidation in the hydrophobic core and in the hydrophilic envelope of lipoproteins was investigated by using two pyrene derivatives, namely, cholesteryl pyrenyl hexanoate (P6Chol) and pyrene dodecanoyl sulfatide (P12CS). The progressive decrease in fluorescence of P6Chol was used to monitor lipid peroxidation in the core of LDL and HDL, whereas that of P12CS was used to follow lipid peroxidation in the envelope of both lipoproteins. alpha-Tocopherol enrichment of LDL and HDL was obtained by incubating blood plasma at 37 degrees C with different concentrations of the vitamin (25-500 microM) before lipoprotein separation. The incorporation of alpha-tocopherol in LDL and HDL presents a progressive, time-dependent increase up to 200 microM alpha-tocopherol, then a plateau up to 500 microM. In the envelopes, the added tocopherol causes a great decrease in the rate of peroxidation and a dramatic increase in the latency phase in both lipoproteins. In the cores the lengthening of latency phase resulting from alpha-tocopherol enrichment was by far greater in LDL than in HDL, and the decrease in the rate of peroxidation in both lipoproteins was less than in the envelopes.

Studies on the antioxidant activity of milk caseins.

The antioxidant properties of milk casein subunits (alpha-casein, beta-casein and kappa-casein) were evaluated in liposomal models. All the subunits of casein are able to inhibit Fe-induced peroxidation of arachidonic acid inserted into multilamellar liposomes of dipalmitoylphosphatidylcholine (0.2 mM and 0.8 mM, respectively). The peroxidation was monitored as thiobarbituric acid reactive substances, and the strongest inhibitory effect occurred when 500 micrograms of alpha-casein were added to 0.5 ml of liposomal suspension. At this concentration, peroxidation was completely inhibited in our experimental conditions (incubation for 2 h at room temperature, with a mixture of ferrous sulfate and ascorbate, 50 and 500 microM final concentration, respectively). The mechanisms of antioxidant action are complex, but the strongest effect is achieved by modifying the Fe2+/Fe3+ equilibrium; in fact, caseins seem to favour the autoxidation of iron, and thus inhibit lipid peroxidation.

pH sensitivity and plasma stability of liposomes containing N-stearoylcysteamine.

In this study, we investigated the pH sensitivity of different liposomal formulations containing 10 mol% N-stearoylcysteamine, as pH sensitive molecule. Liposome stability was monitored by determining the release of different entrapped water soluble molecules, 5,6-carboxyfluorescein (CF) being the marker of leakage mainly used. Small unilamellar vesicles composed of egg phosphatidylcholine (EPC) and N-stearoylcysteamine (9:1 molar ratio) incubated at 20 degrees C in citrate phosphate buffer released, at pH 6.8, 2.5 fold the amount of CF released at pH 7.4. The addition of plasma to the incubation medium and an increase of temperature to 37 degrees C led to significantly increased the CF release from EPC/N-stearoylcysteamine SUV, both at pH 7.4 and 6.8. The addition of cholesterol had a stabilizing effect on liposomal vesicles with respect to both temperature and plasma, without affecting pH sensitivity. In fact, at 37 degrees C and in 25% plasma the ternary mixture showed the highest CF release, as a consequence of the moderate acidification of the medium from 7.4 to 6.8. Thus, these liposome formulations are potentially a useful tool for specific drug delivery to pathological tissues such as tumours, inflammation sites and ischemic areas where it is known that a lowering of the pH can occur.

Pyrene lipids as markers of peroxidative processes in different regions of low and high density lipoproteins.

Three different pyrene derivatives, pyrene decanoyl phosphatidylcholine (P10PC), pyrene dodecanoyl sulfatide (P12CS) and cholesteryl pyrenyl hexanoate (P6Chol), were used to follow lipid peroxidation in low and high density lipoproteins. Probe-labelled lipoproteins were subjected to Cu2+ catalyzed peroxidation. In all cases the fluorescence of the probes progressively decreased due to the involvement of pyrene in the peroxidative reaction. Thus, we used the fluorescence decrease of P6Chol to monitor the lipid peroxidation in the hydrophobic core of LDL and HDL, and that of the amphipatic probes, P10PC and P12CS, to follow lipid peroxidation in the envelope of both lipoproteins. The possibility of following lipid peroxidation in individual lipoprotein regions could lead to more detailed information on the oxidative modifications that play an important role in the altered cholesterol homeostasis involved in the formation of atherosclerotic lesions. No differences were observed in the peroxidation kinetics of the hydrophobic core of HDL and LDL monitored with P6Chol. On the contrary kinetics obtained with P10PC and P12 CS demonstrated the HDL envelope to be more susceptible to Cu2+ -dependent lipid peroxidation than that of the LDL. This could be due to a greater radical generating capacity of the HDL envelope and can be explained on the basis of low vitamin E levels and large amounts of polyunsaturated fatty acids esterified on phospholipids determined in HDL, and on literature evidence that indicates HDL as the principal vehicle of circulating plasma lipids peroxides.

Further studies on the antioxidant role of pyrophosphate in model membranes.

Our previous studies (G. Cervato et al., Chem. Phys. Lipids 56 (1990), 91-99) demonstrated that 100 microM pyrophosphate (PPi) inhibits Fe2+/ascorbate-induced peroxidation of arachidonic acid (AA) inserted in unilamellar liposomes (SUVs) of dipalmitoylphosphatidylcholine (DPPC), by chelating ferrous ions in the aqueous phase. In this work we demonstrate that the kinetics of AA peroxidation in DPPC SUVs are strongly affected by PPi, also at very low concentration (1 microM). In fact at low PPi concentration there is a longer lag-phase, while the maximum of thiobarbituric acid reactive substances (TBARS) is similar in both the presence and absence of 1 microM PPi. The lag-phase of peroxidation of AA in lysophosphatidylcholine (palmitoyl) (LysoPC) micelles is also prolonged. The AA peroxidation in membrane models without choline as the polar headgroup (dipalmitoylphosphatidylethanolamine (DPPE) SUVs, or Triton X-100 micelles), or in which AA is not free but esterified with glycerol (stearoyl-arachidonyl-phosphatidylcholine (SAPC)), is unaffected by the presence of 1 microM PPi.