Effects of different plasma glucose concentrations on lipolytic and ketogenic responsiveness to epinephrine in type I (insulin-dependent) diabetic subjects.

The effects of two different plasma glucose concentrations (5 and 10 mmol/L) on lipolysis and ketogenesis during baseline and in response to epinephrine infusion were evaluated in insulin-dependent diabetic patients. Each insulin-dependent diabetic subject was studied during euglycemia, hyperglycemia with hypoinsulinemia, and hyperglycemia with hyperinsulinemia. Total ketone body (TKB) concentrations were significantly higher in hyperglycemic-hypoinsulinemic diabetics than in hyperglycemic-hyperinsulinemic and normoglycemic diabetics. Hyperglycemic-hyperinsulinemics had higher TKB concentrations than euglycemic diabetics. During epinephrine infusion, the ketone body rate of appearance and concentration significantly increased in all groups. Plasma FFA concentrations were significantly higher in hyperglycemic-hypoinsulinemic diabetics than in the other groups. During epinephrine infusion, the plasma FFA rate of appearance and concentration significantly increased in all groups. The apparent fraction of FFA converted to ketones was increased by epinephrine in all groups, except in hyperglycemic-hyperinsulinemic diabetics. In conclusion, this study demonstrates that although insulin alone decreases FFA and TKB concentrations, it does not affect the fraction of FFA converted to ketones. If hyperinsulinemia is superimposed on hyperglycemia, there is both a reduction of ketogenesis capacity, compared to hyperglycemia alone, and a decrease in the apparent fraction of FFA converted to ketone bodies.

Olive-oil-enriched diet: effect on serum lipoprotein levels and biliary cholesterol saturation.

The effect of diet enriched with a monounsaturated fatty acid (olive oil) on serum lipoproteins, biliary cholesterol saturation index, and gallbladder motility compared with a standard low-fat diet was evaluated in 11 young volunteers admitted to a metabolic ward. A significant decrease of mean total cholesterol (-9.5%), total apo B (-7.4%), LDL cholesterol (-12.2%), and total triglycerides (-25.5%) was observed after the olive-oil-enriched diet. Total HDL- and HDL-subfractions-cholesterol levels as well as serum apo A-I mean levels remained unchanged. Cholesterol saturation index of the bile and fasting and after-meal gallbladder volumes were unaffected by the enriched diet as compared with the low-fat diet. Olive oil may be a natural fat that can be used for the control of plasma and LDL cholesterol as a valid alternative to polyunsaturated fatty acids.

A case of multiple sclerosis with an onset mimicking the Kleine-Levin syndrome.

A 20 years old patient is described, who presented two episodes of day-time hypersomnia, orthostatic hypotension and psychotic behavior. Compulsive masturbation and abnormalities of the eating habits were also present. Both episodes cleared up spontaneously in about one week. From the clinical point of view of Kleine-Levin syndrome, was suspected. However a CSF examination showed IgG oligoclonal bands and an increased IgG index. A NMR showed multiple area of increased signal intensity, suggestive of a demyelinating disease. On these elements a final diagnosis of MS was made, in spite of a normal neurological examination. This case was compared to other cases of MS in which the disease begins with acute remitting psychiatric symptoms. However cases of MS with complex episodes as observed in our patient were not found in the Literature.

Effect of dietary monounsaturated and polyunsaturated fatty acids on the susceptibility of plasma low density lipoproteins to oxidative modification.

Oxidized low density lipoproteins (LDLs) are thought to play an important role in atherogenesis. Nutritional and biochemical studies suggest that diet can modulate the susceptibility of plasma LDL to undergo oxidative degradation by affecting the concentration of polyunsaturated fatty acids and antioxidants in the lipoprotein particle. In the present study 11 healthy male volunteers underwent two diet phases. In one phase the diet was enriched in oleic acid (mono), while in the other it was high in linoleic acid (poly). Both diets lowered plasma total and LDL cholesterol contents. The sensitivity of plasma LDL to oxidation was estimated by challenging these lipoproteins with 2,2'-azobis(2-amidinopropane)dihydrochloride, a free-radical initiator. Although neither diet affected the antioxidant content of plasma LDL, the resistance to lipid peroxidation, measured after the consumption of antioxidants present in the lipoprotein, was higher during the mono phase. Indeed, the peroxidation rate of plasma LDL was inversely correlated with the oleic acid to linoleic acid ratio in the LDL particle. These results support the thesis that diets rich in monounsaturated fatty acids increase the resistance of plasma LDL to oxidative modification, independent of their content of antioxidants. This effect could lower the atherogenicity of these lipoproteins.

Effects of an olive-oil-rich diet on erythrocyte membrane lipid composition and cation transport systems.

1. In this study we sought to test the possibility that an olive-oil-rich diet might influence the membrane lipid composition and cation transport mechanisms in erythrocytes. 2. To this end, 11 normotensive normolipidaemic healthy volunteers were given a standard relatively low fat diet (28% of total energy) for 3 weeks, followed by a high fat (38% of total energy), olive-oil (100 g/day)-enriched diet for the 3 subsequent weeks, in a metabolic ward. The two diets contained the same amount of cholesterol (400 mg), and the polyunsaturated fatty acid/saturated fatty acid ratio was similar and comparatively low (0.35 on the standard vs 0.36 on the olive oil diet). 3. At the end of the study the lipid composition of the erythrocyte membranes showed the following changes: the oleic acid content increased by 15.7% and the amount of saturated fatty acid decreased by 3.2%. The polyunsaturated fatty acid content tended to decrease, while the polyunsaturated fatty acid/saturated fatty acid ratio did not change significantly. The cholesterol/phospholipid molar ratio increased significantly by 7.8%, still remaining within the reference range. 4. At the same time, the mean values of the maximum rates of the cation fluxes mediated by the Na+ -K+ pump, and by Na+ -K+ co-transport rose significantly, while the maximal rate of Na+ -L+ countertransport showed a non-significant trend towards lower values. 5. Urinary excretion of Na+ and K+, body weight and blood pressure did not change significantly.