Effects of different fractions of whey protein on postprandial lipid and hormone responses in type 2 diabetes.

BACKGROUND/OBJECTIVES: Exacerbated postprandial lipid responses are associated with an increased cardiovascular risk. Dietary proteins influence postprandial lipemia differently, and whey protein has a preferential lipid-lowering effect. We compared the effects of different whey protein fractions on postprandial lipid and hormone responses added to a high-fat meal in type 2 diabetic subjects. SUBJECTS/METHODS: A total of 12 type 2 diabetic subjects ingested four isocaloric test meals in randomized order. The test meals contained 100 g of butter and 45 g of carbohydrate in combination with 45 g of whey isolate (iso-meal), whey hydrolysate (hydro-meal), α-lactalbumin enhanced whey (lac-meal) or caseinoglycomacropeptide enhanced whey (CGMP-meal). Plasma concentrations of triglyceride, retinyl palmitate, free fatty acid, insulin, glucose, glucagon, glucagon-like peptide 1 and glucose-dependent insulinotropic peptide were measured before and at regular intervals until 8-h postprandially. RESULTS: We found no statistical significant differences between meals on our primary variable triglyceride. The retinyl palmitate response was higher after the hydro-meal than after the iso- and lac-meal in the chylomicron-rich fraction (P=0.008) while no significant differences were found in the chylomicron-poor fraction. The hydro- and iso-meal produced a higher insulin response compared with the lac- and CGMP-meal (P<0.001). Otherwise no significant differences in the hormone responses were found in the incremental area under the curve over the 480-min period. CONCLUSIONS: A supplement of four different whey protein fractions to a fat-rich meal had similar effects on postprandial triglyceride responses in type 2 diabetic subjects. Whey isolate and whey hydrolysate caused a higher insulin response.

Disruption of the V-ATPase functionality as a way to uncouple bone formation and resorption - a novel target for treatment of osteoporosis.

The unique ability of the osteoclasts to resorb the calcified bone matrix is dependent on secretion of hydrochloric acid. This process is mediated by a vacuolar H+ ATPase (V-ATPase) and a chloride-proton antiporter. The structural subunit of the V-ATPase, a3, is highly specific for osteoclasts, and mutations in a3 lead to infantile malignant osteopetrosis, a phenomenon characterized by increased bone mass, an increased number of non-resorbing osteoclasts, and a complete lack of bone resorption. Importantly, these individuals have normal or even increased osteoblast numbers and bone formation suggesting that the osteoclasts, but not their resorptive capability, relay an anabolic signal, and, hence, that bone formation can be uncoupled from bone resorption when the a3 subunit is eliminated by mutations, or possibly by pharmacological intervention. The pharmacological profile of the a3 subunit as a highly specific target with a mode of action profile augmenting uncoupling and sustained bone formation, as derived from osteopetrotic patients and mice, highlights the relevance of the V-ATPase in future osteoporosis drug development. However, as illustrated by numerous attempts at developing specific inhibitors of the osteoclastic V-ATPase it is a very difficult target to work with, and an inhibitor possessing the desired profile remains elusive, although highly promising approaches recently have been launched.

Differential diagnosis between attention-deficit/hyperactivity disorder and pervasive developmental disorder--not otherwise specified.

The lack of clarity in diagnostic classification and the lack of specificity of assessment devices deter accurate identification of children with Pervasive Developmental Disorder-Not Otherwise Specified (PDD--NOS). The current study was designed to assess the utility of the Personality Inventory for Children (PIC) and the Conners Parent Rating Scale (CPRS-48) in differentiating PDD--NOS from Attention Deficit Hyperactivity Disorder (ADHD), disorders with overlapping symptom constellations. Subjects were 44 children recruited from a tertiary-care center with the diagnosis of ADHD or PDD--NOS. Results showed significant differences between groups on PIC scales assessing internalizing behaviors, social skills, and unusual affect and behavior. There were no group differences on the externalizing or learning scales of the CPRS-48. Discriminant function analysis using preselected PIC variables yielded a correct group classification of 92.7%. The PIC appears to be a useful tool in the differential diagnosis between PDD--NOS and ADD, while the CPRS-48, a commonly used screening measure for attentional and behavioral disorders, does not.

Chronic nonprogressive headaches in children and adolescents.

Chronic nonprogressive headaches are common in adolescents. The features of this syndrome are distinct from those of migraine. Chronic nonprogressive headaches have received less attention and study than migraine headaches. The prevalence of this syndrome is not clear. A structured psychological interview with the patient and the parents of the patient coupled with psychological testing of the patient will usually identify factors playing a role in the continuing headache. Counseling, biofeedback, and cognitive training, combined with judicious use of medication, will frequently lead to resolution of the headache.