Nutritional markers in patients with diabetes and pancreatic exocrine failure.

AIMS: Altered pancreatic exocrine function can be observed in patients with type 1 or type 2 diabetes. In the present study, we evaluated the potential nutritional consequences of this dysfunction. METHODS: Serum concentrations of nutritional markers, including albumin, cholesterol, triacylglycerol, vitamins A, D, and E, were assessed in a cohort of 468 patients (137 with type 1 diabetes and 331 with type 2 diabetes), after exclusion of the patients with a CRP > 10 mg/l. These patients were compared with 47 patients with diseases of the exocrine pancreas and diabetes (type 3c diabetes or pancreatogenic diabetes). Fecal elastase-1 and chymotrypsin concentrations were measured and patients with type 1 and type 2 diabetes were divided into three groups according to whether zero (group NN), one (group LN), or both (group LL) concentrations were decreased. RESULTS: Several markers differed significantly between the groups of patients, including BMI, albumin, phosphorus, and fat-soluble vitamins. Patients with pancreatogenic diabetes had markedly more profound alterations than patients with type 1 or type 2 diabetes and altered exocrine function. However, patients with type 1 or type 2 diabetes and decreased concentrations of both elastase-1 and chymotrypsin had lower albumin, phosphorus, and vitamin A than patients with normal pancreatic exocrine function. CONCLUSIONS: Modest nutritional alterations were found in patients with type 1 or type 2 diabetes and altered exocrine function. Patients with type 1 or type 2 diabetes and altered exocrine function may thus deserve to be screened for nutritional deficiencies.

Adipose tissue angiogenesis in obesity.

Adipose tissue is the most plastic tissue in all multicellular organisms, being constantly remodelled along with weight gain and weight loss. Expansion of adipose tissue must be accompanied by that of its vascularisation, through processes of angiogenesis, whereas weight loss is associated with the regression of blood vessels. Adipose tissue is thus among the tissues that have the highest angiogenic capacities. These changes of the vascular bed occur through close interactions of adipocytes with blood vessels, and involve several angiogenic factors. This review presents studies that are the basis of our understanding of the regulation of adipose tissue angiogenesis. The growth factors that are involved in the processes of angiogenesis and vascular regression are discussed with a focus on their potential modulation for the treatment of obesity. The hypothesis that inflammation of adipose tissue and insulin resistance could be related to altered angiogenesis in adipose tissue is presented, as well as the beneficial or deleterious effect of inhibition of adipose tissue angiogenesis on metabolic diseases.

Link between adipose tissue angiogenesis and fat accumulation in severely obese subjects.

BACKGROUND: White adipose tissue (WAT) can rapidly expand or regress under different nutritional conditions. The role of angiogenesis in the expandability of human adipose tissue is established. However, whether sc and omental WAT (scWAT and oWAT) angiogenesis could influence fat distribution and metabolic diseases is not known. AIM: The aim of this study was to analyze whether the capacity of angiogenesis in scWAT and oWAT correlates with fat accumulation and fat loss, fat distribution, adipocyte hypertrophy, and metabolic disorders in obese subjects. METHODS: Samples of scWAT and oWAT were obtained during bariatric surgery in 29 obese nondiabetic subjects. Vascular density and inflammatory infiltrate were analyzed by immunohistochemistry, and expression of angiogenic genes was analyzed by quantitative PCR. These parameters were correlated with anthropometric and metabolic parameters. RESULTS: Vascular density of scWAT correlated positively with body mass index, whereas vascular density of the oWAT correlated with waist circumference. There was no correlation of markers of angiogenesis and metabolic disorders. The number of vessels per adipocyte and the expression level of receptor 2 of vascular endothelial growth factor correlated with adipocyte area in scWAT and oWAT. Finally, weight loss after bariatric surgery correlated negatively with adipocyte hypertrophy and vascular density and positively with inflammation and angiogenesis of WAT. CONCLUSION: Angiogenesis may influence WAT expansion and plasticity but does not appear to be involved in the development of insulin resistance in subjects with severe obesity.