American Journal of Clinical Nutrition, Vol 65, 861-870, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Effect of glycemic control on the kinetics of whole-body protein metabolism in obese subjects with non-insulin-dependent diabetes mellitus during iso- and hypoenergetic feeding

R Gougeon, PB Pencharz and RJ Sigal
McGill Nutrition and Food Science Centre, Royal Victoria Hospital, Montreal, Quebec, Canada. rgougeon@rvhmed.1an.mcgill.ca

We postulated whether interventions capable of restoring euglycemia would correct whole-body protein metabolism, shown previously to be elevated in hyperglycemic persons with non-insulin-dependent diabetes (NIDDM). The kinetics of protein metabolism were estimated in obese subjects with NIDDM in the hyper- and normoglycemic states during isoenergetic feeding and in the normoglycemic state induced by 4 wk of a very-low-energy diet (VLED) with constant protein intake. Seven NIDDM subjects [three males and four females with a body mass index (in kg/m2) of 39 +/- 2] were given a weight-maintaining, liquid formula providing 95 g protein/d for 15 d, followed in six subjects (two males and four females) for 27 d by a diet providing 1.7 MJ, 93 g protein derived from casein-soy, 13 g carbohydrate, 2 g fat, multivitamins and minerals, and a potassium bicarbonate supplement (32 mmol) per day. Exogenous insulin was given to achieve normoglycemia during the first 8 d of isoenergetic feeding. On days 6-8, 12-14, and 25-27, nitrogen flux rate was calculated from the urine [15N]urea enrichment by using the 60- h oral [15N]glycine method to obtain "integrated" feeding and fasting values. Rates of synthesis and breakdown were calculated from nitrogen flux. During isoenergetic feeding, normoglycemia was associated with more positive nitrogen balance (2.6 +/- 0.5 compared with -0.6 +/- 0.6 g N/d, P < 0.05); 18-23% lower nitrogen flux, and synthesis and breakdown rates (P < 0.05), and a 3% decrease in resting energy expenditure (P < 0.05). During the VLED, euglycemia was achieved but nitrogen balance, although it became less negative with time, never reached equilibrium. This was associated with significant (P < 0.05) decreases in the synthesis rate, resulting in net protein losses. Thus, the altered protein metabolism in moderately hyperglycemic NIDDM subjects was improved with exogenous insulin in doses sufficient to restore normoglycemia in the isoenergetic fed state, but it remained abnormal with a reduced non-protein energy intake. This suggests that protein metabolism is more sensitive to insulinization than was thought previously.

This article has been cited by other articles:

				P. M. Janiszewski, T. J. Saunders, and R. Ross Themed Review: Lifestyle Treatment of the Metabolic Syndrome American Journal of Lifestyle Medicine, April 1, 2008; 2(2): 99 - 108. [Abstract] [PDF]

				R. Gougeon, J. A. Morais, S. Chevalier, S. Pereira, M. Lamarche, and E. B. Marliss Determinants of Whole-Body Protein Metabolism in Subjects With and Without Type 2 Diabetes Diabetes Care, January 1, 2008; 31(1): 128 - 133. [Abstract] [Full Text] [PDF]

				S. Pereira, E. B. Marliss, J. A. Morais, S. Chevalier, and R. Gougeon Insulin Resistance of Protein Metabolism in Type 2 Diabetes Diabetes, January 1, 2008; 57(1): 56 - 63. [Abstract] [Full Text] [PDF]

				Q. Zhou, J. Du, Z. Hu, K. Walsh, and X. H. Wang Evidence for Adipose-Muscle Cross Talk: Opposing Regulation of Muscle Proteolysis by Adiponectin and Fatty Acids Endocrinology, December 1, 2007; 148(12): 5696 - 5705. [Abstract] [Full Text] [PDF]

				M. J. Fowler Diabetes Treatment, Part 1: Diet and Exercise Clin. Diabetes, July 1, 2007; 25(3): 105 - 109. [Full Text] [PDF]

				C. Carver Insulin Treatment and the Problem of Weight Gain in Type 2 Diabetes The Diabetes Educator, November 1, 2006; 32(6): 910 - 917. [Abstract] [Full Text] [PDF]

				S. Chevalier, S. C. Burgess, C. R. Malloy, R. Gougeon, E. B. Marliss, and J. A. Morais The Greater Contribution of Gluconeogenesis to Glucose Production in Obesity Is Related to Increased Whole-Body Protein Catabolism Diabetes, March 1, 2006; 55(3): 675 - 681. [Abstract] [Full Text] [PDF]

				S. Chevalier, R. Gougeon, N. Choong, M. Lamarche, and J. A. Morais Influence of adiposity in the blunted whole-body protein anabolic response to insulin with aging. J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2006; 61(2): 156 - 164. [Abstract] [Full Text] [PDF]

				S. Chevalier, E. B Marliss, J. A Morais, M. Lamarche, and R. Gougeon Whole-body protein anabolic response is resistant to the action of insulin in obese women Am. J. Clinical Nutrition, August 1, 2005; 82(2): 355 - 365. [Abstract] [Full Text] [PDF]

				G. Lattuada, L. P. Sereni, D. Ruggieri, A. Scollo, S. Benedini, F. Ragogna, F. Costantino, A. Battezzati, L. Luzi, and G. Perseghin Postabsorptive and Insulin-Stimulated Energy Homeostasis and Leucine Turnover in Offspring of Type 2 Diabetic Patients Diabetes Care, November 1, 2004; 27(11): 2716 - 2722. [Abstract] [Full Text] [PDF]

				J. W. Anderson, C. W.C. Kendall, and D. J.A. Jenkins Importance of Weight Management in Type 2 Diabetes: Review with Meta-analysis of Clinical Studies J. Am. Coll. Nutr., October 1, 2003; 22(5): 331 - 339. [Abstract] [Full Text] [PDF]

				P. Halvatsiotis, K. R. Short, M. Bigelow, and K. S. Nair Synthesis Rate of Muscle Proteins, Muscle Functions, and Amino Acid Kinetics in Type 2 Diabetes Diabetes, August 1, 2002; 51(8): 2395 - 2404. [Abstract] [Full Text] [PDF]

				M. J. Franz, J. P. Bantle, C. A. Beebe, J. D. Brunzell, J.-L. Chiasson, A. Garg, L. A. Holzmeister, B. Hoogwerf, E. Mayer-Davis, A. D. Mooradian, et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications Diabetes Care, January 1, 2002; 25(1): 148 - 198. [Full Text] [PDF]

				C. Castaneda, O. I Bermudez, and K. L Tucker Protein nutritional status and function are associated with type 2 diabetes in Hispanic elders Am. J. Clinical Nutrition, July 1, 2000; 72(1): 89 - 95. [Abstract] [Full Text] [PDF]

				J. A. Morais, R. Ross, R. Gougeon, P. B. Pencharz, P. J. H. Jones, and E. B. Marliss Distribution of Protein Turnover Changes with Age in Humans as Assessed by Whole-Body Magnetic Resonance Image Analysis to Quantify Tissue Volumes J. Nutr., April 1, 2000; 130(4): 784 - 791. [Abstract] [Full Text]

				B. E Wisse, L A. Campfield, E. B Marliss, J. A Morais, R. Tenenbaum, and R. Gougeon Effect of prolonged moderate and severe energy restriction and refeeding on plasma leptin concentrations in obese women Am. J. Clinical Nutrition, September 1, 1999; 70(3): 321 - 330. [Abstract] [Full Text] [PDF]

				Y. Schutz, C. M Rueda-Maza, M. Zaffanello, and C. Maffeis Whole-body protein turnover and resting energy expenditure in obese, prepubertal children Am. J. Clinical Nutrition, May 1, 1999; 69(5): 857 - 862. [Abstract] [Full Text] [PDF]