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Elbelt U.,Charite - Medical University of Berlin | Schuetz T.,Integrated Research and Treatment Center Adiposity Diseases | Lochs H.,Innsbruck Medical University
Nutrition in Clinical Practice | Year: 2012

Background: The measurement of resting energy expenditure (REE) in an ambulatory setting raises methodological problems. Therefore, the use of predictive equations for the estimation of REE is common. Alternatively, the measurement of sleeping energy expenditure (SEE) has been proposed. The authors retrospectively analyzed data on SEE assessed with a portable armband (PA) device in an ambulatory setting and evaluated this approach against predictive equations and REE measured by indirect calorimetry (IC). Methods: REE was measured with IC, and SEE was assessed with the PA using standardized conditions in 81 participants (aged 46 ± 13 years) over a wide range of body weight (mean body mass index [BMI] 36.4 ± 9.3 kg/m2; range, 21.6-55.7). Results: SEE (1756 ± 393 kcal/d) was 7.6% higher than REE (1632 ± 346 kcal/d) (P <.001). This difference (123 ± 214 kcal/d) was smaller than that using the predictive equation for REE by Harris and Benedict (207 ± 217 kcal/d) and the BMI group-specific equations according to Müller et al (209 ± 190 kcal/d). Linear regression analysis was significant (r2 = 0.705; P <.001). SEE showed similar 95% confidence intervals compared with both of the predictive equations. Conclusions: The described standardized assessment of SEE by a PA device appears to be a promising approach to estimate REE in an ambulatory setting. SEE reflects REE at least as precisely as the predictive equations. © 2012 American Society for Parenteral and Enteral Nutrition.

Kosacka J.,University of Leipzig | Kern M.,University of Leipzig | Kloting N.,University of Leipzig | Kloting N.,Integrated Research and Treatment Center Adiposity Diseases | And 9 more authors.
Molecular and Cellular Endocrinology | Year: 2015

Background: Pathophysiology of obesity is closely associated with enhanced autophagy in adipose tissue (AT). Autophagic process can promote survival or activate cell death. Therefore, we examine the occurrence of autophagy in AT of type 2 diabetes (T2D) patients in comparison to obese and lean individuals without diabetes. Methodology/principal findings: Numerous autophagosomes accumulated within adipocytes were visualized by electron transmission microscopy and by immunofluorescence staining for autophagy marker LC3 in obese and T2D patients. Increased autophagy was demonstrated by higher LC3-II/LC3-I ratio, up-regulated expression of LC3 and Atg5 mRNA, along with decreased p62 and mTOR protein levels. Increased autophagy occurred together with AT inflammation. Conclusions: Our data suggest fat depot-related differences in autophagy regulation. In subcutaneous AT, increased autophagy is accompanied by increased markers of apoptosis in patients with obesity independently of T2D. In contrast, in visceral AT only in T2D patients increased autophagy was related to higher markers of apoptosis. © 2015 Elsevier Ireland Ltd.

Himmerich H.,University of Leipzig | Himmerich H.,Integrated Research and Treatment Center Adiposity Diseases | Minkwitz J.,University of Leipzig | Minkwitz J.,Integrated Research and Treatment Center Adiposity Diseases | Kirkby K.C.,University of Tasmania
Endocrine, Metabolic and Immune Disorders - Drug Targets | Year: 2015

Weight gain and metabolic disturbances are common side effects during psychopharmacological treatment with specific antipsychotics and antidepressants. The antipsychotics clozapine and olanzapine, and antidepressants tricyclics and mirtazapine have a high risk of inducing weight gain. Recently discovered pathophysiological mechanisms include antihistaminergic effects, activation of hypothalamic adenosine monophosphate-activated protein kinase (AMPK), modulation of hormonal signaling of ghrelin and leptin, changes in the production of cytokines such as tumor necrosis factor-alpha (TNF)-alpha and adipokines such as adiponektin, and the impact of genes, in particular the melanocortin 4 receptor (MC4R), serotonin 2C receptor (HTR2C), leptin, neuropeptide Y (NPY) and cannabinoid receptor 1 (CNR1) genes. Metabolic changes associated with weight gain include disturbances of glucose and lipid metabolism. Clozapine and olanzapine may, in addition to mechanisms resulting from weight gain, impair glucose metabolism by blockade of the muscarinic M3 receptor (M3R). Antidepressants associated with weight gain appear to have fewer unfavourable effects on glucose and lipid metabolism than the second-generation antipsychotics clozapine and olanzapine. To assess the risk of weight gain and its consequences for the patient’s health, assessing body weight changes and metabolic monitoring in the first week of treatment as well as in long-term treatment is recommended. © 2015 Bentham Science Publishers.

Tiepolt S.,University of Leipzig | Hesse S.,University of Leipzig | Hesse S.,Integrated Research and Treatment Center Adiposity Diseases | Patt M.,University of Leipzig | And 8 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2016

Purpose: [18F]FDG is a commonly used neuronal injury biomarker for early and differential diagnosis of dementia. Typically, the blood supply to the brain is closely coupled to glucose consumption. Early uptake of the Aβ tracer [11C]PiB on PET images is mainly determined by cerebral blood flow and shows a high correlation with [18F]FDG uptake. Uptake data for 18F-labelled Aβ PET tracers are, however, scarce. We investigated the value of early PET images using the novel Aβ tracer [18F]FBB in the diagnosis of Alzhimers disease (AD). Methods: This retrospective analysis included 22 patients with MCI or dementia who underwent dual time-point PET imaging with either [11C]PiB (11 patients) or [18F]FBB (11 patients) in routine clinical practice. Images were acquired 1 – 9 min after administration of both tracers and 40 – 70 min and 90 – 110 min after administration of [11C]PiB and [18F]FBB, respectively. The patients also underwent [18F]FDG brain PET imaging. PET data were analysed visually and semiquantitatively. Associations between early Aβ tracer uptake and dementia as well as brain atrophy were investigated. Results: Regional visual scores of early Aβ tracer and [18F]FDG PET images were significantly correlated (Spearman’s ρ = 0.780, P < 0.001). Global brain visual analysis revealed identical results between early Aβ tracer and [18F]FDG PET images. In a VOI-based analysis, the early Aβ tracer data correlated significantly with the [18F]FDG data (r = 0.779, P < 0.001), but there were no differences between [18F]FBB and [11C]PiB. Cortical SUVRs in regions typically affected in AD on early Aβ tracer and [18F]FDG PET images were correlated with MMSE scores (ρ = 0.458, P = 0.032, and ρ = 0.456, P = 0.033, respectively). A voxel-wise group-based search for areas with relatively higher tracer uptake on early Aβ tracer PET images compared with [18F]FDG PET images revealed a small cluster in the midbrain/pons; no significant clusters were found for the opposite comparison. Conclusion: Early [18F]FBB and [11C]PiB PET brain images are similar to [18F]FDG PET images in AD patients, and these tracers could potentially be used as biomarkers in place of [18F]FDG. Thus, Aβ tracer PET imaging has the potential to provide biomarker information on AD pathology and neuronal injury. The potential of this approach for supporting the diagnosis of AD needs to be confirmed in prospective studies in larger cohorts. © 2016 Springer-Verlag Berlin Heidelberg

Mueller K.,Max Planck Institute for Human Cognitive and Brain Sciences | Horstmann A.,Max Planck Institute for Human Cognitive and Brain Sciences | Horstmann A.,Integrated Research and Treatment Center Adiposity Diseases | Moller H.E.,Max Planck Institute for Human Cognitive and Brain Sciences | And 9 more authors.
PLoS ONE | Year: 2014

Obesity is known to affect the brains gray matter (GM) and white matter (WM) structure but the interrelationship of such changes remains unclear. Here we used T1-weighted magnetic resonance imaging (MRI) in combination with voxel-based morphometry (VBM) and diffusion-tensor imaging (DTI) with tract-based spatial statistics (TBSS) to assess the relationship between obesity-associated alterations of gray matter density (GMD) and anisotropic water diffusion in WM, respectively. In a small cohort of lean to obese women, we confirmed previous reports of obesityassociated alterations of GMD in brain regions involved in executive control (i.e., dorsolateral prefrontal cortex, DLPFC) and habit learning (i.e., dorsal striatum). Gray matter density alterations of the DLPFC were negatively correlated with radial diffusivity in the entire corpus callosum. Within the genu of the corpus callosum we found a positive correlation with axial diffusivity. In posterior region and inferior areas of the body of the corpus callosum, axial diffusivity correlated negatively with altered GMD in the dorsal striatum. These findings suggest that, in women, obesityrelated alterations of GMD in brain regions involved in executive control and habit learning might relate to alterations of associated WM fiber bundles within the corpus callosum. © 2014 Mueller et al.

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