Dataset Information

Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge.

ABSTRACT:

Background

A key feature of metabolic health is the ability to adapt upon dietary perturbations. Recently, it was shown that metabolic challenge tests in combination with the new generation biomarkers allow the simultaneous quantification of major metabolic health processes. Currently, applied challenge tests are largely non-standardized. A systematic review defined an optimal nutritional challenge test, the "PhenFlex test" (PFT). This study aimed to prove that PFT modulates all relevant processes governing metabolic health thereby allowing to distinguish subjects with different metabolic health status. Therefore, 20 healthy and 20 type 2 diabetic (T2D) male subjects were challenged both by PFT and oral glucose tolerance test (OGTT). During the 8-h response time course, 132 parameters were quantified that report on 26 metabolic processes distributed over 7 organs (gut, liver, adipose, pancreas, vasculature, muscle, kidney) and systemic stress.

Results

In healthy subjects, 110 of the 132 parameters showed a time course response. Patients with T2D showed 18 parameters to be significantly different after overnight fasting compared to healthy subjects, while 58 parameters were different in the post-challenge time course after the PFT. This demonstrates the added value of PFT in distinguishing subjects with different health status. The OGTT and PFT response was highly comparable for glucose metabolism as identical amounts of glucose were present in both challenge tests. Yet the PFT reports on additional processes, including vasculature, systemic stress, and metabolic flexibility.

Conclusion

The PFT enables the quantification of all relevant metabolic processes involved in maintaining or regaining homeostasis of metabolic health. Studying both healthy subjects and subjects with impaired metabolic health showed that the PFT revealed new processes laying underneath health. This study provides the first evidence towards adopting the PFT as gold standard in nutrition research.

SUBMITTER: Wopereis S

PROVIDER: S-EPMC5576306 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge.

Wopereis Suzan S Stroeve Johanna H M JHM Stafleu Annette A Bakker Gertruud C M GCM Burggraaf Jacobus J van Erk Marjan J MJ Pellis Linette L Boessen Ruud R Kardinaal Alwine A F AAF van Ommen Ben B

Genes & nutrition 20170829

<h4>Background</h4>A key feature of metabolic health is the ability to adapt upon dietary perturbations. Recently, it was shown that metabolic challenge tests in combination with the new generation biomarkers allow the simultaneous quantification of major metabolic health processes. Currently, applied challenge tests are largely non-standardized. A systematic review defined an optimal nutritional challenge test, the "PhenFlex test" (PFT). This study aimed to prove that PFT modulates all relevant ...[more]

PMID: 28861127

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Project description:BackgroundEvidence is increasing that plant sterols and stanols not only lower fasting serum low-density lipoprotein concentrations, but also those of triglycerides (TG). Insight into effects of these components on postprandial TG metabolism, an emerging risk factor for cardiovascular disease, is missing.ObjectiveOur objective was to examine the 8-hour postprandial response after consuming plant sterol or stanol enriched margarine as part of a mixed meal.MethodsThis postprandial study was part of a randomized crossover study in which 42 subjects consumed plant sterol enriched (3 g/d plant sterols), plant stanol enriched (3 g/d plant stanols), and control margarines for 4 weeks. After each period, subjects consumed a shake enriched with 3g plant sterols (sterol period), 3g plant stanols (stanol period) or no addition (control period). Subjects received a second shake with no addition after 4 hours.ResultsTG and apoB48 incremental areas under the curves (iAUC) of the total (0-8h) and 1st meal response (0-4h) were comparable between the meals and in all age categories (I:18-35y, II:36-52y, III:53-69y). In subjects aged 53-69y, TG iAUC after the 2nd meal (4-8h) was higher in the stanol period as compared with the sterol (63.1±53.0 mmol/L/min; P < 0.01) and the control period (43.2±52.4 mmol/L/min; P < 0.05). ApoB48 iAUC after the 2nd meal was higher after the stanol than after the sterol period (67.1±77.0 mg/L/min; P < 0.05) and tended to be higher than after the control period (43.1±64.5 mg/L/min; P = 0.08) in subjects aged 53-69y. These increased postprandial responses may be due to reduced lipoprotein lipase activity, since postprandial apoCIII/II ratios were increased after stanol consumption compared with the control meal.ConclusionPostprandial TG and apoB48 responses are age-dependently increased after plant stanol consumption, which might be related to a changed clearance of triglyceride-rich lipoproteins.Trial registrationClinicalTrials.gov NCT01559428.

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Dataset Information

Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge.

Background

Results

Conclusion

Publications

Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge.

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