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Physical activity, postprandial metabolism and vascular function in insulin resistant states
Başlık:
Physical activity, postprandial metabolism and vascular function in insulin resistant states
Yazar:
Al-Mamari, Ali Saif Marhoon, author.
ISBN:
9780438060050
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (293 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Advisors: John Ross Petrie.
Özet:
Inefficient postprandial lipid metabolism of triglyceride-rich lipoproteins (TG- RL) is implicated in the pathogenesis of vascular dysfunction and atherosclerosis. Previous work has demonstrated that a single session of moderate exercise attenuates postprandial lipaemia in healthy individuals. This form of intervention has not previously been studied in insulin resistant states. This thesis therefore examines the effect of a prior single session of moderate exercise on lipoprotein metabolism and haemostatic factors in the postprandial state in lean and centrally obese subjects and in patients with type 2 diabetes. In addition, it examines the extent to which these effects are paralleled by changes in fasting and postprandial micro vascular endothelial function. Further studies were conducted to explore the relationship between habitual physical activity and forearm cutaneous microvascular endothelial function in patients with essential hypertension. The results showed that a single session of prior moderate exercise attenuates postprandial triglyceride-rich lipoprotein concentrations in both lean and centrally obese subjects. This reduction was mainly in the VLDLl-fraction in lean subjects and in the VLDLl and chylomicron fractions in centrally obese subjects. These changes were paralleled by an improvement in microvascular endothelial function in the fasting state in lean and centrally obese subjects, which extended to the postprandial state in lean subjects. No significant changes were detected in postprandial lipoprotein metabolism or forearm microvascular endothelial function in patients with type 2 diabetes. However, there was a reduction in glucose and insulin concentrations with improvement of insulin sensitivity as assessed by homeostasis model assessment (HOMA). Endothelial dysfunction in terms of acetylecholine (ACh) response in the cutaneous microvascular circulation was confirmed in male patients with essential hypertension, with no difference detected in female patients. In contrast to the hypothesis, habitual physical activity as assessed by uni-axial physical activity accelerometry did not reveal a significant association with endothelial function in patients with essential hypertension. Male patients with essential hypertension, however, had higher concentrations of thrombotic factors (fibrinogen, FVIIc), marker of endothelial activation (tissue plasminogen activator, (tPA)), and inflammatory markers (C-reactive protein (CRP)).Laser Doppler imaging (LDI) combined with iontophoresis (acetylcholine (ACh) and sodium nitroprusside (SNP)) is a valid non-invasive method for assessment of endothelial function. Its results are consistent with previous studies using other methods. It was able to detect small changes in endothelial responses after acute exercise and a high-fat meal. The studies carried out in this thesis are the first to my knowledge to address the effects of a prior moderate session of exercise on postprandial lipaemia in subjects with insulin resistant states (type 2 diabetes, central obesity), and on microvascular function as assessed with laser Doppler imaging combined with iontophoresis (ACh; endothelium dependent and SNP; endothelium-independent substances). They are also the first to use this method to assess forearm cutaneous microvascular function in patients with essential hypertension.
Notlar:
School code: 0547
Tüzel Kişi Ek Girişi:
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(684782.1) | 684782-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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