References of "Jandrain, Bernard"
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See detailComment j’explore …Une différence de risque de survenue d’un événement dans les études cliniques
SCHEEN, André ULg; ERNEST, Philippe ULg; JANDRAIN, Bernard ULg

in Revue Médicale de Liège (2012), 67(11), 597-602

Evidence-based medicine often requires the comparison of two therapeutic interventions in controlled clinical trials with the demonstration of a superiority (versus a placebo or an active comparator) or ... [more ▼]

Evidence-based medicine often requires the comparison of two therapeutic interventions in controlled clinical trials with the demonstration of a superiority (versus a placebo or an active comparator) or at least a non-inferiority (versus an active reference) concerning a primary endpoint that has been defined a priori (occurrence of a major clinical event, for instance). The difference in the occurrence of such an event between two treatments may be statistically analyzed by absolute risk reduction, relative risk reduction, hazard ratio or odds ratio. The present article discusses the nuances, sometimes of importance, concerning the significance of these various indices and analyses the cautions to be taken and the pitfalls to be avoided in their interpretation and use in practice. The clinician is, indeed, increasingly confronted to results of clinical trials, but is generally poorly informed regarding the nuances of these various statistical analyses. [less ▲]

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See detailInhibiteurs du cotransporteur du glucose SGLT rénal pour traiter le diabète de type 2
SCHEEN, André ULg; RADERMECKER, Régis ULg; ERNEST, Philippe ULg et al

in Revue Médicale Suisse (2011), 7(306), 1621-1629

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See detailStrategies pour eviter l'inertie et la non-observance dans les essais cliniques.
Jandrain, Bernard ULg; Ernest, Philippe ULg; Radermecker, Régis ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 246-9

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia ... [more ▼]

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia and to combat patient's non compliance, two pitfalls that may hinder the demonstration of the therapeutic efficacy of the drug. Clinical inertia may be limited by titration, forced or optional, driven by therapeutic targets, or by the use, if necessary, of rescue medications. Compliance may be verified by "pill count". This simple technique allows to exclude non compliant patients when they are detected during the placebo run-in period before randomisation or not to take into account patients with poor compliance in the final evaluation by using a statistical analysis restricted to individuals who have strictly adhered to the study protocol ("per protocol analysis"). Self-monitoring and patient's empowerment in the treatment also contribute to improve drug compliance. Clinicians may take advantage of these approaches derived from clinical trials to improve their daily practice. [less ▲]

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See detailOptimisation du traitement pharmacologique chez un patient avec un diabete de type 2 nouvellement diagnostique.
De Flines, Jenny ULg; Radermecker, Régis ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2009), 64(2), 109-14

The diabetic patient, when type 2 diabetes is newly diagnosed, raises a therapeutic problem commonly observed in clinical practice, which is more complex than expected at first glance. The physician has ... [more ▼]

The diabetic patient, when type 2 diabetes is newly diagnosed, raises a therapeutic problem commonly observed in clinical practice, which is more complex than expected at first glance. The physician has to select the most appropriate antidiabetic oral agent as first choice, to consider the potential of using combined glucose-lowering therapies, to fix glycaemic target taking into account the individual benefit/risk ratio, and to offer the best protection against cardiovascular complications. The present clinical case illustrates such therapeutic problem describing a patient with a high cardiovascular risk profile who experienced a hypoglycaemic episode after the prescription of glibenclamide following the discovery of a moderate hyperglycaemia. [less ▲]

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See detailL'etude clinique du mois. Controle glycemique et morbimortalite cardio-vasculaire chez le patient diabetique de type 2. Resultats des etudes ACCORD, ADVANCE et VA-Diabetes.
Radermecker, Régis ULg; Philips, Jean-Christophe ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2008), 63(7-8), 511-8

Type 2 diabetes is associated with a high risk of complications, essentially macrovascular events. Surprisingly, the effect of improved glucose control on coronary and cerebrovascular complications in ... [more ▼]

Type 2 diabetes is associated with a high risk of complications, essentially macrovascular events. Surprisingly, the effect of improved glucose control on coronary and cerebrovascular complications in this population remains questionable. Furthermore, the target level of glycated haemoglobin (HbA1c) to minimise the risk of diabetic complications is controversial. We report the results of three recent randomised control trials (ACCORD, ADVANCE, Veterans Affairs Diabetes), which assessed the impact on cardiovascular events of intensive glucose-lowering therapy. None of these studies was able to demonstrate a significant reduction of cardiovascular events in the intensive group as compared to the standard group. On the contrary, in ACCORD, the study with the most ambitious goal (HbA1c < 6%), the overall and cardiovascular mortality was greater in the intensive group. In contrast, in the ADVANCE trial, the mortality and the incidence of cardiovascular events were not statistically different between the two treatment groups, whereas the risk of microangiopathic complications, especially nephropathy, was significantly decreased in the intensive group (HbA1c < or = 6.5%, with modified release gliclazide as main treatment). Finally, VA-Diabetes showed that the effect of better glucose control on cardiovascular complications disappeared with duration of the disease and that the risk of cardiovascular events increased in patients with severe hypoglycaemic episodes. In the three studies, the hypoglycaemic risk was indeed increased in the intensive group, which may contribute to reduce the positive impact of better glucose control on cardiovascular complications. The best way to protect type 2 diabetic patients against coronary and cerebrovascular disease is to target all cardiovascular risk factors. [less ▲]

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See detailLe cerveau, un organe gluco-dependant. Effets deleteres de l'hypoglycemie et de l'hyperglycemie.
Radermecker, Régis ULg; Philips, Jean-Christophe ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 280-6

Glucose is almost the only energy substrate for the brain. Such glucose dependence explains why any large variation of plasma glucose levels could lead to cerebral dysfunction, which may be severe and ... [more ▼]

Glucose is almost the only energy substrate for the brain. Such glucose dependence explains why any large variation of plasma glucose levels could lead to cerebral dysfunction, which may be severe and progress to a coma. Hypoglycaemic coma, the most common one, has a pure metabolic origin (neuroglucopenia) whereas hyperglycaemic coma is more complex and mainly due to osmotic disturbances. Besides acute changes of plasma glucose concentrations, it is generally recognized that more subtle chronic or recurrent glucose abnormalities could also result in brain dysfunction. However, such clinical consequences are more difficult to assess in clinical practice. Nevertheless, learning perturbations in young patients with type 1 diabetes and memory losses, sometimes severe and subject to progress to dementia ("diabetic encephalopathy") in older type 1 or type 2 diabetic patients, have been reported, although with some controversy. The present paper summarizes the current knowledge of both acute and chronic cerebral dysfunctions following perturbations of blood glucose levels in diabetic patients. [less ▲]

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See detailPrevention des hypoglycemies chez le patient diabetique de type 1.
Radermecker, Régis ULg; Jandrain, Bernard ULg; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2003), 58(6), 361-8

Hypoglycaemia is the most common metabolic disorder in type 1 diabetic patients. It is rarely dangerous, but significantly alters the quality of life and hinders the achievement of "normoglycaemia". Even ... [more ▼]

Hypoglycaemia is the most common metabolic disorder in type 1 diabetic patients. It is rarely dangerous, but significantly alters the quality of life and hinders the achievement of "normoglycaemia". Even if hypoglycaemia is impossible to be avoided, both its frequency and severity may be reduced if patients follow several practical recommendations. After having defined hypoglycaemia, we shall briefly describe its pathophysiology and its main causes in type 1 diabetic patients. Afterwards, the different approaches of prevention of hypoglycaemia will be discussed. We will particularly stress the need to revise the glycaemic target in high-risk patients, the role of optimising insulin therapy, the valuable help of blood glucose monitoring, the critical support of diet adjustments, and the appropriate management in case of physical activity. There is no doubt that patient's education plays a crucial role in such a strategy that aims at preventing severe hypoglycaemia in type 1 diabetic individuals. [less ▲]

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See detailAlcool, sensibilite a l'insuline et diabete sucre.
Magis, Delphine ULg; Jandrain, Bernard ULg; Scheen, André ULg

in Revue Médicale de Liège (2003), 58(7-8), 501-7

The relationship between alcohol consumption and insulin resistance shows a U-shaped curve: insulin resistance is minimal in individuals with regular mild to moderate alcohol consumption and increases in ... [more ▼]

The relationship between alcohol consumption and insulin resistance shows a U-shaped curve: insulin resistance is minimal in individuals with regular mild to moderate alcohol consumption and increases in both heavy drinkers and subjects without any alcohol consumption. These favourable metabolic effects on insulin sensitivity of moderate alcohol consumption may explain the significant reduction in the development of type 2 diabetes and the risk of cardiovascular complications reported in numerous epidemiological studies. This latter effect has also reported in patients with diabetes mellitus, although this observation remains controversial. However, alcohol consumption could increase the global risk of hypoglycaemia, both in the fasting state and after a meal (reactive hypoglycaemia) in both diabetic and nondiabetic subjects. These latter effects may result from a direct inhibition of gluconeogenesis, from a reduced secretion of counterregulatory hormones and/or from an alcohol-induced inappropriate behaviour. [less ▲]

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See detailApproches pharmacologiques de prévention du diabète de type 2.
SCHEEN, André ULg; PAQUOT, Nicolas ULg; LETIEXHE, Michel ULg et al

in Médecine et Hygiène (2002), 60

L’augmentation rapide de la prévalence du diabète de type 2 impose la mise en place de stratégies de prévention. Outre les mesures hygiéno-diététiques, essentielles, diverses approches pharmacologiques ... [more ▼]

L’augmentation rapide de la prévalence du diabète de type 2 impose la mise en place de stratégies de prévention. Outre les mesures hygiéno-diététiques, essentielles, diverses approches pharmacologiques ont apporté récemment la preuve d’une certaine efficacité chez les sujets à risque de par la présence d’un excès pondéral et/ou d’une diminution de la tolérance au glucose. C’est le cas de plusieurs antidiabétiques oraux comme la metformine, l’acarbose ou encore la troglitazone. C’est également le cas de médicaments anti-obésité comme l’orlistat et, peut-être aussi, la sibutramine. L’inhibition du système rénine-angiotensine par un inhibiteur de l’enzyme de conversion ou par un antagoniste sélectif des récepteurs AT1 peut aussi, outre protéger contre les complications cardiovasculaires, prévenir l’apparition d’un diabète de type 2. Enfin, le rôle des médicaments hypolipidémiants reste controversé. De nouvelles études prospectives sont en cours pour confirmer ces résultats. [less ▲]

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See detailComment j'explore ... Le risque d'un patient d'evoluer vers un diabete de type 2.
Scheen, André ULg; Paquot, Nicolas ULg; Jandrain, Bernard ULg

in Revue Médicale de Liège (2002), 57(2), 113-5

Both the prevalence and the incidence of type 2 diabetes are increasing rapidly. Effective prevention measures, including lifestyle or drug prescription, have been recently reported. It is thus important ... [more ▼]

Both the prevalence and the incidence of type 2 diabetes are increasing rapidly. Effective prevention measures, including lifestyle or drug prescription, have been recently reported. It is thus important to detect at risk individuals in order to provide appropriate diet and exercise recommendations or even pharmacological treatment. We summarize the most useful indices based on anamnesis, clinical examination and biological assays that can help to detect subjects at high risk of progression towards type 2 diabetes. [less ▲]

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See detailL'hyperglycemie post-prandiale. I. Physiopathologie, consequences cliniques et approaches dietetiques.
Scheen, André ULg; Paquot, Nicolas ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2002), 57(3), 138-41

Postprandial hyperglycaemia depends on the amount and type of ingested carbohydrates and/or the degree of inhibition of hepatic glucose output following a meal. The kinetics of carbohydrate absorption is ... [more ▼]

Postprandial hyperglycaemia depends on the amount and type of ingested carbohydrates and/or the degree of inhibition of hepatic glucose output following a meal. The kinetics of carbohydrate absorption is directly influenced by the type of food (carbohydrates with variable glycaemic indices, fibre content of the meal) and by the speed of gastric emptying. Hepatic glucose output is remarkably inhibited by insulin and strongly stimulated by glucagon. It remains abnormally high after a meal in diabetic patients because of insufficient portal insulin concentrations, hepatic insulin resistance and/or hyperglucagonaemia. In diabetic patients, postprandial hyperglycaemia contributes to the aggravation of chronic hyperglycaemia, and thus to the increase of glycated haemoglobin levels. Furthermore, it has been recently demonstrated that postprandial hyperglycaemia increases the cardiovascular risk, even in nondiabetic subjects, probably by inducing endothelial dysfunction. Appropriate dietary counselling plays a key-role in the control of postprandial hyperglycaemia. Generally speaking, it includes a selection of carbohydrates with low glycaemic index and a higher fibre intake. Pharmacological interventions may also be considered when necessary. [less ▲]

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See detailL'hyperglycemie post-prandiale. II. Approches therapeutiques medicamenteuses.
Scheen, André ULg; Letiexhe, Michel ULg; Geronooz, I. et al

in Revue Médicale de Liège (2002), 57(4), 196-201

Besides dietary approaches, various pharmacological means have been recently developed in order to better control postprandial hyperglycaemia. This objective may be obtained: 1) by slowing down the ... [more ▼]

Besides dietary approaches, various pharmacological means have been recently developed in order to better control postprandial hyperglycaemia. This objective may be obtained: 1) by slowing down the intestinal absorption of carbohydrates; 2) by insuring a better insulin priming soon after the meal; and 3) by inhibiting post-prandial glucagon secretion or action. Some hormones (amylin, glucagon-like peptide-1) can slow gastric emptying while alpha-glucosidase inhibitors (acarbose, miglitol) retard intestinal digestion and resorption of complex carbohydrates. A more physiological post-meal profile of insulin may be obtained in type 2 diabetes by using new insulin secretagogues of the glinide family (repaglinide, nateglinide) with an earlier and shorter insulinotropic action or, mainly in type 1 diabetes but also in type 2 diabetes, by using short-acting insulin analogues (lispro. Asp B28) or inhated insulin the action of which is faster than that of subcutaneous insulin. Post-prandial glucagon secretion can be inhibited by amylin. GLP-1 or insulin while other glucagon antagonists are currently in development. [less ▲]

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See detailContrôle pharmacologique de l’hyperglycémie postprandiale
SCHEEN, André ULg; JANDRAIN, Bernard ULg; PAQUOT, Nicolas ULg et al

in Médecine et Hygiène (2001), 59

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See detailAdaptations hormono-metaboliques a l'exercice musculaire.
Scheen, André ULg; Jandrain, Bernard ULg

in Revue Médicale de Liège (2001), 56(4), 195-9

Physical exercise induces numerous metabolic and hormonal changes that may be influenced by various factors, among which the intensity and the duration of the exertion seem to play a major role besides ... [more ▼]

Physical exercise induces numerous metabolic and hormonal changes that may be influenced by various factors, among which the intensity and the duration of the exertion seem to play a major role besides the possible influence of the intake of exogenous substrates. Such modifications are necessary to satisfy the marked increase in energy demand by exercising muscles, while maintaining plasma glucose concentrations within physiological range. The purpose of the present concise review is to analyse the most important fuel-hormonal adaptations observed during short heavy muscular exercise or during prolonged exercise of moderate intensity as well as those observed after physical training in normal subjects. [less ▲]

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See detailPratique de l'exercice musculaire chez le patient diabetique.
Jandrain, Bernard ULg; Scheen, André ULg

in Revue Médicale de Liège (2001), 56(5), 300-5

Muscular exercise is recommended in patients with type 1 or type 2 diabetes mellitus and is part of the overall management, in combination with diet, oral antidiabetic agents and/or insulin. From a ... [more ▼]

Muscular exercise is recommended in patients with type 1 or type 2 diabetes mellitus and is part of the overall management, in combination with diet, oral antidiabetic agents and/or insulin. From a pathophysiological point of view, regular physical activity enhances insulin sensitivity, thus contributing to improve blood glucose control and to reduce cardiovascular risk factors associated to diabetes mellitus. From a practical point of view, however, muscular exercise in a diabetic patient requires special caution, in particular careful selection of the type of exercise, respect of metabolic and/or cardiovascular contraindications, and appropriate adjustment of current pharmacological/dietary treatment. [less ▲]

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See detailUn sujet obese par une approche multidisciplinaire: l'exemple du Centre de l'Obesite du CHU Ourthe-Ambleve.
Scheen, André ULg; Rorive, Marcelle ULg; Letiexhe, Michel ULg et al

in Revue Médicale de Liège (2001), 56(7), 474-9

Obesity is a mulfactorial disease whose prevalence is progressively increasing. Ideally, it requires a multidisciplinary management by medical doctors, dieticians, psychologists and kinetherapists. The ... [more ▼]

Obesity is a mulfactorial disease whose prevalence is progressively increasing. Ideally, it requires a multidisciplinary management by medical doctors, dieticians, psychologists and kinetherapists. The new "Centre de l'Obesite" at the University of Liege aims at fulfilling such objectives with: 1) a first outpatient visit including the simultaneous participation of an endocrinologist, a dietician and a psychologist; 2) a structured and individualized programme of physical rehabilitation; 3) an individualized management of obese subjects as in-(hospital) and/or outpatients, using medical and/or surgical approaches; and 4) an opportunity to benefit of other specialized medical advices, if necessary, in order to increase both the efficacy and safety of the treatment. Owing to the increasing importance of obesity and the well-known difficulties to succeed in treating it, general practitioners should consider this new centre as a valuable help rather than a competitive structure for the management of their patients, especially those with severe or morbid obesity. [less ▲]

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See detailComment j'explore ... les differentes formes de diabete sucre: diagnostic differentiel clinique et biologique.
Scheen, André ULg; Philips, Jean-Christophe ULg; Luyckx, Françoise ULg et al

in Revue Médicale de Liège (2001), 56(9), 650-5

Owing to the increasing prevalence of diabetes mellitus and the various aspects of this disease, we present a practical approach which allows the clinician to more easily differentiate type 1 diabetes ... [more ▼]

Owing to the increasing prevalence of diabetes mellitus and the various aspects of this disease, we present a practical approach which allows the clinician to more easily differentiate type 1 diabetes, type 2 diabetes and secondary diabetes of pancreatic origin, i.e. the most common forms of diabetes mellitus. Such an approach uses simple diagnostic criteria, based upon both clinical characteristics (family history, personal history, clinical presentation) and biological markers (C-peptide, autoantibodies,...). A right diagnosis should allow to optimize the management of the diabetic patient. [less ▲]

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See detailAvailability of glucose ingested during muscle exercise performed under acipimox-induced lipolysis blockade.
Gautier, J. F.; Pirnay, Freddy ULg; Jandrain, Bernard ULg et al

in European Journal of Applied Physiology and Occupational Physiology (1994), 68(5), 406-12

This study investigated the percentage of carbohydrate utilization than can be accounted for by glucose ingested during exercise performed after the ingestion of the potent lipolysis inhibitor Acipimox ... [more ▼]

This study investigated the percentage of carbohydrate utilization than can be accounted for by glucose ingested during exercise performed after the ingestion of the potent lipolysis inhibitor Acipimox. Six healthy male volunteers exercised for 3 h on a treadmill at about 45% of their maximal oxygen uptake, 75 min after having ingested 250 mg of Acipimox. After 15-min adaptation to exercise, they ingested either glucose dissolved in water, 50 g at time 0 min and 25 g at time 60 and 120 min (glucose, G) or sweetened water (control, C). Naturally labelled [13C]glucose was used to follow the conversion of the ingested glucose to expired-air CO2. Acipimox inhibited lipolysis in a similar manner in both experimental conditions. This was reflected by an almost complete suppression of the exercise-induced increase in plasma free fatty acid and glycerol and by an almost constant rate of lipid oxidation. Total carbohydrate oxidation evaluated by indirect calorimetry, was similar in both experimental conditions [C, 182, (SEM 21); G, 194 (SEM 16) g.3 h-1], as was lipid oxidation [C, 57 (SEM 6); G, 61 (SEM 3) g.3 h-1]. Exogenous glucose oxidation during exercise G, calculated by the changes in 13C:12C ratio of expired air CO2, averaged 66 (SEM 5) g.3 h-1 (19% of the total energy requirement). Consequently, endogenous carbohydrate utilization was significantly smaller after glucose than after placebo ingestion: 128 (SEM 18) versus 182 (SEM 21) g.3 h-1, respectively (P < 0.05). Symptoms of intense fatigue and leg cramps observed with intake of sweet placebo were absent with glucose ingestion.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailRelationships between metabolic clearance rate of insulin and body mass index in a female population ranging from anorexia nervosa to severe obesity.
Castillo, M. J.; Scheen, André ULg; Jandrain, Bernard ULg et al

in International Journal of Obesity & Related Metabolic Disorders (1994), 18(1), 47-53

Changes in the metabolic clearance rate of insulin (MCRI) have been described in several pathological conditions. Conflicting data suggest that they may be related to either body mass index (BMI) or body ... [more ▼]

Changes in the metabolic clearance rate of insulin (MCRI) have been described in several pathological conditions. Conflicting data suggest that they may be related to either body mass index (BMI) or body composition. This study aimed to investigate the relationship between the MCRI and BMI in an exclusively female population showing a wide range of BMI. For that purpose, hyperinsulinemic normoglycemic glucose clamps were performed in nine anorectic subjects (BMI: 14.5 +/- 0.8 kg/m2), 11 healthy volunteers (BMI: 20.3 +/- 0.5 kg/m2) and 12 obese patients (BMI: 33.0 +/- 0.9 kg/m2). To exclude any influence of the menstrual cycle on the MCRI, five healthy women underwent three tests at different days of the menstrual cycle: menstruation period, late follicular pre-ovulatory phase and luteal phase, in random order. The MCRI, which was quite reproducible in a given subject, was not significantly modified by the menstrual cycle. In the premenopausal female population studied, the mean (+/- s.e.m.) MCRI normalized for body weight (kg) were 35.4 +/- 3.4, 24.7 +/- 1.8 and 14.0 +/- 1.0 ml/kg/min (P < 0.01) for anorectic subjects, healthy volunteers and obese patients, respectively. These differences were maintained when the MCRI was normalized according to corporeal surface (m2) (1018 +/- 75, 859 +/- 67, 638 +/- 40 ml/m2/min, P < 0.01) or lean body mass (kg) (37.1 +/- 3.4, 32.6 +/- 2.7 and 24.1 +/- 0.5 ml/kgLBM/min, P < 0.01), but disappeared when MCRI was expressed per kg of ideal body weight (24.6 +/- 2.2, 24.6 +/- 2.1 and 22.4 +/- 1.4 ml/kgIBW/min, n.s.).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailEndogenous substrate oxidation during exercise and variations in breath 13CO2/12CO2.
Gautier, J. F.; Pirnay, Freddy ULg; Jandrain, Bernard ULg et al

in Journal of Applied Physiology (Bethesda, Md. : 1985) (1993), 74(1), 133-8

This study attempted to induce a major shift in the utilization of endogenous substrates during exercise in men by the use of a potent inhibitor of adipose tissue lipolysis, Acipimox, and to see to what ... [more ▼]

This study attempted to induce a major shift in the utilization of endogenous substrates during exercise in men by the use of a potent inhibitor of adipose tissue lipolysis, Acipimox, and to see to what extent this affects the 13C/12C ratio in expired air CO2. Six healthy volunteers exercised for 3 h on a treadmill at approximately 45% of their maximum O2 uptake, 75 min after having ingested either a placebo or 250 mg Acipimox. The rise in plasma free fatty acids and glycerol was almost totally prevented by Acipimox, and no significant rise in the utilization of lipids, evaluated by indirect calorimetry, was observed. Total carbohydrate oxidation averaged 128 +/- 17 (placebo) and 182 +/- 21 g/3 h (Acipimox). Conversely, total lipid oxidation was 84 +/- 5 (placebo) and 57 +/- 6 g/3 h (Acipimox; P < 0.01). Under placebo, changes in expired air CO2 delta 13C were minimal, with only a 0.49/1000 significant rise at 30 min. In contrast, under Acipimox, the rise in expired air CO2 delta 13C averaged 1/1000 and was significant throughout the 3-h exercise bout; in these conditions calculation of a "pseudooxidation" of an exogenous sugar naturally or artificially enriched in 13C, but not ingested, would have given an erroneous value of 19.8 +/- 2.6 g/3 h. Thus under conditions of extreme changes in endogenous substrate utilization, an appropriate control experiment is mandatory when studying exogenous substrate oxidation by 13C-labeled substrates and isotope-ratio mass spectrometry measurements on expired air CO2. [less ▲]

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