Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: Role of fat and carbohydrate meals
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Objectives To compare the effect of a high-fat meal and a high-carbohydrate meal (pizza), with and without antioxidant vitamins, on endothelial activation in healthy subjects and in patients with type 2 diabetes mellitus.Background The postprandial state is becoming increasingly acknowledged to affect some early events of atherogenesis.Methods In a randomized, observer-blinded, crossover study, 20 newly diagnosed type 2 diabetic patients and 20 age- and gender-matched healthy subjects received two meals at one-week intervals: a high-fat meal (760 calories) and an isoenergetic high-carbohydrate meal (non-cheese pizza). In all subjects, the same meals were repeated immediately following ingestion of vitamin E, 800 IU, and ascorbic acid, 1,000 mg.Results In normal subjects, the high-fat meal increased the plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), which were prevented by vitamins. No change in these parameters occurred after pizza ingestion or pizza ingestion with vitamins. In diabetic patients, basal concentrations of glucose, cytokines and adhesion molecules were significantly higher than in nondiabetic controls. Both meals significantly increased cytokine and adhesion molecule levels, but the increase was more sustained following the high-fat meal. There was no significant change from baseline when vitamin supplementation accompanied each meal. There was a relationship between changes in serum triglycerides and changes in TNF-alpha (r = 0.39, p < 0.01), IL-6 (r = 0.28, p < 0.05) and VCAM-1 (r = 0.25, p < 0.05), and between changes in plasma glucose and changes in IL-6 (r = 0.36, p < 0.01) and ICAM-1 (r = 0.31, p < 0.02).Conclusions An oxidative mechanism mediates endothelial activation induced by post-meal hyperlipidemia and hyperglycemia.
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Postprandial hypertriglyceridemia has been reported to impair endothelial function in normal and diabetic subjects.
“Similarly, a negative influence of postprandial hypertriglyceridemia on endothelial function has been reported in both normal and diabetic subjects.”
In diabetic patients, postprandial hyperglycemia and hypertriglyceridemia each contribute independently and additively to endothelial dysfunction accompanied by oxidative stress and inflammation.
“This study confirms that in diabetic patients both postprandial hyperglycemia and hypertriglyceridemia have an independent and cumulative effect in favoring endothelial dysfunction accompanied by generation of oxidative stress and inflammation.”
Quercetin at 1 g per day for 21 days failed to attenuate muscle inflammation in ultramarathon runners and trained cyclists.
“Quercetin (1 g/d for 21 d) failed to attenuate muscle inflammation in ultramarathon runners (807) and in trained cyclists (808,809) .”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [807]
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- Authors
- Nappo, F., Esposito, K., Cioffi, M., Giugliano, G., Molinari, A. M., Paolisso, G., Marfella, R., & Giugliano, D.
- Affiliations
- University of Campania "Luigi Vanvitelli" (IT)
- Corresponding author
- Giugliano, Dario
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 39
- Issue
- 7
- Pages
- 1145-1150
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2061278204
- Cited by
- 555
- References
- 30
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 9 · 2022: 13 · 2021: 13 · 2020: 19 · 2019: 22 · 2018: 17 · 2017: 29 · 2016: 25 · 2015: 34 · 2014: 24 · 2013: 44 · 2012: 28
- FWCI
- 16.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Università degli Studi di Napoli Federico II
- Seconda Università degli Studi di Napoli
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- type 2 diabetes, high-fat meal, high-carbohydrate meal, pizza, antioxidant vitamins, vitamin E, vitamin C, TNF-α, interleukin-6, adhesion molecules, ICAM-1, VCAM-1, hyperlipidemia, hyperglycemia, oxidative stress, atherogenesis
- MeSH terms
- Adult, Antioxidants, Ascorbic Acid, Blood Glucose, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Dietary Fats, Endothelium, Vascular, Female, Humans, Male, Middle Aged, Tumor Necrosis Factor-alpha, Vitamin E, Interleukin-6, Cross-Over Studies, Intercellular Adhesion Molecule-1, Vascular Cell Adhesion Molecule-1, Postprandial Period
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