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Determinants of whole-body protein metabolism in subjects with and without type 2 diabetes. | LitMetric

Determinants of whole-body protein metabolism in subjects with and without type 2 diabetes.

Diabetes Care

McGill Nutrition and Food Science Centre, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada.

Published: January 2008

AI Article Synopsis

  • The study investigates how factors like glycemia, insulin resistance, and waist circumference affect whole-body protein metabolism in individuals with and without type 2 diabetes.
  • Researchers measured protein turnover in lean and obese subjects on a controlled diet, finding that those with type 2 diabetes had higher protein turnover but lower net balance compared to those without diabetes.
  • Results suggest that men with type 2 diabetes experience worsened protein metabolism with higher blood sugar levels, while larger hip circumferences in women may offer some protection, indicating that dietary protein needs may be higher for diabetics.

Article Abstract

Objective: Whole-body protein metabolism is abnormal in suboptimally controlled type 2 diabetes and obesity. We hypothesized that glycemia, insulin resistance, and waist circumference modulate these alterations in type 2 diabetes and, to a lesser extent, in individuals without type 2 diabetes.

Research Design And Methods: In 88 lean and obese subjects without and 40 with type 2 diabetes on an inpatient protein-controlled isoenergetic diet for 7 days, whole-body protein turnover was measured using the fed-fasted 60-h oral (15)N-glycine method. Nitrogen flux was determined from urinary (15)N urea and protein synthesis, breakdown and net balance calculated. Indexes of diabetes control, resting energy expenditure (REE), and body composition were assessed.

Results: Higher protein turnover in obese subjects was further increased, and net balance was lower in type 2 diabetes. Waist-to-hip ratio and ln homeostasis model assessment of insulin resistance (HOMA-IR) explained 40% of the variance in flux in type 2 diabetes; fat-free mass and lnHOMA-IR explained 62% in subjects without type 2 diabetes. Overall, fasting glucose explained 16% of the variance in net balance. In type 2 diabetes, net balance correlated negatively with fasting glucose in men and positively with hip circumference in women.

Conclusions: Kinetics of whole-body protein metabolism are elevated, and net balance is diminished in type 2 diabetes, independently of obesity. Elevated flux is associated with greater visceral adiposity, REE, and insulin resistance of glucose. In type 2 diabetic men, these alterations worsened with magnitude of hyperglycemia. In type 2 diabetic women, larger hip circumferences may protect against such alterations. Our findings suggest that dietary protein requirements may be greater in type 2 diabetes to offset a reduced net balance, aggravated as glycemia increases, especially in men.

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Source
http://dx.doi.org/10.2337/dc07-1268DOI Listing

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