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2. Nutritional Evaluation and Optimisation in Neonates (NEON) trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition: a randomised double-blind controlled trial

Author

Sabita Uthaya, Xinxue Liu, Daphne Babalis, Caroline Dore, Jane Warwick, Jimmy Bell, Louise Thomas, Deborah Ashby, Giuliana Durighel, Ash Ederies, Monica Yanez-Lopez, and Neena Modi

Subjects
parenteral nutrition, amino acids, preterm infants, randomised double-blind controlled trial, intralipid, smoflipid, Medicine
Abstract

Background: Parenteral nutrition (PN) is central to the care of very immature infants. Early intakes of higher amounts of amino acids and the use of lipid emulsions containing fish oils are recommended by current international recommendations. Objective: To confirm the safety and demonstrate efficacy of the immediate introduction of the recommended daily intake of amino acids (Imm-RDI) and soya bean oil, medium-chain triglycerides, olive oil and fish oil lipid in PN to increase non-adipose (lean) body mass and decrease intrahepatocellular lipid (IHCL) content. Design: Multicentre, double-blind, 2 × 2 factorial and randomised controlled trial (RCT). Setting: Neonatal units in London and south-east England, UK. Participants: Extremely preterm infants born before 31 weeks of gestation without major congenital or life-threatening abnormalities who could to be randomised to receive PN within 24 hours of birth. Interventions: Infants were randomised within 24 hours of birth to receive PN containing either high [RDI of amino acids (Imm-RDI)] or low [incremental amino acids (Inc-AA) control] levels of amino acids. In addition, infants were randomised to receive either 20% SMOFlipid® (Fresenius Kabi AG, Richmond Hill, ON, Canada) or 20% Intralipid® (Fresenius Kabi AG, Richmond Hill, ON, Canada) (control). This resulted in four groups: (1) Inc-AA/Intralipid, (2) Inc-AA/SMOFlipid, (3) Imm-RDI/Intralipid and (4) Imm-RDI/SMOFlipid. The intervention was continued until infants were receiving 150 ml/kg/day of enteral feeds for 24 hours. Primary outcome measure: For the amino acid intervention, this was non-adipose or lean body mass measured by magnetic resonance imaging. For the lipid composition intervention, this was IHCL content as measured by hepatic magnetic resonance spectroscopy. Primary outcomes were measured at term age equivalent, between 37 and 44 weeks postmenstrual age. Results: We randomised 168 infants born before 31 weeks of gestation. We evaluated outcomes, at term, in 133 infants. There were no significant differences in non-adipose mass between the Imm-RDI and Inc-AA groups [adjusted mean difference 1.0 g, 95% confidence interval (CI) –108 to 111 g] or in levels of IHCLs between the SMOFlipid and Intralipid groups (adjusted mean SMOFlipid to Intralipid ratio 1.1, 95% CI 0.8 to 1.6). Infants receiving the Imm-RDI were more likely than Inc-AA infants to have blood urea nitrogen levels > 7 mmol/l [75% vs. 49% (p 10 mmol/l [49% vs. 18% (p

Published
2016
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3. Abstracts of the Heart Failure 2019 and the World Congress on Acute Heart Failure, 25-28 May 2019, Megaron Athens International Conference Centre, Greece

Author

KYRYLO MIKHALIEV, AAYUSH SINGAL, Joanna Jaroch, Marta Wleklik, Ewa A Jankowska, Agnieszka Slawuta, Pawel Gac, Anna Szymanska-Chabowska, Svetlana Alexandrova, Mateusz Sokolski, Georgios Rampidis, Samir Rafla, María Abellás Sequeiros, Magdalena Lisiak, Anton Borisov, Ekaterina Gitelzon, Justyna Sokolska, Daniela Supe Domic, Robert Zymlinski, Ekaterina Kartamyscheva, Marcin Drozd, KATARZYNA LOMPER, Jimmy Bell, Lina Venceviciene, Thomas Alexander Gerds, Lorna Cassidy, Lidia Malinova, Izabella Uchmanowicz, Cenk Sari, Anura Malaweera, Job Van der Palen, Loreena Hill, Oksana Kalashnykova, Panagiotis Simitsis, Anna Chudiak, Vincenzo Ezio SANTOBUONO, Tim Eijgenraam, Jan Biegus, and Beata Jankowska-Polanska

Subjects
medicine.medical_specialty, business.industry, medicine.disease, Abstracts Programme, Heart failure, Internal medicine, Cardiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business, Acute dyspnea, ACID-BASE BALANCE DISORDERS, Acid–base imbalance
Published
2020

4. Genome-Wide and Abdominal Imaging Data Characterizes Common Alleles Associated with Higher BMI and Subcutaneous Fat but Less Liver Fat and Lower Risk of Type 2 Diabetes

Author

Ewan R. Pearson, Dennis Mook-Kanamori, Jessica Tyrrell, Yingjie Ji, Hanieh Yaghootkar, Alex I. Blakemore, Louise Thomas, Karla V. Allebrandt, Jimmy Bell, Renée De Mutsert, Samuel E. Jones, Beaumont Rn, Andrianos M. Yiorkas, H Staiger, Francesca Frau, Andrew R. Wood, Timothy M. Frayling, and Norbert Stefan

Subjects
medicine.medical_specialty, biology, Adiponectin, business.industry, Endocrinology, Diabetes and Metabolism, Genome-wide association study, Type 2 diabetes, Lower risk, medicine.disease, Body fat percentage, Sex hormone-binding globulin, Endocrinology, Alanine transaminase, Internal medicine, Internal Medicine, biology.protein, Medicine, Allele, business
Abstract

Genetic studies have identified “favourable adiposity” variants - where the allele associated with higher adiposity is associated with lower risk of type 2 diabetes. We took a novel approach to find more of these alleles and find the underlying mechanisms. We first performed a genome wide association study (GWAS) of body fat percentage using 451000 individuals from UK Biobank. Second, we used published genetic data in a multivariate test to find alleles associated with higher adiposity but a “favourable” metabolic phenotype: higher HDL-C, adiponectin, sex hormone binding globulin, but lower triglycerides, fasting insulin and alanine transaminase. Third, we used abdominal imaging data from 4 studies to define the adiposity phenotype in more detail. We identified 620 variants associated with body fat percentage (p “Favourable adiposity” alleles associated with higher BMI but lower risk of type 2 diabetes are characterized by higher subcutaneous but lower liver fat. Disclosure H. Yaghootkar: None. Y. Ji: None. A.M. Yiorkas: None. F. Frau: None. D. Mook-Kanamori: None. R. de Mutsert: None. J. Tyrrell: None. S.E. Jones: None. R. Beaumont: None. A.R. Wood: None. L. Thomas: None. K.V. Allebrandt: None. N. Stefan: Consultant; Self; Merck Sharp & Dohme Corp.. Speaker's Bureau; Self; Novo Nordisk A/S. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, OmniaMed Ltd.. H. Staiger: None. E. Pearson: Speaker's Bureau; Self; Eli Lilly and Company. A.I. Blakemore: None. J.D. Bell: None. T.M. Frayling: None.

Published
2018

5. Angiotensin-converting-enzyme gene insertion/deletion polymorphism and response to physical training

Author

Hugh Montgomery, Peter Clarkson, Maria Barnard, Jimmy Bell, Audrey Brynes, Joseph Hajnal, Harry Hemingway, Dawn Mercer, Paul Jarman, Richard Marshall, Krishna Prasad, Mark Rayson, Nadeem Saeed, Louise Thomas, Mick Jubb, Michael World, Claire Dollery, Phillipa Talmud, and Steve Humphries

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Genotype, Anabolism, Adipose tissue, Bradykinin, Physical exercise, Peptidyl-Dipeptidase A, Biology, Cohort Studies, Renin-Angiotensin System, chemistry.chemical_compound, Insulin resistance, Internal medicine, medicine, Humans, Allele, Muscle, Skeletal, Physical Education and Training, Polymorphism, Genetic, Angiotensin-converting enzyme, General Medicine, medicine.disease, Military Personnel, Endocrinology, Adipose Tissue, chemistry, Body Composition, Physical Endurance, biology.protein, Energy Metabolism, Gene Deletion
Abstract

Summary Background The function of local renin-angiotensin systems in skeletal muscle and adipose tissue remains largely unknown. A polymorphism of the human angiotensin converting enzyme (ACE) gene has been identified in which the insertion ( I ) rather than deletion ( D ) allele is associated with lower ACE activity in body tissues and increased response to some aspects of physical training. We studied the association between the ACE gene insertion or deletion polymorphism and changes in body composition related to an intensive exercise programme, to investigate the metabolic effects of local human renin-angiotensin systems. Methods We used three independent methods (bioimpedance, multiple skinfold-thickness assessment of whole-body composition, magnetic resonance imaging of the mid-thigh) to study changes in body composition in young male army recruits over 10 weeks of intensive physical training. Findings Participants with the II genotype had a greater anabolic response than those with one or more D alleles for fat mass (0·55 vs −0·20 kg, p=0·04 by bioimpedance) and non-fat mass (1·31 vs −0·15 kg, p=0·01 by bioimpedance). Changes in body morphology with training measured by the other methods were also dependent on genotype. Interpretation II genotype, as a marker of low ACE activity in body tissues, may conserve a positive energy balance during rigorous training, which suggests enhanced metabolic efficiency. This finding may explain some of the survival and functional benefits of therapy with ACE inhibitors.

Published
1999

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