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Bloodletting And Diabetes
"These results justify iron depletion"
http://care.diabetesjournals.org/cgi/content/extract/31/3/e18
Diabetes Care. 2008 Jan;31(1):3-8. Epub 2007 Oct 24. Links
Bloodletting ameliorates insulin sensitivity and secretion in parallel
to reducing liver iron in carriers of HFE gene mutations.
Equitani F, Fernandez-Real JM, Menichella G, Koch M, Calvani M, Nobili
V, Mingrone G, Manco M.
Transfusion Medicine, SanFilippo Neri Hospital, Rome, Italy.
OBJECTIVE:
To clarify the pathogenesis of diabetes associated with mutations of
the hemochromatosis (HFE) gene, 17 carriers, 9 normal glucose tolerant
(NGT) and 8 diabetic, were evaluated in an interventional trial.
RESEARCH DESIGN AND METHODS:
At enrollment and after a 2-year bloodletting period, euglycemic-
hyperinsulinemic clamp, oral glucose tolerance test (OGTT), liver
histology (nonalcoholic fatty liver disease activity score [NAS]), and
liver iron content (LIC) were assessed.
RESULTS:
NGT subjects had significantly higher baseline insulin sensitivity (P
<or= 0.001), secretion, and insulinogenic index (calculated from the
OGTT) (P <or= 0.0001 for both) and lower LIC (P = 0.004) and NAS (P =
0.02) than diabetic patients. Baseline LIC correlated negatively with
insulin secretion (NGT r(0) = -0.676, P <or= 0.0001; diabetes r(0) =
-0.589, P = 0.02) and insulin sensitivity (M value) (NGT r(0) =
-0.597, P = 0.009; diabetes r(0) = -0.535, P = 0.03) and positively
with NAS (diabetes r(0) = 0.649, P = 0.007) and triglycerides (NGT
r(0) = 0.563, P = 0.015). At month 24, circulating iron was reduced by
179 +/- 26% in NGT and 284 +/- 54% in diabetic subjects. Insulin
secretion (NGT 20 +/- 4%; diabetes 33 +/- 7%) and insulin sensitivity
(NGT 25 +/- 5%; diabetes 18 +/- 3%) increased. LIC decreased in both
groups (NGT 126 +/- 42%; diabetes 61 +/- 13%), and NAS ameliorated
(NGT 65.1 +/- 6.5 vs. 38.1 +/- 6.83; P <or= 0.0001; diabetes 2.1 +/-
10.7 vs. 69.9 +/- 10; P <or= 0.0001).
CONCLUSIONS:
Iron depletion ameliorates insulin secretion and sensitivity in NGT
and diabetic carriers of HFE gene mutations. This amelioration occurs
in parallel with decreased LIC and improved NAS. These results justify
glucose tolerance testing and prophylactic iron depletion in
asymptomatic carriers as well.
PMID: 17959863 [PubMed - indexed for MEDLINE]
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Tom
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http://care.diabetesjournals.org/cgi/content/extract/31/3/e18
Diabetes Care. 2008 Jan;31(1):3-8. Epub 2007 Oct 24. Links
Bloodletting ameliorates insulin sensitivity and secretion in parallel
to reducing liver iron in carriers of HFE gene mutations.
Equitani F, Fernandez-Real JM, Menichella G, Koch M, Calvani M, Nobili
V, Mingrone G, Manco M.
Transfusion Medicine, SanFilippo Neri Hospital, Rome, Italy.
OBJECTIVE:
To clarify the pathogenesis of diabetes associated with mutations of
the hemochromatosis (HFE) gene, 17 carriers, 9 normal glucose tolerant
(NGT) and 8 diabetic, were evaluated in an interventional trial.
RESEARCH DESIGN AND METHODS:
At enrollment and after a 2-year bloodletting period, euglycemic-
hyperinsulinemic clamp, oral glucose tolerance test (OGTT), liver
histology (nonalcoholic fatty liver disease activity score [NAS]), and
liver iron content (LIC) were assessed.
RESULTS:
NGT subjects had significantly higher baseline insulin sensitivity (P
<or= 0.001), secretion, and insulinogenic index (calculated from the
OGTT) (P <or= 0.0001 for both) and lower LIC (P = 0.004) and NAS (P =
0.02) than diabetic patients. Baseline LIC correlated negatively with
insulin secretion (NGT r(0) = -0.676, P <or= 0.0001; diabetes r(0) =
-0.589, P = 0.02) and insulin sensitivity (M value) (NGT r(0) =
-0.597, P = 0.009; diabetes r(0) = -0.535, P = 0.03) and positively
with NAS (diabetes r(0) = 0.649, P = 0.007) and triglycerides (NGT
r(0) = 0.563, P = 0.015). At month 24, circulating iron was reduced by
179 +/- 26% in NGT and 284 +/- 54% in diabetic subjects. Insulin
secretion (NGT 20 +/- 4%; diabetes 33 +/- 7%) and insulin sensitivity
(NGT 25 +/- 5%; diabetes 18 +/- 3%) increased. LIC decreased in both
groups (NGT 126 +/- 42%; diabetes 61 +/- 13%), and NAS ameliorated
(NGT 65.1 +/- 6.5 vs. 38.1 +/- 6.83; P <or= 0.0001; diabetes 2.1 +/-
10.7 vs. 69.9 +/- 10; P <or= 0.0001).
CONCLUSIONS:
Iron depletion ameliorates insulin secretion and sensitivity in NGT
and diabetic carriers of HFE gene mutations. This amelioration occurs
in parallel with decreased LIC and improved NAS. These results justify
glucose tolerance testing and prophylactic iron depletion in
asymptomatic carriers as well.
PMID: 17959863 [PubMed - indexed for MEDLINE]
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
