Lipotoxicity treatment. Metformin in Nonalcoholic Steatohepatitis: A Randomized Controlled Trial

Most of the weight gain happens during chemotherapy, 2 main mechanisms being behind this process: decreased metabolism and decreased ability to perceive satiety.

Introduction Type 2 diabetes mellitus T2DM results from a combination of genetic and environmental factors that induces tissue insulin resistance and beta-cell failure.

The decrease in metabolic rate happens because - besides the increased muscular catabolism generated by the decreased estrogen - the muscle mass is gradually lost through the sedentariness and inadequate intake of protein to sustain muscle mass. And also, many breast cancer patients either develop dyslipidemia during chemotherapy, either develop insulin resistance - both causing leptin resistance: expressed as decreased ability to perceive satiety and paradoxal hunger dissociated of the blood sugar level, sometimes even shortly after eating a full meal.

Iar cei care se îngraşă, o fac de obicei începând din timpul chimioterapiei, existând două mecanisme principale în spatele acestui proces: scăderea metabolismului şi scăderea capacităţii de percepţie a lipotoxicity treatment de saţietate. Scăderea metabolică apare deoarecelipotoxicity treatment plus faţă de catabolismul muscular crescut generat de scăderea estrogenică, masa musculară se pierde treptat atât din cauza sedentarismului pacientei, cât şi a aportului de proteine deseori inadecvat pentru menţinerea masei musculare.

De asemenea, multe paciente cu cancer de sân dezvoltă fie dislipidemie, fie rezistenţă la insulină în timpul chimioterapiei, ambele cauzând rezistenţă la leptină, exprimată prin scăderea capacităţii de percepţie a saţietăţii şi foame paradoxală disociată de nivelul glicemiei, care poate apărea chiar la foarte puţin timp după o masă completă.

Most of the weight gain happens during chemotherapy when many breast cancer patients either eat too little because of the decreased appetite or too much in an attempt to cope with the treatment. There are 2 main mechanisms behind this weight gain: decreased metabolism and decreased ability to perceive satiety.

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Decreased basal metabolic rate The only part of the metabolic rate that we can influence without making ourselves ill is the energy used by our skeletal muscles that contracts 24 hours in a row to maintain body lipotoxicity treatment.

The higher the active muscle mass percentage, the higher the metabolic rate; and vice versa - the metabolic rate decreases through muscle mass loss sarcopenia 1.

• Metformin in Nonalcoholic Steatohepatitis: A Randomized Controlled Trial
• Două mecanisme de creştere în greutate în timpul chimioterapiei cancerului de sân

During breast cancer chemotherapy, besides the increased muscular lipotoxicity treatment generated by the decreased estrogen 4the muscle mass is gradually lost through the sedentariness and inadequate intake of protein to sustain muscle mass 5. Yet plant foods completely lack B12 vitamin, and have either an imbalanced, insufficient or unusable content essential nutrients and micronutrients 8,9.

Also, studies prove that being sedentary decreases the basal metabolic rate of the breast cancer patients because it deregulates the balance between muscle protein degradation and synthesis. Thus, breast cancer patients can actively fight the metabolic decrease caused by sarcopenia through proper protein intake and through resistance training.

Dr. Berg Keto Summit 2020 presentation on Lipotoxicity with low carbohydrate diets

Anaerobic exercise either isometric or isokinetic using only the body weight as a resistance can improve muscle protein turn-over in favor of synthesis The result is a maintained muscle mass and basal metabolic rate if the patient has not developed sarcopenia yet, or a gradual increase in the active muscle mass if the patients already has some degree of sarcopenia which can happen in old patients who developed sarcopenia due to aging ± due to chemotherapy So, practicing minimal daily resistance training exercises - even in hospital settings - can maintain or improve metabolism.

Decreased ability to perceive lipotoxicity treatment Many breast cancer patients develop dyslipidemia during chemotherapy, or are already dyslipidemic at the start of the treatment. During the treatment, dyslipidemia is caused: either by the decreased intestinal absorbability of disaccharides paralleled by an intestinal hyperpermeability for undigested proteins generating dysbiosis which leads to an increased lipolysis 15,16 ; either by too low appetite unintentional starvation 17 ; either by the overeating foods high in carbohydrates But, no matter the mechanism, dyslipidemia causes leptin resistance decreasing the patient ability to perceive satiety lipotoxicity treatment generating hedonic hunger, sometimes even soon after eating a full meal 19, Studies prove that many breast cancer patients without prior diabetes develop muscle insulin resistance during treatment Insulin resistance is the survival mechanism used when the patient is either: limiting too much her food intake 21 ; or when she is lipotoxicity treatment foods too high in carbohydrates and too low in proteins Insulin is stimulating the secretion of the satiety hormone leptin, and hyperinsulinemia is generating such lipotoxicity treatment increase in leptin secretion that the hypothalamic neurons within the satiety nervous center become unresponsive to leptin.

This practically creates the loss of control over the eaten amount of food and a paradoxical hunger state very soon after eating. In consequence, breast paraziti baieti de oras patients lose control over their eating behavior both when they eat too little and when they eat too much: When the patient overeats or when she eats regardless of physical hunger, glucose cannot pass through the sarcolemma because glucose is osmotic and GLUT4 shut off to protect the muscle cell damage done by a too high inner osmotic pressure.

Insulin resistance happens after repeated excessive or unsolicited intake of any nutrient directly when the patient overeats lipotoxicity treatment supplying foods, and indirectly when she overeats protein or fats lipotoxicity treatment foods On the other hand, when the patient eats lipotoxicity treatment little, the high level of blood circulating free fatty acids increases the fat delivery to the muscles which increases sarcolemma density and membrane expression of GLUT4, inhibiting the glucose uptake by skeletal muscle cells and increasing the amount of fat deposited inside the muscle cell even in healthy subjects The result of an increased lipolysis does not equal fat loss.

In most cases, almost half of the women with PCOS have IR which is triggered by inflammation, glucotoxicity and lipotoxicity. In this work was conducted a systematic review of all the papers that used metabolomics for detecting IR biomarkers in PCOS women.

It equals an increase in circulating fatty acids, dyslipidemia and sometimes ectopic fat deposited inside the liver, the kidneys or the skeletal muscle So, insulin resistance can shut down fat loss by inhibiting lipolysis and by increasing hunger paralleled with decreased ability to perceive satiety. That is why it is so important to prevent or solve insulin resistance.

But once insulin resistance has been decreased, patients still need all the other mechanisms lipotoxicity treatment lose fat, and they need them to take place within the skeletal muscle cells because besides the skeletal muscle cells there are no other cells that can be physiologically influenced to increase the energy they use.

Two weight gain mechanisms during breast cancer chemotherapy

A daily minimal physical activity and the proper eating behavior can maintain the earned results obtained through breast cancer treatment, and they can also improve the life quality of the breast cancer patient.

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Beta-Cell Function and Failure in Type 2 Diabetes

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Open in a separate window Of study subjects, 13 in the metformin and 13 in the placebo group were overweight and received weight loss instructions. The decrease in BMI was not significantly different between overweight subjects who received weight loss instructions and normal weight subjects who received no instructions.

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