Nutritional and Metabolic Diseases

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Glucose Metabolism Disorders

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Cola

Louise L Lehrskov, MD, PhD

Maria S Svane, MD, PhD

Maria S Svane, MD,PhD

Louise L Lehrskov, PhD, MD

Colon cancer (CC) survivors have an increased risk of developing T2D. A recent study revealed that the surgical procedures per se may be causally involved. Hence, left-sided colon resections increased the risk of developing T2D. In addition, treatment with chemotherapy may play a role in the pathogenesis. Given the steadily improving survival rate after a CC diagnosis, prevention of secondary diseases such as T2D is important to improve quality of life in these patients and to reduce socioeconomic expenses. This study aims to elucidate the effect of resection of tumors located in the left part of the colon on pathophysiological intermediates, which may lead to T2D 12 months post-surgery or later. The physiological mechanism might be a changed postprandial secretion of gut hormones including glucagon-like peptide-1 (GLP-1) secreted from L-cells in the left part of the colon. The investigators will evaluate changes in primarily glucose homeostasis as well as in gastrointestinal hormones, microbiota, visceral fat accumulation and markers of low-grade inflammation etc. in CC survivors who underwent a left hemicolectomy or sigmoidectomy.

Material and Methods: 60 patients will be included in this explorative clinical study. Patients will be divided into 4 groups depending on surgical procedure and treatment with chemotherapy. In the group of patients undergoing left hemicolectomy or sigmoidectomy ± treatment with chemotherapy 2 x 15 patients will be included, and in the group of patients scheduled to undergo right hemicolectomy ± treatment with chemotherapy another 2 x 15 patients will be included. During the 3 study visits (before surgery, 3-4 weeks post-surgery and 12 months post-surgery) the following tests will be performed: An oral glucose tolerance test, blood and fecal sampling, a DXA scan and an ad libitum meal test.

Implications: With this study the investigators expect to obtain an insight in the pathogenesis behind the possible development of T2D in CC survivors who underwent a resection of the left part of the colon ± treatment with chemotherapy. This insight may also help scientists develop new ways of treating or preventing T2D in general.

COLONIC RESECTION FOR CANCER AS DIABETOGENIC RISK FACTOR

COLONIC RESECTION FOR CANCER AS DIABETOGENIC RISK FACTOR - A Study of the Pathophysiological Effects of Colon Resection on Glucose Homeostasis

Herlev Hospital

Rigshospitalet, Denmark

Hvidovre University Hospital

Investigator

Symptoms and General Pathology

Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Gland and Hormone Related Diseases

Heart and Blood Diseases

Syndrome

Glucose Intolerance

Polycystic Ovary Syndrome

Insulin Resistance

Cardiac Complexes, Premature

Cysts

Ovarian Cysts

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Gonadal Disorders

Endocrine System Diseases

Hyperglycemia

Hypoglycemic Agents

Hematinics

Insulin

Insulin, Globin Zinc

Liver Extracts

For the assessment of glucose metabolism, including beta-cell function and insulin sensitivity an 75g-OGTT was conducted.

Oral glucose tolerance test (OGTT)

The amount of ectopic lipids in the liver, heart and the skeletal muscle was measured using 1H-magnetic resonance spectroscopy.

1H-magnetic resonance spectroscopy

Alexandra Kautzky-Willer, Univ.Prof.Dr.

In the present study glucose metabolism and ectopic lipids in the liver, heart and muscle were investigated in women with the polycystic ovary syndrome (PCOS) and in healthy control subjects.

In detail an oral glucose tolerance test (OGTT) was conducted in women with the PCOS defined by the Rotterdam and the NIH-criteria, as well as in healthy control subjects. In addition 1H-magnetic resonance spectroscopy and Imaging was used for the assessment of the ectopic lipid content in the liver, heart and skeletal muscle. The aim of the present study was to compare the glucose metabolism and the ectopic lipid conent in the liver, heart and muscle between women with the PCOS defined by the NIH-criteria, Rotterdam-criteria and healthy control subjects.

Glucose Metabolism in Different PCOS Phenotypes

Associatons of PCOS Phenotypes With Ectopic Lipids, Adipocytokines and Parameters of Insulin Resistance

In the present study the Glucose metabolism in PCOS women and control subjects was assessed with an OGTT. Therefore the dynamic levels of glucose, insulin and C-peptide were assessed during an extended OGTT for the calculation of Insulin resistance and beta-cell function. In addition an 1H-magnetic resonance spectroscopy was done for the assessment of the ectopic lipid content in the liver, heart and the skeletal muscle.

Medical University of Vienna

Univ.Prof.Dr.

Skin and Connective Tissue Diseases

Diabetes Mellitus

Breast Neoplasms

Diabetes, Gestational

Altered metabolic milieu is defined as a fasting glucose level \>100 mg/dL at the first trimester of pregnancy by national guidelines. Altered metabolic milieu during the second trimester (24-28 weeks of pregnancy) is defined as a fasting glucose levels \> 92 mg/dL and/or plasma glucose levels \> 153 mg/dL two hours after load in the oral glucose tolerance test according to ADA guidelines or a fasting glucose \>100 mg/dL and/or \> 140 mg/dL two hours after load in the oral glucose tolerance test according to national guidelines. The COVID-19 pandemic is considered as a natural nutritional and mental health exposure.

Nutrition and mental health during pregnancy

María L Garmendia, PhD

Camila L Corvalán Aguilar, PhD

María F Mujica Coopman, PhD

The Chilean Maternal \& Infant Cohort Study II (ChiMINCs II) is an ongoing cohort that is part of the Chilean Maternal and Infant Nutrition Observatory of the South-East area of Santiago, Chile. In total, 1927 pregnant women beneficiaries of the public health systems and their offspring were recruited before 12 weeks of gestation and are followed across pregnancy (\<15, 26-28, and 35-37 weeks of gestation) and up to 2 years of age of their offspring. Two studies are currently nested in ChiMINCs II: 1) Breast Cancer Risk Assessment in Mothers (BRECAM) study, and 2) the ChiMINCs-COVID study. The primary objective of BRECAM study is to test the association between maternal metabolic indicators (i.e., insulin, glucose, IGF-1, and HbAc1 concentrations) at early pregnancy (i.e., \<15 and 26-28 weeks of gestation) and breast density 3 months after the cessation of lactation. For this purpose, we collect maternal obstetric, lifestyle, dietary intake, anthropometric, and biochemical information. The aim of the ChiMINCs-COVID study is to assess dietary-related risks and mental health problems derived from the COVID-19 pandemic and their influence on maternal and infant's health and nutrition. Thus, we collected detailed information on dietary behaviors, mental health and COVID-related information at each trimester, along with neonatal and infant nutritional information. The purpose of the present work is to describe the design, methods, and descriptive information at recruitment of ChiMINCs-II, also discussing the implications that this study can have to better understand maternal and infant nutrition and health during the COVID-19 era.

Additional fasting venous samples will be collected during routine public health care blood extractions and at delivery (maternal venous and umbilical cord blood samples). Also, feces samples of newborn will be collected after delivery. Whole blood, plasma, buffy coat, serum and red blood cells will be separated by centrifugation within the next 3 hours. Biological specimens will be aliquot and keep to -80ºC until the determination of metabolic markers, growth factors and hormones.

Chilean Maternal & Infant Cohort Study II (CHiMINCs-II)

The Chilean Maternal and Infant Nutrition Cohort Study II

Data and blood samples that will be collected in this study will be under the custody of the principal investigator and a human subject protection review board will regulate its use. Others researchers may access the data by contacting to María Luisa Garmendia (Principal Investigator).

Pontificia Universidad Catolica de Chile

Servicio de Salud Metropolitano Sur Oriente

Instituto de Nutrición y Tecnología de los Alimentos

Associate Professor

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
COLONIC RESECTION FOR CANCER AS DIABETOGENIC RISK FACTOR	NCT04649567	Glucose Metabol... Colon Cancer Surgery Chemotherapy Ef...		18 Years - 100 Years	Hvidovre University Hospital
Glucose Metabolism in Different PCOS Phenotypes	NCT03204461	Polycystic Ovar... Glucose Intoler... Liver Fat Glucose Metabol...	Oral glucose to... 1H-magnetic res...	20 Years - 40 Years	Medical University of Vienna
Glucose Metabolism in Different PCOS Phenotypes	NCT03204461	Polycystic Ovar... Glucose Intoler... Liver Fat Glucose Metabol...	Oral glucose to... 1H-magnetic res...	20 Years - 40 Years	Medical University of Vienna
Chilean Maternal & Infant Cohort Study II (CHiMINCs-II)	NCT03920098	Breast Density Body Compositio... Nutritional Sta... Mental Health I...	Nutrition and m...	18 Years - 50 Years	Instituto de Nutrición y Tecnología de los Alimentos
COLONIC RESECTION FOR CANCER AS DIABETOGENIC RISK FACTOR	NCT04649567	Glucose Metabol... Colon Cancer Surgery Chemotherapy Ef...		18 Years - 100 Years	Hvidovre University Hospital

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