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fecal fat test [keywords]
- Early Enteral Fat Supplementation Improves Protein Absorption in Premature Infants with an Enterostomy. [JOURNAL ARTICLE]
- Neonatology 2014 Mar 6; 106(1):10-16.
Background: Early enteral fat supplementation and fish oil (FO) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterostomy. Objective: To test the hypothesis that early fat supplement and FO increases post-resection protein absorption, intestinal RNA, protein without decreasing intestinal arachidonic acid (AA) in premature infants with an enterostomy. Methods: 36 premature infants (<2 months old) with an enterostomy after surgical treatment for necrotizing enterocolitis or spontaneous intestinal perforation who tolerated enteral feeding at 20 ml/kg/day were randomized to usual care (control, n = 18) or early supplementing enteral Microlipid (ML) and FO (treatment, n = 18). Intralipid was decreased as the dose of enteral fat was increased. Daily weight, ostomy output and nutritional intake were recorded. Weekly 24-hour ostomy effluent was collected to measure fecal protein. Protein absorption was calculated by subtracting fecal protein from dietary protein. Tissue samples from the functional stoma and the nonfunctional distal diverted end were collected during bowel reanastomosis to measure RNA, protein, and fatty acid (FA) profile. Results: Compared to controls, the treatment group had higher protein absorption (g/kg/day) and intestinal RNA and protein (μg/mg tissue) proximal to the ostomy. The two groups had similar FA profiles except that the treatment group had higher n-3 eicosapentaenoic acid (EPA, μg/mg tissue) proximal to the ostomy. Conclusion: Early supplementation of enteral ML and FO to premature infants with an enterostomy increased dietary protein absorption, intestinal RNA, protein and n-3 EPA content without altering other FA content. © 2014 S. Karger AG, Basel.
- Paratuberculosis: decrease in milk production of German Holstein dairy cows shedding Mycobacterium avium ssp. paratuberculosis depends on within-herd prevalence. [JOURNAL ARTICLE]
- Animal 2014 Mar 4.:1-7.
Paratuberculosis impairs productivity of infected dairy cows because of reduced milk production and fertility and enhanced risk of culling. The magnitude of the milk yield depression in individual cows is influenced by factors such as parity, the stage of the disease and the choice of test used. The objectives of this case-control study were to substantiate the influence of the different levels of the within-herd prevalence (WHP) on individual milk yield of fecal culture (FC)-positive cows (FC+) compared with FC-negative herd-mates (FC-), and to estimate the magnitude of the deviation of the milk yield, milk components and somatic cell count (SCC) in an FC-based study. Of a total of 31 420 cows from 26 Thuringian dairy herds tested for paratuberculosis by FC, a subset of 1382 FC+ and 3245 FC- with milk recording data were selected as cases and controls, respectively. The FC- cows were matched for the same number and stage of lactation (±10 days in milk) as one FC+ from the same herd. Within a mixed model analysis using the fixed effects of Mycobacterium avium ssp. paratuberculosis (MAP) status, lactation number, days in milk, prevalence class of farm and the random effect of farm on milk yield per day (kg), the amount of fat and protein (mg/dl) and lactose (mg/dl) as well as the SCC (1000/ml) were measured. On the basis of least square means, FC+ cows had a lower test-day milk yield (27.7±0.6 kg) compared with FC- (29.0±0.6 kg), as well as a lower milk protein content and a slightly diminished lactose concentration. FC status was not associated with milk fat percentage or milk SCC. In FC+ cows, reduction in milk yield increased with increasing WHP. An interaction of FC status and farm was found for the test-day milk yield, and milk protein percentage, respectively. We conclude that the reduction in milk yield of FC+ cows compared with FC- herd-mates is significantly influenced by farm effects and depends on WHP class. Owners of MAP-positive dairy herds may benefit from the reduction in WHP not only by reducing number of infected individuals but also by diminishing the individual losses in milk production per infected cow, and therefore should establish control measures.
- Modeling and simulation of orlistat to predict weight loss and weight maintenance in obesity patients. [JOURNAL ARTICLE]
- Drug Metab Pharmacokinet 2014 Jan 14.
Orlistat is used clinically worldwide as anti-obesity drug. It is a chemically synthesized hydrogenated derivative of lipstatin and is an inhibitor of gastric and pancreatic lipases. It has been found to reduce the absorption of dietary fat in the gastrointestinal tract. Modeling and simulation based on pharmacokinetic/pharmacodynamic analysis is becoming increasingly used in the design of clinical trials to assure that the trials are of high quality and are conducted efficiently. We developed a clinical trial simulation model for orlistat based on Phase III clinical study data. This innovative weight loss model includes the relationships between orlistat dose amount, changes in fecal fat excretion, and weight loss, and also incorporates a dropout function. The model guided the dose-finding strategy and allowed simulation of long-term clinical outcomes of orlistat.
- Maldigestion from pancreatic exocrine insufficiency. [Journal Article]
- J Gastroenterol Hepatol 2013 Dec.:99-102.
Pancreatic exocrine insufficiency (PEI) is one of the long-term consequences of chronic pancreatitis (CP). Majority of patients with PEI were undiagnosed or undertreated. Inadequately treated or subclinical severe PEI causes malnutrition and may pose the patients at risk of premature atherosclerosis and cardiovascular events. Indication of pancreatic enzyme replacement therapy (PERT) is patients with severe PEI, as indicated by the presence of steatorrhea, diarrhea, weight loss, fecal fat > 7 g/day, (13) C-mixed triglyceride breath test < 29%, fecal elastase < 100 ug/g stool, imaging or endoscopic findings of pancreatic ductal dilatation or calculi, and eight endosonographic criteria of CP. The mainstay treatment of PEI is PERT. Dietary fat restriction is unnecessary. PERT with lipase > 40,000 U per meal is recommended. Enteric-coating may be preferred to conventional enzymes because of the availability of high-dose preparations and no need of acid suppression co-therapy. Administration of enzymes with meals is proven to be the most effective regimen. Response to PERT should be measured by the improvement of patients' symptoms, nutritional status, and, in selected cases, by fecal fat or (13) C-mixed triglyceride breath test. Patients unresponsive to PERT should be checked for compliance, increase the dose of lipase to 90,000 units/meal or co-therapy with proton pump inhibitor. In patient with previous gastrointestinal surgery that may interfere enzyme-food mixing, opening the capsules and administering the enzyme granules with meals. Finally, search for small intestinal bacterial overgrowth syndrome and other causes of small bowel malabsorption.
- Diagnosis and treatment of pancreatic exocrine insufficiency. [Journal Article]
- World J Gastroenterol 2013 Nov 14; 19(42):7258-66.
Pancreatic exocrine insufficiency is an important cause of maldigestion and a major complication in chronic pancreatitis. Normal digestion requires adequate stimulation of pancreatic secretion, sufficient production of digestive enzymes by pancreatic acinar cells, a pancreatic duct system without significant outflow obstruction and adequate mixing of the pancreatic juice with ingested food. Failure in any of these steps may result in pancreatic exocrine insufficiency, which leads to steatorrhea, weight loss and malnutrition-related complications, such as osteoporosis. Methods evaluating digestion, such as fecal fat quantification and the (13)C-mixed triglycerides test, are the most accurate tests for pancreatic exocrine insufficiency, but the probability of the diagnosis can also be estimated based on symptoms, signs of malnutrition in blood tests, fecal elastase 1 levels and signs of morphologically severe chronic pancreatitis on imaging. Treatment for pancreatic exocrine insufficiency includes support to stop smoking and alcohol consumption, dietary consultation, enzyme replacement therapy and a structured follow-up of nutritional status and the effect of treatment. Pancreatic enzyme replacement therapy is administered in the form of enteric-coated minimicrospheres during meals. The dose should be in proportion to the fat content of the meal, usually 40-50000 lipase units per main meal, and half the dose is required for a snack. In cases that do not respond to initial treatment, the doses can be doubled, and proton inhibitors can be added to the treatment. This review focuses on current concepts of the diagnosis and treatment of pancreatic exocrine insufficiency.
- Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP. [Journal Article]
- World J Gastroenterol 2013 Nov 7; 19(41):7177-82.
To obtain reference values for pancreatic flow output rate (PFR) and peak time (PT) in healthy volunteers and chronic pancreatitis (CP); to correlate quantification of secretin enhanced magnetic resonance cholangiopancreatography (SMRCP) of pancreatic fluid output following secretin with fecal elastase-1 (FE-1) tests.The present study includes 53 subjects comprised of 17 healthy individuals and 36 patients with CP from April 2011 to January 2013. The 36 patients with CP were divided into three groups of mild CP (n = 14), moderate CP (n = 19) and advanced CP (n = 3) by M-ANNHEIM classification for CP.. Fifty-three cases underwent FE-1 test and magnetic resonance imaging using 3.0 T-device (Signa EXCITE, GE Healthcare). Coronal T2-weighted single-shot turbo spin-echo, spiratory triggered, covering the papillae, duodenum and small bowel. MRCP was performed with a heavily T2-weighted fat-suppressed long TE HASTE sequence (thick slab 2D MRCP sequence), repeated every 2 min up to 11 min after 0.1 mL/kg secretin injection (Secrelux, Sanochemia(®), Germany). FE-1 test used sandwich enzyme-linked immunosorbent assay (ELISA) test (ScheBo. Tech(®), Germany).A good linear correlation showed between the calculated volume and the actual volume by Phantom experiments. Fifty-three paired Quantification of secretin enhanced magnetic resonance cholangiopancreatography (MRCPQ) and FE-1 data sets were analyzed. The mean FE-1 of 53 cases was 525.41 ± 94.44 μg/g for 17 healthy volunteers, 464.95 ± 136.13 μg/g for mild CP, 301.55 ± 181.55 μg/g for moderate CP, 229.30 ± 146.60 μg/g for advanced CP. Also, there was statistically significant difference in FE-1 (P = 0.0001) between health and CP. The mean values of PFR and PT were 8.18 ± 1.11 mL/min, 5.76 ± 1.71 min for normal; 7.27 ± 2.04 mL/min, 7.71 ± 2.55 min for mild CP; 4.98 ± 2.57 mL/min, 9.10 ± 3.00 min for moderate CP; 4.13 ± 1.83 mL/min, 12.33 ± 1.55 min for advanced CP. Further, statistically significant difference in PFR (P = 0.0001) and PT (P = 0.0001) was observed between health and CP. Besides, there was correlation (r = 0.79) and consistency (K = 0.6) between MRCPQ and ELISA Test. It was related between M-ANNHEIM classification and PFR (r = 0.55), FE-1 (r = 0.57).SMRCP can provide a safe, non-invasive and efficient method to evaluate the exocrine function of the pancreas.
- Clostridium butyricum MIYAIRI 588 improves high-fat diet-induced non-alcoholic fatty liver disease in rats. [Journal Article]
- Dig Dis Sci 2013 Dec; 58(12):3534-44.
Non-alcoholic fatty liver disease (NAFLD) has become a common liver disease, as its prevalence has increased markedly in recent decades. The aim of the present study was to examine the improving effect of Clostridium butyricum MIYAIRI 588 (CBM588), a probiotic in clinical use for antibiotic-associated diarrhea, against high-fat diet (HFD)-induced fatty liver in rats.After feeding HFD or HFD coated with CBM588 (HFD-CBM) for 12 weeks, we evaluated the hepatic mRNA levels related to lipid metabolism, and then assessed the hepatic protein levels of several transcription factors regulating these lipogenic gene expressions.The HFD-CBM group had decreased accumulation of lipid droplets in the liver compared with the HFD group. The HFD-CBM group had significantly decreased diacylglycerol acyltransferase (DGAT) 2 mRNA in the liver compared with the HFD group, whereas DGAT1 mRNA did not change between the HFD group and the HFD-CBM group. Moreover, the HFD-CBM group had significantly increased hepatic mRNA regulating cholesterol catabolism enzymes and excretion transporters. Correspondingly, the HFD-CBM588 groups had increased hepatic protein levels of peroxisome proliferator-activated receptor α/γ and liver X receptor α compared with the HFD group. The HFD-CBM group had accelerated excretion of total bile acid and non-esterified fatty acid in the feces.CBM588 intake may have novel potential for improving NAFLD.
- Potato fiber as a dietary fiber source in dog foods. [Journal Article]
- J Anim Sci 2013 Nov; 91(11):5344-52.
Potato fiber (PF), a coproduct of potato starch manufacture, was evaluated as a potential novel fiber source in dog food. Potato fiber contained 55% total dietary fiber, 29% starch, 4% crude protein, and 2% acid-hydrolyzed fat. The PF substrate was evaluated for chemical composition, in vitro digestion and fermentation characteristics, and in vivo responses. For the in vitro hydrolytic-enzymatic digestion and fermentation experiment, raw and cooked PF substrates were first subjected to hydrolytic-enzymatic digestion to determine OM disappearance and then fermented using dog fecal inoculum. Fermentation characteristics were then measured at 0, 3, 6, 9, and 12 h. For the in vivo experiment, 10 female mixed-breed dogs (6.13±0.17 yr; 22±2.1 kg) were provided 5 diets with graded concentrations (0%, 1.5%, 3%, 4.5%, or 6%) of PF in a replicated 5×5 Latin square design. Dogs were acclimated to the test diet for 10 d, followed by 4 d of total fecal collection. Fresh fecal samples were collected to measure fecal pH and fermentation end products. In vitro digestion revealed that raw and cooked PF were 32.3% and 27.9% digested enzymatically, whereas in vitro fermentation showed that PF was fermentable through 9 h. Raw PF had greater (P<0.05) acetate, propionate, and total short-chain fatty acid (SCFA) concentrations at the 12-h time point compared with cooked PF. The in vivo experiment showed no differences in apparent total tract DM, OM, CP, acid-hydrolyzed fat, or energy digestibility of diets containing graded concentrations of PF. However, total dietary fiber digestibility exhibited a linear increase (P<0.01) with increasing PF concentrations in the diet. Overall, linear increases (P<0.01) were observed for all individual and total SCFA, with a concomitant linear decrease (P<0.01) in fecal pH with increasing dietary PF. Fecal protein catabolite concentrations were low or undetectable, with the exception of spermidine, which exhibited a linear increase with increasing concentrations of PF. These findings indicated that inclusion of PF elicited favorable fermentation characteristics without negatively affecting nutrient digestibility or stool characteristics, indicating that PF could be a functional dietary fiber source in dog foods.
- Noninvasive analysis of microbiome dynamics in the fruit fly Drosophila melanogaster. [Journal Article, Research Support, Non-U.S. Gov't]
- Appl Environ Microbiol 2013 Nov; 79(22):6984-8.
The diversity and structure of the intestinal microbial community has a strong influence on life history. To understand how hosts and microbes interact, model organisms with comparatively simple microbial communities, such as the fruit fly (Drosophila melanogaster), offer key advantages. However, studies of the Drosophila microbiome are limited to a single point in time, because flies are typically sacrificed for DNA extraction. In order to test whether noninvasive approaches, such as sampling of fly feces, could be a means to assess fly-associated communities over time on the same cohort of flies, we compared the microbial communities of fly feces, dissected fly intestines, and whole flies across three different Drosophila strains. Bacterial species identified in either whole flies or isolated intestines were reproducibly found in feces samples. Although the bacterial communities of feces and intestinal samples were not identical, they shared similarities and obviously the same origin. In contrast to material from whole flies and intestines, feces samples were not compromised by Wolbachia spp. infections, which are widespread in laboratory and wild strains. In a proof-of-principle experiment, we showed that simple nutritional interventions, such as a high-fat diet or short-term starvation, had drastic and long-lasting effects on the micobiome. Thus, the analysis of feces can supplement the toolbox for microbiome studies in Drosophila, unleashing the full potential of such studies in time course experiments where multiple samples from single populations are obtained during aging, development, or experimental manipulations.
- Short-chain fructo-oligosaccharides modulate intestinal microbiota and metabolic parameters of humanized gnotobiotic diet induced obesity mice. [Journal Article, Research Support, Non-U.S. Gov't]
- PLoS One 2013; 8(8):e71026.
Prebiotic fibres like short-chain fructo-oligosaccharides (scFOS) are known to selectively modulate the composition of the intestinal microbiota and especially to stimulate Bifidobacteria. In parallel, the involvement of intestinal microbiota in host metabolic regulation has been recently highlighted. The objective of the study was to evaluate the effect of scFOS on the composition of the faecal microbiota and on metabolic parameters in an animal model of diet-induced obesity harbouring a human-type microbiota. Forty eight axenic C57BL/6J mice were inoculated with a sample of faecal human microbiota and randomly assigned to one of 3 diets for 7 weeks: a control diet, a high fat diet (HF, 60% of energy derived from fat)) or an isocaloric HF diet containing 10% of scFOS (HF-scFOS). Mice fed with the two HF gained at least 21% more weight than mice from the control group. Addition of scFOS partially abolished the deposition of fat mass but significantly increased the weight of the caecum. The analysis of the taxonomic composition of the faecal microbiota by FISH technique revealed that the addition of scFOS induced a significant increase of faecal Bifidobacteria and the Clostridium coccoides group whereas it decreased the Clostridium leptum group. In addition to modifying the composition of the faecal microbiota, scFOS most prominently affected the faecal metabolome (e.g. bile acids derivatives, hydroxyl monoenoic fatty acids) as well as urine, plasma hydrophilic and plasma lipid metabolomes. The increase in C. coccoides and the decrease in C. leptum, were highly correlated to these metabolic changes, including insulinaemia, as well as to the weight of the caecum (empty and full) but not the increase in Bifidobacteria. In conclusion scFOS induce profound metabolic changes by modulating the composition and the activity of the intestinal microbiota, that may partly explain their effect on the reduction of insulinaemia.