L'épithélium intestinal, en constant renouvellement, assure de nombreuses fonctions vitales comme l'absorption des nutriments et le maintien d'une barrière entre le milieu extérieur et l'organisme. L'absorption intestinale des sucres est assurée par de nombreux transporteurs au niveau de l'intestin proximal. Parmi eux, GLUT2, localisé dans les entérocytes et les cellules endocrines de l'intestin, transporte le glucose, le fructose et le galactose. Les cellules L entéroendocrines produisent le GLP-1, un puissant stimulateur de la sécrétion d'insuline en réponse au glucose. L'objectif de ma thèse a été d'élucider le rôle de GLUT2 intestinal dans l'absorption des sucres et la fonction entéroendocrine grâce à l'étude d'un modèle murin spécifiquement invalidé pour ce transporteur dans les cellules épithéliales intestinales. La délétion intestinale de GLUT2 entraîne une malabsorption intestinale modérée des sucres associée à une distribution retardée du glucose aux tissus périphériques. Le retard spatial et temporel de l'absorption des sucres provoque une dysbiose intestinale au profit de bactéries ayant un rôle protecteur de l'homéostasie intestinale. De façon surprenante, l'invalidation de GLUT2 intestinal s'accompagne d'une chute de la densité de cellules L entéroendocrines, sans modification des niveaux plasmatiques de GLP-1. Cette étude met en exergue le rôle primordial de GLUT2 intestinal dans l'absorption des sucres et la fonction endocrine de l'intestin. Elle permet d'envisager le criblage de molécules capables d'inhiber l'activité de GLUT2 intestinal, pour atténuer la prise de poids et limiter les perturbations métaboliques induites par des régimes riches en sucres. / The constantly renewing intestinal epithelium handles various essential functions including nutrient absorption and persistence of a barrier between our internal and external environments. Several transporters mediate sugar absorption in the proximal intestine. Among them, GLUT2, a very efficient glucose, fructose and galactose transporter and receptor, is located at the membranes of enterocytes and enteroendocrine cells. The enteroendocrine L-cells produce GLP-1, a strong activator of glucose-induced insulin secretion. This thesis aimed to further decipher the role of intestinal GLUT2 in sugar absorption and enteroendocrine cell function. To address this question, mice lacking GLUT2 specifically in intestinal epithelial cells have been generated and studied. Intestinal GLUT2 invalidation alters intestinal glucose absorption and delays glucose biodistribution to peripheral tissues. This spatial and temporal sugar absorption delay provokes intestinal dysbiosis, favoring gut microbiota having a protective impact on gut homeostasis. Surprisingly, intestinal GLUT2 deletion leads to a strong loss in enteroendocrine L cell density, with no impact on GLP-1 plasma levels. This study highlights critical roles for GLUT2 in sugar absorption and enteroendocrine cell function management. The use of specific GLUT2 inhibitors could be considered to limit body weight gain and metabolic disorders induced by sugar rich diets.

En France, l’obésité touche 15% de la population et est en perpétuelle augmentation. Elle est une cause majeure du diabète de type 2. Elle se traduit par un accroissement du nombre de cellules de stockage du gras (adipocytes) et une résistance périphérique à l’insuline. Chez des individus obèses, l’augmentation du nombre d’adipocytes est associée à une diminution de l’expression de la sortiline, protéine transmembranaire dont le clivage entraine la formation du propeptide (PE) et sa libération dans la circulation sanguine. L’analogue synthétique du PE, la spadine, est connu pour moduler l’activité du canal potassique TREK-1. Ce canal étant exprimé dans la cellule bêta pancréatique qui sécrète l’insuline, une hormone participant à la régulation du taux de glucose dans le sang, il est possible que la spadine joue un rôle dans l’homéostasie du glucose. Mes résultats confirment cette hypothèse. En effet, la spadine améliore la tolérance au glucose des souris, en favorisant la libération d’insuline. La spadine est également connue pour interagir avec sortiline, indispensable au trafic du transporteur de glucose Glut4 vers la membrane des adipocytes. Cette interaction spadine-sortiline suggère que la spadine pourrait moduler l’entrée du glucose dans les adipocytes via la sortiline. Mes résultats montrent que la spadine ne modifie pas les capacités de stockage du glucose des adipocytes. En conclusion, la spadine joue un rôle dans la sécrétion de l’insuline et dans la régulation de la glycémie, ce qui peut présenter un intérêt pharmaceutique / In France, approximately 15% of the population is obese and this number keeps rising up every year. Obesity is a major cause of diabetes, inducing an increase of the number of fat-filled cells, called the adipocytes, and a peripheral insulin resistance. This increase of the number of adipocytes is associated with a decrease of sortilin expression, a transmembrane protein which is involved in the release of a propeptide (PE) in the blood circulation. Spadin, a synthetic PE analog, is known to modulate the potassium TREK-1 channel activity. Since, this channel is expressed in pancreatic beta cells which secrete insulin, a hormone involved in blood glucose regulation, spadin may play a role in glucose homeostasis. Consistent with this hypothesis, spadin improves glucose tolerance in mice, by stimulating insulin release. Spadin is a natural peptide derived from sortilin, which is known to control the glucose transporter Glut4 trafficking to the plasma membrane of adipocytes. This suggests that spadin may regulate glucose storage in adipocytes by affecting the sortilin function. However, my results show that spadin has no effect on glucose storage. In summary, spadin is involved in insulin secretion and glucose homeostasis and may be an alternative treatment against obesity and diabetes

No description available.

Sweet taste receptors are primarily found in the oral cavity of the mammalian species. However, recent studies have shown that sweet taste receptors can be found in extraoral tissues such as the pancreas, intestines, and adipose tissue. Our lab has previously found that sweet taste receptors are down-regulated on the pancreas in the presence of high plasma glucose levels. In order to assess the possibility that sweet taste receptors respond to high levels of glucose by suppressing its expression, we wanted to see if they reacted similarly on the intestines. We found that intestinal sweet taste receptors are down regulated in the presence of a 24 hour high sucrose diet (60% sucrose), and a 7 day high sucrose diet in both wild type (WT) mice on the high sucrose diet, and T1R2-KO (lacking sweet taste receptors) mice. We also examined their glucose excursion levels, and found that these mice are lacking a normal response to dietary glucose via an oral glucose tolerance test (OGTT). This led us to conclude that the mice lacking sweet taste receptor expression exhibit abnormal glucose absorption, possibly indicating that sweet taste receptors regulate glucose absorption in the intestines.

Cardiovascular disease (CVD) is the leading cause of death in the United States. Age is a primary risk factor for the development of CVD and middle-age is a vulnerable period where risk factors for the disease begin to exceed diagnostic thresholds. Interest has increased for the use of low carbohydrate high fat (LCHF) ketogenic diets due to their reported improvements for cardiometabolic health. Supplementation with exogenous ketone esters (KE) has been shown to increase plasma β-hydroxybutyrate (BHB) and mimic the metabolic effects of LCHF ketogenic diets. Evidence suggests elevated concentrations of plasma BHB may lower blood pressure, improve vascular function, attenuate hyperglycemic responses, and enhance cognitive function. The majority of research has been conducted in preclinical models, and whether exogenous KE supplementation has similar improvements in humans of any ages remains relatively unanswered. To address this we conducted a randomized, placebo controlled, crossover design study in healthy, sedentary, middle to older aged adults who received the exogenous KE (or placebo), and consumed the supplement for 2-weeks (3x/day, 15 minutes prior to each meal; breakfast, lunch, and dinner). Our first hypothesis was to test that KE supplementation would improve vascular function by increasing flow-mediated dilation, reducing arterial stiffness, and lowering blood pressure. Secondly, we hypothesized that KE supplementation would attenuate the glycemic response to an oral glucose tolerance test, improve glycemic variability, and show reductions in postprandial glucose levels. Thirdly, we tested the hypothesis that KE supplementation would improve cognitive performance by showing improvements in processing speed, memory, attention control, and executive functions. In support of our first hypotheses, KE supplementation increased flow-mediated dilation (8.1 ± 1.3 vs. 7.7 ± 1.2%, p = 0.023), but it did not show any difference in arterial stiffness or blood pressure. In contrast to our second hypotheses, following the KE supplementation intervention there were no significant difference from the placebo in terms of glycemic response, variability or mean 2-hour post-meal glucose. In support of our third hypotheses, we found a significant improvement in measures of working memory (7.55 ± 0.93 vs. 7.27 ± 0.29, p = 0.026) and inhibitory control (80 ± 38 vs. 87 ± 32ms, p = 0.035) following the 14-day KE supplementation. More research is needed to elucidate the effects of KE on cardiometabolic health and cognition. / Doctor of Philosophy / Recently there has been an increase in the popularity of low carbohydrate high fat (LCHF) ketogenic diets, with advocates for the diet claiming increased benefits in weight loss and blood glucose control, therefore leading to an increased interest for its use in the treatment for cardiovascular disease, obesity, and diabetes. As more evidence has accumulated much of the impact LCHF ketogenic diets are said to have, has been attributed to a state known as nutritional ketosis, which occurs in response to the restriction of carbohydrates from the diet. Ketone esters (KE) have been shown to effectively elevate ketone bodies (alternative energy produced by the body during times when glucose stores are low) without the need of altering one's own diet, however, this method of inducing ketosis is still lacking evidence for its impact on cardiometabolic health in humans. The purpose of these studies is to determine the effect of having sustained elevations of ketone bodies on our health and cognition in humans. Study 1 included healthy, sedentary middle to older aged adults who consumed a KE for 2-weeks (3x/day, prior to each meal) and a placebo. Following supplementation participants completed test to assess our vascular health and blood sugar control. Study 2 included healthy, sedentary middle to older aged adults who consumed a KE for the same 2-weeks (3x/day, prior to each meal) and a placebo. Participants underwent a series of tests to assess cognitive performance. Overall, after a 2-week supplementation period we found significant improvements in our blood vessel function and with cognitive performance where we saw improvements in working memory, and inhibitory control.

A incidência da obesidade e do diabetes do tipo 2 tomou proporções epidêmicas nos últimos anos, atingindo bilhões de indivíduos em todo o mundo. A descoberta de formas inovadoras capazes de reduzir as alterações metabólicas associadas a estas doenças é fundamental para minimizar o seu impacto na qualidade de vida da população e na economia dos países. Muitos estudos têm demonstrado que os compostos bioativos de alimentos possuem efeitos benéficos à saúde. O camu-camu e o cupuaçu são frutas nativas da região amazônica com potencial agroeconômico ainda inexplorado, que contêm um grande número de compostos fitoquímicos que podem atuar sobre o metabolismo corporal. Desta forma, o objetivo deste estudo foi verificar os efeitos dos compostos fenólicos de extratos do camu-camu e do cupuaçu no desenvolvimento da obesidade e do diabetes tipo 2 em ensaios in vivo e in vitro, e identificar os possíveis metabólitos envolvidos nestes efeitos. Os extratos ricos em compostos fenólicos da polpa comercial destes frutos foram extraídos em fase sólida, caracterizados por cromatografia líquida de alta eficiência (CLAE/DAD) e avaliados quanto à inibição da atividade de enzimas digestivas in vitro. Os extratos obtidos foram então testados em duas diferentes concentrações (2,25 e 4,5 mg de equivalentes de catequina/Kg de peso corporal para o cupuaçu; 7 e 14 mg de equivalentes de ácido gálico/Kg de peso corporal para o camu camu) em um modelo animal de obesidade e resistência insulínica induzida por dieta com alto teor de lipídios e sacarose em camundongos C57BL/6J. Foram investigados os efeitos destes compostos sobre as homeostases glicídica e lipídica através de análises séricas, testes de tolerância à insulina e à glicose e conteúdo de lipídios hepáticos e fecais. O extrato do camu camu apresentou flavonóis, ácido elágico e elagitaninos em sua composição. A suplementação com o extrato de compostos fenólicos do camu camu reduziu o ganho de peso corporal e diminuiu a intolerância à glicose e à insulina, independente da dose administrada. No entanto, a administração destes extratos não apresentou efeitos sobre o metabolismo lipídico. Estes resultados foram associados a um possível efeito de saciedade, com consequente redução da ingestão da dieta e da glicolipotoxicidade, e com um efeito anti-inflamatório devido à diminuição dos níveis de proteína C reativa. Já o extrato de cupuaçu apresentou flavanóis, flavonas e proantocianidinas em sua composição. A suplementação com o extrato de cupuaçu na maior dose testada melhorou a homeostase da glicose e principalmente dos lipídios, protegendo o tecido hepático dos danos causados pela dieta com alto teor de lipídios e sacarose. Estes efeitos foram associados à inibição de enzimas digestivas, com consequente menor absorção de lipídios provenientes da dieta, reduzindo assim a resistência à insulina no fígado, a hiperglicemia e a dislipidemia. Ainda, foi avaliada a distribuição de metabólitos no trato gastrointestinal de camundongos após a administração aguda do extrato de cupuaçu. Foi possível identificar a complexa mistura de polifenóis presentes no extrato de cupuaçu ao longo do trato gastrointestinal, que posteriormente foi metabolizada pela microbiota. Entre os metabólitos encontrados estão as agliconas hipolaetina e isoscutelareína, e os metabolitos microbianos da epicatequina como o 3,4-diHPP-2-ol e a 5-(3,4-dihidroxiphenil)-γ-valerolactona. De acordo com estes resultados, as diferenças na composição de compostos fenólicos encontradas entre os extratos das duas frutas foram responsáveis pelos diferentes resultados nos protocolos in vivo e a identificação dos metabólitos microbianos possibilita o conhecimento dos compostos possivelmente implicados nos efeitos benéficos. Novos estudos podem contribuir para um melhor entendimento dos mecanismos, bem como quais metabólitos estão associados aos efeitos benéficos que os compostos presentes nestas duas frutas apresentaram neste estudo. / The incidence of obesity and type 2 diabetes reached epidemic proportions in recent years, arriving to billions of people around the world. The discovery of innovative ways that can reduce the metabolic abnormalities associated with these diseases is essential to minimize its impact on the population\'s quality of life and the economy of the countries. Many studies have demonstrated that food bioactive compounds have beneficial health effects. Camu-camu and cupuassu are native fruits of the Amazon region with unexplored agroeconomic potential, which contain a large number of phytochemical compounds that can act on body metabolism. Thus, the objective of this study was verify the effects of phenolic compounds of camu-camu and cupuassu extracts on the development of obesity and type 2 diabetes in vivo and in vitro, and identfy the possible metabolites involved in these effects. The phenolic compound-rich extracts were obtained from commercial frozen fruit pulps by solid phase extraction, characterized by high-performance liquid chromatography (HPLC/DAD) and evaluated for inhibition of digestive enzymes activities in vitro. Then, the extracts were tested at two different doses (2.25 and 4.5 mg catechin equivalents/kg body weight for cupuassu; 7 and 14 mg of gallic acid equivalents/kg body weight for camu camu) in an animal model (C57BL/6J mice) of obesity and insulin resistance induced by high fat high sucrose diet. The effects of extract supplementation on glucose and lipid homeostasis were assessed by serum analysis, insulin and glucose tolerance tests in mice, and contents of fat in liver and fecal samples. Camu camu extract presented flavonols, ellagic acid and ellagitannins in its composition. Supplementation with camu camu phenolic extract reduced weight gain and decreased glucose and insulin intolerance independent of the dose administered. However, no effects on lipid metabolism were found. These findings were associated with a possible effect of satiety with a consequent reduction in energy intake and glicolipotoxicity, and anti-inflammatory properties. Cupuassu extract presented flavanols, flavones and proanthocyanidins in its composition. Supplementation with cupuacu extract at the highest dose improved glucose homeostasis and plasmatic lipid levels, protecting the liver tissue from damage caused by diet rich in lipids and sucrose. These effects were associated with inhibition of digestive enzymes, with consequent lower absorption of lipids from the diet, thereby reducing the insulin resistance in the liver, the hyperglycemia and dyslipidemia. Furthermore, the distribution of metabolites in the gastrointestinal tract of mice was evaluated after acute administration of cupussu extract by HPLC-ESI-QTOF. We identified the complex mixture of polyphenols present in cupuassu extract along the gastrointestinal tract, which was subsequently metabolized by the intestinal microbiota. Among detected metabolites are hypolaetin and isoscutellarein aglycones and microbial metabolites of epicatechin as 3,4-diHPP-2-ol and 5-(3,4-dihydroxyphenyl)-γvalerolactone. According to these results, the differences in the composition of phenolic compounds found between the two fruit extracts were responsible for the different effects in vivo and identification of microbial metabolites enables the knowledge of the compounds potentially implicated in the beneficial effects. New studies can contribute to a better understanding of the metabolism and mechanisms of action.

Introdução: Especula-se que exista uma possível relação entre a ingestão de vitamina K e a diminuição da gordura corporal. Além disso, embora os resultados permaneçam controversos, há um número crescente de estudos que apoiam um papel chave dessa vitamina na melhora do perfil lipídico, da sensibilidade à insulina e na redução do risco de diabetes mellitus tipo 2, contudo pouco se sabe sobre quais mecanismos estariam envolvidos. Objetivo: Investigar as relações entre a ingestão de vitamina K (na forma de filoquinona - PK), gordura corporal, perfil lipídico e marcadores da homeostase da glicose em adultos e idosos. Métodos: Estudo transversal com 298 indivíduos de ambos os sexos, participantes do inquérito ISA - Capital 2015. Amostras de sangue foram coletadas para determinação do perfil lipídico, glicemia de jejum e concentrações de insulina; e índice de estimativa de resistência à insulina (HOMAIR), índice de estimativa da função de células β-pancreáticas (HOMA-β) e índice de estimativa da sensibilidade à insulina (QUICKI) foram calculados. A ingestão de vitamina K foi avaliada por meio de um recordatório alimentar de 24hrs (repetido em 75% da amostra), e a investigação quantitativa da massa gorda foi conduzida por meio da absorciometria de feixe duplo (DXA). Indivíduos com ingestão de vitamina K inferior aos valores de AI foram divididos em subgrupos de acordo com o estado nutricional e faixa etária. Foi realizada a Correlação de Spearman em grupos estratificados de acordo com o Índice de Massa Corporal (IMC) e com o Índice de Gordura Corporal (IGC). Para avaliar as associações entre a ingestão de vitamina K e cada uma das medidas bioquímicas e de adiposidade, foi realizada a regressão linear múltipla. Resultados: Dentre os avaliados, 46% eram do sexo masculino (n=136), com idade mediana de 61 anos (20 - 94 anos), e 56,4% apresentavam sobrepeso ou obesidade (n=168). A mediana de ingestão de vitamina K foi de 102,7 μg, ou 59,9 μg,/1000 kcal, sem diferença de acordo com sexo ou idade. A ingestão de vitamina K apresentou correlação negativa com o HOMA-IR (r = -0,603; p = 0,0134) e correlação positiva com QUICKI (r = 0,603; p = 0,0134) entre os adultos eutróficos do sexo masculino (n = 16). Em idosas com baixo peso (n = 12), a ingestão de vitamina K foi negativamente correlacionada com o Colesterol Total (CT) (r = -0,644; p = 0,0443). Entre as mulheres com elevado IGC e ingestão de vitamina K inferior aos valores de AI (n = 117), foram observadas correlações negativas entre a ingestão de vitamina K e HOMA-IR (r = -0,187; p = 0,0451) e correlações positivas com QUICKI (r = 0,187; p = 0,0451). Conclusões: Os resultados encontrados sugerem uma possível relação entre a ingestão dietética de filoquinona, gordura corporal, perfil lipídico e marcadores da homeostase da glicose, em amostra de adultos e idosos. / Introduction: Recent research have investigated a possible inverse relationship between vitamin K intake and body fat. In addition, although the results remain controversial, there is an increasing number of studies supporting a key role of this vitamin in improving lipid profile, insulin sensitivity and reducing the risk of type 2 diabetes mellitus, but little is known about what mechanisms would be involved. Objective: To investigate the relationship between vitamin K intake (in the form of phylloquinone - PK), body fat, lipid profile and markers of glucose homeostasis in adults and elderly. Methods: Cross-sectional study with 298 individuals of both sexes, participants in the ISA - Capital 2015 survey. Blood samples were collected for determination of lipid profile, fasting glycemia and insulin concentrations, and homeostasis model assesment estimate for insulin resistance (HOMA-IR), homeostasis model assessment estimate for β-cell function (HOMA-β) and the quantitative insulin sensitivity check index (QUICKI) were calculate accordingly. Vitamin K intake was assessed by a 24-hour dietary recall (repeated in 75% of the sample) and quantitative investigation of fat mass was conducted using dual-energy x-ray absorptiometry (DXA). Subjects with vitamin K intake lower than AI values were divided into subgroups according to nutritional status and age group. Spearman correlation was performed in stratified groups according to Body Mass Index (BMI) and Fat Mass Index (FMI). To evaluate the associations between vitamin K intake and each of the biochemical and adiposity measures, multiple linear regression were performed. Results: Among the sample, 46% were male (n = 136), with a median age of 61 years (20 - 94 years), and 56.4% were overweight or obese (n= 168). The median vitamin K intake was 102.7 μg, or 59.9 μg, / 1000 kcal, with no difference according to sex or age. Vitamin K intake presented negative correlation with HOMA-IR (r = -0.603; p = 0.0134) and positive correlation with QUICKI (r = 0.603; p=0.0134) among normal weight male adults (n=16). In underweight elderly women (n=12), vitamin K intake was negatively correlated with total cholesterol (TC) (r = -0.644, p = 0.0443). Among females with high FMI and vitamin K intake lower than AI values (n=117), vitamin K intake was negatively correlated with HOMA-IR (r = -0.187; p = 0.0451) and positively correlated with QUICKI (r 12 = 0.187; p = 0.0451). Conclusions: Results suggest a possible relationship between dietary intake of phylloquinone, body fat, lipid profile and glucose homeostasis, among a sample of adults and elderly.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-06-14T17:35:19Z No. of bitstreams: 1 DanyloMelo.pdf: 745489 bytes, checksum: c5ad51adb0decdb7d8050bcf5074660b (MD5) / Made available in DSpace on 2017-06-14T17:35:19Z (GMT). No. of bitstreams: 1 DanyloMelo.pdf: 745489 bytes, checksum: c5ad51adb0decdb7d8050bcf5074660b (MD5) Previous issue date: 2016-09-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Synthetic glucocorticoids (GCs) induce several adverse effects when administered in high doses and/or prolonged, as peripheral insulin resistance, glucose intolerance, and alterations in lipid metabolism, especially hypertriglyceridemia. There are few studies on the metabolic impact caused by long-term treatments with different synthetic GCs, especially with prednisone, GC of intermediate action and first choice in its pharmacologic class. Therefore, we seek to verify the metabolic alterations caused by sub chronic treatment with prednisone in rats and compare them with existing and in acute model of insulin resistance induced by dexamethasone effects. For this, Wistar rats with of 90 days were treated with dexamethasone (D5) (1 mg/kg, i.p.) for 5 consecutive days and, its controls (C5) with saline, and Wistar rats of 60 days old were treated with prednisone (80 mg/kg, orally) for 15 days (P15) and 30 days (P30) consecutive and their respective controls (C15 and C30), received vehicle solution. The D5 results a decreased body weight (12.3%) and lower weight of retroperitoneal fat (38%), increased serum fasting glucose (12%) and fed (30%), insulin (80%) and triglycerides (339%) (p <0.05). Total fat and triglycerides liver were 29% and 52% higher in rats D5, compared to the C5 rats (p <0.05). The P15 rats had increased weight 61% less, reduction of retroperitoneal fat (29%) and increased plasma triglyceride concentrations (60%) compared to the C15 rats (p <0.05). As long as P30 rats had increased weight 44% less, reduction of retroperitoneal fat (25%) and increased serum triglycerides (78%) and liver total fat (26%) compared to the C30 rats (p <0,05). In vivo tests revealed the presence of impaired glucose tolerance (oGTT) in rats D5 and P30, and reduced insulin sensitivity (ipITT, HOMA, TYG) in D5 animals (p <0.05). Ex vivo test showed greater sensitivity in the pancreatic islets front glucose only in D5 rats. In conclusion, the sub chronic administration of prednisone promoted finer metabolic changes in glucose homeostasis, compared to acute administration of dexamethasone, suggesting the preferential use of prednisone when it is intended to minimize the adverse metabolic effects associated with the use of GCs. / Os glicocorticoides (GCs) sintéticos podem induzir diversos efeitos adversos, quando administrados em doses elevadas e/ou por tempo prolongado, como resistência insulínica periférica, intolerância à glicose, e alterações no metabolismo lipídico, especialmente hipertrigliceridemia. Porém existem poucos estudos sobre o impacto metabólico promovido por tratamentos prolongados com diferentes GCs sintéticos, especialmente com a prednisona, GC de ação intermediária e de primeira escolha em sua classe farmacológica. Diante disso, buscou-se verificar as alterações metabólicas ocasionadas pelo tratamento subcrônico com prednisona em ratos e compará-las aos efeitos presentes e conhecidos em modelo agudo de indução de resistência insulínica pela dexametasona. Para tal, ratos Wistar com noventa dias de vida foram tratados com dexametasona (D5) (1 mg/Kg, i.p.) durante 5 dias consecutivos e, os seus controles (C5) com salina, e ratos Wistar com 60 dias de vida foram tratados com prednisona (80 mg/Kg, v.o.) durante 15 dias (P15) e 30 dias (P30) consecutivos e, os seus respectivos controles (C15 e C30), receberam veículo. Os ratos D5 apresentaram redução do peso corpóreo (12,3%) e menor peso da gordura retroperitoneal (38%), aumento das concentrações séricas de glicose em jejum (12%) e alimentado (30%), insulina (80%) e triglicerídeos (339%) (p<0,05). O conteúdo de gordura total hepático, bem como triglicerídeos foram 29% e 52% maiores nos ratos D5, em relação aos ratos C5 (p<0,05). Os ratos P15 apresentaram um ganho de peso 61% menor, redução da gordura retroperitoneal (29%) e aumento nas concentrações plasmáticas de triglicerídeos (60%), em relação aos ratos C15 (p<0,05). Enquanto os ratos P30 apresentaram um ganho de peso 44% menor, redução da gordura retroperitoneal (25%) e aumento nas concentrações séricas de triglicerídeos (78%) e gordura total hepática (26%), em relação aos ratos C30 (p<0,05). Os testes in vivo revelaram a presença de intolerância à glicose (GTT) nos ratos D5 e P30 e redução da sensibilidade à insulina (ITT, HOMA, TyG) nos animais D5 (p<0,05). O teste ex vivo revelou maior sensibilidade nas ilhotas pancreáticas frente à glicose somente nos ratos D5. Em conclusão, a administração subcrônica de prednisona promoveu alterações metabólicas mais sutis na homeostasia da glicose, quando comparada à administração aguda de dexametasona, sugerindo assim, o uso preferencial da prednisona quando se pretende minimização dos efeitos adversos metabólicos associados ao uso de GCs.

Les adaptations du fœtus aux stimuli intra-utérins ont des conséquences immédiates puis à long terme sur sa santé après la naissance. Chez l’équin, ce concept connu sous le nom de DOHaD (Developmental Origins of Health and Disease) a été validé à l’aide de croisements inter-races : la taille de la jument, qui conditionne l’environnement maternel pendant la gestation puis la lactation, a un impact crucial sur la croissance postnatale du poulain, mais aussi sur la sensibilité à l’insuline du nouveau-né. L’ostéochondrose, pathologie du cheval en croissance, est responsable de pertes financières majeures pour la filière équine. Elle a été reliée à des anomalies de l’homéostasie glucidique et son origine anténatale est fortement suspectée. Dans cette thèse, nous avons mesuré l’impact de perturbations expérimentales au cours du développement fœtal sur la croissance, l’homéostasie glucidique et la prédisposition à l’ostéochondrose du poulain jusqu’à l’âge de 1 an ½. Un premier modèle de croissance fœtale augmentée versus restreinte a été obtenu par transferts d’embryons inter-races (« poneys dans traits » versus « selles dans poneys », respectivement). L’environnement maternel « enrichi » de la jument de trait versus restreint de la ponette s’est révélé déterminant dans la régulation de la croissance des différents segments osseux, de l’axe thyréotrope, de la fonction des cellules β pancréatiques, de la sensibilité à l’insuline de l’organisme et de la santé ostéoarticulaire du poulain dès la naissance et jusqu’à 1 an ½. Tout en validant le concept de DOHaD chez l’équin, ce modèle souligne le soin qui doit être apporté à la sélection des juments receveuses dans la pratique du transfert d’embryons. En démontrant l’ampleur des effets post-nataux programmés in utero et pendant la lactation, ce modèle alerte aussi l’éleveur sur la gestion des poulinières et ses impacts à long terme. En ce sens, le second modèle est en adéquation avec les préoccupations d’élevage puisqu’une perturbation de l’environnement nutritionnel du fœtus a été induite en apportant un concentré (orge) dans la ration hivernale de la jument gravide versus des fourrages uniquement. A ce jour, l’impact de cette modification anténatale sur l’homéostasie glucidique du poulain avant sevrage semble limité à la période néonatale, tandis que sa croissance n’est pas du tout affectée. En revanche, sa prédisposition à l’ostéochondrose à l'âge de 6 mois semble être accrue, ce qui ne permet pas de présager de la suite car le statut ostéoarticulaire du poulain âgé de 6 mois reste susceptible d’évoluer jusqu’à 1 an ½. Ces travaux devraient permettre d’ajuster les recommandations nutritionnelles chez les poulinières. / Fetal adaptations to intra-uterine stimuli have immediate and long term effects on the offspring’s health after birth. In equids, this concept known as the DOHaD (Developmental Origins of Health and Disease) was validated using cross-breeding: the mare’s size which affects the fetal environment throughout gestation and then lactation, has a critical impact on the foal’s post-natal growth, as well as on the neonate’s sensitivity to insulin. Osteochondrosis, a pathology of the growing horse, induces heavy financial losses in the equine industry. It has been associated to abnormalities in glucose homeostasis and its antenatal origin is highly suspected. The present research aimed to evaluate the impact of experimental disturbances during fetal development on growth, glucose homeostasis and predisposition to osteochondrosis in the foal until age 1½ year. Increased versus restricted fetal growth was obtained using between-breed embryo transfers (“ponies in draft horses” versus “saddlebreds in ponies”, respectively). The lush environment of the draft mare versus the restricted environment of the pony mare turned out to be critical in the regulation of bone growth, thyroid hormones secretion, β-cells function, insulin sensitivity and the osteoarticular status of the foal from birth to 1½ year of age. This validates the concept of the DOHaD in equids and shows that recipient mares should be carefully selected in embryo transfer practice. By demonstrating the scope of post-natal effects which were programmed in utero and throughout the lactating period, it also alerts the breeder about the importance of broodmare management and its long term impacts. Thus, the second model was developed to address breeders' practices. A disturbance of the nutritional environment of the fetus was induced by supplementing mares in late pregnancy with concentrated feed (barley). So far, only the neonatal foal's glucose homeostasis was affected, whereas all other studied parameters, including growth, were not affected. The foal’s predisposition to osteochondrosis, however, was increased at 6 months of age, which does not preclude that it will affect the animals afterwards since the osteoarticular status of the 6-month-old foal will evolve beyond weaning time. This research could help adjust nutritional recommendations to broodmares.

<p>In type 2 diabetes the concentration of glucose in the blood is increased, and tissues like fat and musclebecome less sensitive to insulin. These two phenomena are interrelated, but since the glucose-insulininterplay is highly complex, many aspects are still not understood. Here, a model-based approachmight help. Nevertheless, also a model-based approach has a limited impact, unless models for thesub-systems can be combined into a model for the whole-body regulation. Such a multi-level,module-based model is referred to as a hierarchical model, and this thesis is a proof-of-principle studyfor the future development of such models.</p><p>We have extended one of the best available models for the whole-body regulations, to include azoomable module for the fat tissue. The first step was to implement the whole-body model in thesoftware MathModelica, which support hierarchical modeling. Second, the originally mergedinsulin-responding module was sub-divided, so that a fat tissue was singled out. Third, a model for theinput-output profile for the fat tissue was developed by combining mechanistic knowledge withexisting and novel data from human fat cells. Finally, this detailed model was fitted to the profile of theoriginal fat model, and inserted in the whole-body model, with negligible effect on the whole-bodysimulations.</p><p>The resulting model has the ability to translate mechanistically oriented simulations on the biochemicallevel, which is the level were drugs act, to the whole-body level, which is of clinical interest. This is aquantum leap forward for modeling, and understanding, glucose homeostasis and type 2 diabetes.</p>