The effect of acute red wine polyphenol consumption on postprandial lipaemia in postmenopausal women

Postprandial lipoproteins are potentially atherogenic. The aim of this study was to elucidate whether acute consumption of red wine (RW) and dealcoholised red wine (DRW) regulates postprandial lipid and lipoprotein metabolism in 17 dyslipidaemic postmenopausal women. A mixed meal accompanied by either water, RW or DRW was consumed on three separate visits, in random order, 2 weeks apart. One fasting and 6 hourly postprandial blood samples were taken for lipid analysis. Results showed no significant quantitative changes in postprandial apolipoprotein (apo) B48 levels following the consumption of DRW or RW compared to water. However, qualitatively, DRW may reduce arterial exposure to apoB48-containing lipoproteins over the 6-h postprandial period measured. DRW consumption did not significantly change postprandial TG or insulin levels. A 35% (p = 0.02) increase in postprandial triglyceride (TG) levels and a 54% (p = 0.02) increase in insulin levels were observed following RW consumption, compared to water. In conclusion, acute DRW consumption had no effect on postprandial lipid and lipoprotein metabolism in dyslipidaemic postmenopausal women. However, the consumption of full-compliment RW exacerbated the postprandial lipaemic and insulin response over the 6-h period. Collectively, our findings suggest that neither polyphenols nor red wine reduce atherosclerotic risk by acutely modulating postprandial lipaemia over a 6-h period.     

The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women

BACKGROUND: Moderate red wine has been shown to reduce cardiovascular disease (CVD) risk, however the effects on certain CVD risk factors are unclear. In this study we have investigated the effects of dealcoholised red wine (DRW) and full-complement red wine (RW) on several cardiovascular risk factors in mildly hypercholesterolaemic postmenopausal women. OBJECTIVES: To elucidate whether the chronic consumption of red wine polyphenols improves risk factors associated with CVD in hypercholesterolaemic postmenopausal women. DESIGN: Forty-five hypercholesterolaemic postmenopausal women were randomly assigned to consume 400 mL/day of either water, DRW or RW for 6 weeks following a 4-week washout. Fasting measures of lipids, lipoproteins, insulin and glucose were taken at 0 and 6 weeks. RESULTS: DRW consumption had no effect of fasting concentrations of lipids, lipoproteins, insulin and glucose. However, chronic consumption of RW significantly reduced fasting LDL cholesterol concentrations by 8% and increased HDL cholesterol concentrations by 17% in hypercholesterolaemic postmenopausal women. CONCLUSIONS: Collectively, regular consumption of full-complement red wine reduces CVD risk by improving fasting lipid levels in hypercholesterolaemic postmenopausal women. This study uniquely demonstrated the LDL cholesterol-lowering effects of red wine in individuals at high CVD risk, which has not previously been shown.     

Concomitant consumption of red wine and polyunsaturated fatty acids in edible oil does not influence the peroxidation status of chylomicron lipids despite increasing plasma catechin concentration

Background and aimsAtherosclerosis may be ameliorated by red wine consumption possibly by providing antioxidants. The effects of red wine on the peroxidation status of chylomicrons (CM) are unknown. The aims were to compare the lipid peroxidation status of oil rich in polyunsaturated fatty acids (PUFA) from a standardised high-fat meal with that of the CM at peak concentrations following ingestion of the meal with and without wine, and to examine the contribution of wine to the antioxidant content of the plasma.Methods and resultsFasted subjects ingested the meal randomly with and without red wine. The peroxidation status was described by conjugated dienes (CD), lipid hydroperoxides (LOOH) and thiobarbituric acid reactive substances (TBARS). CM lag times and the area under the curve (AUC) of CD were determined under oxidative stress. Plasma catechin concentrations and oxygen radical absorbance capacity (ORAC) values were determined. The CM produced with and without wine did not differ in their concentration of CD, LOOH and TBARS. Lag times of CM with and without wine were not significantly different, nor were the AUC. Plasma catechin values increased significantly after consumption of wine with the meal, whereas ORAC values did not.ConclusionRed wine consumption increases plasma catechins, but does not influence lipid peroxidation in postprandial CM.     

Life style habits such as alcohol consumption and physical activity in relation to serum apoB / apoA-I ratio amongst 64-year-old women with varying degrees of glucose tolerance

OBJECTIVES: To investigate how life style factors such as alcohol consumption and physical activity relate to the serum apoB / apoA-I ratio in a cohort of middle-aged women with varying degrees of glucose tolerance. DESIGN: Observational, cross-sectional cohort study. SETTING: Research laboratory at a University Hospital. SUBJECTS: A screened cohort of 64-year-old postmenopausal women with varying degrees of glucose tolerance, ranging from diabetes (n = 232), impaired (n = 212) and normal (n = 191) glucose tolerance. MAIN OUTCOME MEASURE: ApoB / apoA-I ratio in relation to alcohol consumption and physical activity as assessed by questionnaires. RESULTS: Alcohol consumption and regular physical activity at high levels were inversely associated with the serum apoB / apoA-I ratio independently of confounding factors such as obesity, lipid-lowering treatment, degree of glucose tolerance and hormone replacement therapy. Alcohol seemed related to the apoB / apoA-I ratio mainly through increasing apoA-I, whereas physical activity seemed mainly related to lowering of apoB. Alcohol consumption above a daily intake of 8.9 g, i.e. less than a glass of wine was accompanied by a decrease in apoB / apoA-I ratio. CONCLUSIONS: Amongst these 64-year-old women with varying degrees of glucose tolerance, a moderate alcohol intake and regular physical exercise leading to sweating were associated with lower apoB / apoA-I ratio and these effects seem to be additive.     

Postprandial lipoprotein metabolism in familial hypobetalipoproteinemia

OBJECTIVE: Familial hypobetalipoproteinemia (FHBL) is an autosomal codominantly inherited disorder of lipoprotein metabolism characterized by decreased plasma concentrations of low-density lipoprotein-cholesterol and apolipoprotein (apo) B. We examined the effect of truncated apoB variants (相似文献   

Constituents of red wine other than alcohol improve endothelial function in patients with coronary artery disease

BACKGROUND: Several studies suggest that red wine is beneficial in coronary artery disease (CAD). Although the long-term effect of moderate red wine consumption on endothelial function is currently under investigation, there is little knowledge about its effect on postprandial endothelial function and haemostatic factors. The aim of the present study was to investigate the postprandial effects of alcohol content and the antioxidants of red wine on endothelial function and fibrinogen levels in CAD patients. METHODS: Fifteen males with angiographically documented CAD were recruited for the study. All volunteers ingested 250 ml of either red wine or de-alcoholized red wine on two different days. Blood samples (for analysis of fibrinogen and blood lipids) were collected and flow-mediated dilatation (FMD) was determined before and 30, 60 and 90 min following consumption of each beverage RESULTS: FMD was higher following the consumption of de-alcoholized red wine [type of wine effect, P=0.05 repeated measures analysis of variance (ANOVA)]. Furthermore, the pattern of the response was different between the two beverages, as FMD increased following the ingestion of de-alcoholized red wine, but it decreased after consumption of regular red wine (type of wine by time interaction effect, P=0.006 repeated measures ANOVA). Fibrinogen concentrations were unaltered CONCLUSIONS: Acute ingestion of red wine without alcohol led to higher FMD than ingestion of regular red wine in CAD patients. The acute effect of red wine on endothelial function may be different than its long-term effect and it could be attributed to its constituents other than alcohol.     

Effects of a short-term (4 weeks) protein-sparing modified fast on plasma lipids and lipoproteins in obese women

The aim of this study was to evaluate the effects of a short-term (4 weeks) protein-sparing modified fast (PSMF) diet of 400 cal on plasma lipids and lipoproteins in a group (n = 51) of pre- and postmenopausal women with moderately severe obesity (body mass index greater than 30) as well as the eventual relations of plasma lipids to the type of fat distribution. Women with android-type obesity had higher plasma cholesterol, low-density lipoprotein cholesterol (LDL-C), apoprotein B (apoB) and glucose levels and lower high-density lipoprotein cholesterol (HDL-C) levels and HDL-C/LDL-C ratio than women with gynoid-type obesity. Besides waist-hip ratio (WHR), also age was an important determinant of HDL-C and HDL-C/LDL-C. PSMF for 4 weeks caused a 20% decrease in plasma cholesterol, LDL-C and apoB levels but also a decrease of HDL-C, apoA1 and apoA2. Nevertheless the HDL-C/LDL-C ratio increased, and, overall, PSMF resulted in less atherogenic profile of plasma lipids. Weight loss was independent of WHR but somewhat higher in premenopausal women (mean 10 kg) than in postmenopausal women (mean 8 kg), suggesting a more important energy deficit in pre- than in postmenopausal women. No correlation was observed between the importance of weight loss and the changes in plasma lipid levels: this indicates that the normalization of plasma lipids is the consequence of the diet itself and not secondary to weight loss.     

Effect of moderate alcohol consumption on parameters of reverse cholesterol transport in postmenopausal women

BACKGROUND: Alcohol consumption is associated with increased high-density lipoprotein (HDL) cholesterol levels. One of the main antiatherogenic functions of HDL is reverse cholesterol transport. Three early steps of reverse cholesterol transport are (1) cellular cholesterol efflux, (2) plasma cholesterol esterification (EST), and (3) cholesteryl ester transfer (CET) to apolipoprotein B-containing lipoproteins. Our previous study in healthy middle-aged men showed that moderate alcohol consumption increases cellular cholesterol efflux and EST. This study investigated the effect of moderate alcohol consumption on three early steps of reverse cholesterol transport in postmenopausal women. METHODS: In a randomized crossover study, 18 postmenopausal women--all apparently healthy, non-smoking, and moderate alcohol drinkers--consumed white wine or white grape juice with evening dinner during 2 successive periods of 3 weeks. During the white wine period, alcohol intake equaled 24 g/day. At the end of each of the two experimental periods, blood samples were collected. RESULTS: Three weeks of alcohol consumption increased serum HDL cholesterol levels (5.0%; p < 0.05), serum HDL phospholipid levels (5.8%; p < 0.05), and the ex vivo cellular cholesterol efflux capacity of plasma, measured with Fu5AH cells (3.4%; p < 0.05). Plasma EST and CET did not change. CONCLUSIONS: Moderate alcohol intake increases serum HDL cholesterol level and stimulates cellular cholesterol efflux in postmenopausal women. Moderate alcohol consumption does not seem to affect two other early steps of reverse cholesterol transport at this level of alcohol intake. Our data suggest that the relative protection of moderate alcohol consumption against cardiovascular disease in postmenopausal women may involve the stimulation of reverse cholesterol transport through increased HDL.     

Chylomicron remnant metabolism studied with a new breath test in postmenopausal women with and without type 2 diabetes mellitus

OBJECTIVES: The kinetic basis for the effect of type 2 diabetes mellitus (DM) on postprandial lipoproteins has not been fully established. We investigated chylomicron remnant metabolism using a stable isotope breath test and fasting measurements of plasma apolipoprotein (apo) B-48 and apoC-III concentrations in postmenopausal women with and without type 2 DM. PATIENTS: Twenty-four postmenopausal women without DM and 14 postmenopausal women with diet-controlled DM of similar age and body mass index (BMI) were studied in the postabsorptive state. METHODS: The fractional catabolic rate (FCR) of an intravenously injected chylomicron remnant-like emulsion was determined from the appearance of 13CO2 in the breath using isotope-ratio mass spectrometry and multicompartmental modelling. apoB-48, a marker of particle number of intestinal lipoproteins, was determined immunoelectrophoretically. apoC-III was measured by immunoturbidimetric assay. RESULTS: Compared with the nondiabetic women, the women with DM had significantly higher plasma apoB-48 concentration (16.40 +/- 1.18 mg/l vs. 13.0 +/- 0.9 mg/l; mean +/- standard error mean; P = 0.021), higher plasma apoC-III concentration (204.24 +/- 15.18 mg/l vs. 170.74 +/- 10.75 mg/l; P = 0.042) and lower FCR of the chylomicron remnant-like emulsion (0.06 +/- 0.05 pools/h vs. 0.12 +/- 0.02 pools/h; P < 0.001). In the diabetic patients, the FCR of the emulsion was correlated significantly with plasma apoB-48 levels (r = -0.641, P = 0.007) but not with apoC-III levels. CONCLUSIONS: In postmenopausal women, diabetes mellitus appears to decrease the catabolism of chylomicron remnants and result in an accumulation of these particles in plasma. This may chiefly be due to decreased clearance by hepatic receptors related to an effect of insulin resistance. Impairment in the catabolism of chylomicron remnants may contribute to increased risk of atherosclerosis in postmenopausal women with type 2 diabetes mellitus.     

Impaired postprandial apolipoprotein-B48 metabolism in the obese, insulin-resistant JCR:LA-cp rat: increased atherogenicity for the metabolic syndrome

AIM: Postprandial lipaemia is a significant contributor to the development of dyslipidaemia and cardiovascular disease, which has more recently been shown as a potential risk factor for obesity and pre-diabetes. Clinically however, the diagnosis of early insulin-resistance remains confounded due to the fact that aberrations in lipid metabolism are not often readily identified using classic indicators of hypercholesterolemia (i.e. LDL). METHODS: In this study, we assessed the metabolism of apolipoprotein-B48 (apoB48)-containing lipoproteins in an animal model of obesity and insulin-resistance, the JCR:LA-cp rat. The contribution of lipoproteins from the intestine was assessed by measuring plasma apoB48 concentration in the postprandial period following an oral fat load. Plasma apoB48 was measured by improved enhanced chemiluminescent detection and other biochemical parameters measured by established analysis. RESULTS: Fasting concentrations of plasma apoB48, postprandial apoB48 area under the curve (AUC), as well as incremental-AUC (iAUC), were all significantly greater in the obese phenotype compared to lean controls. Fasting apoB48 correlated significantly with apoB48-iAUC, triglyceride (TG)-iAUC and insulin-iAUC. In addition, there was a highly significant association with fasting insulin and the postprandial ratio of TG:apoB48, a relationship not often detected in humans during insulin-resistance. CONCLUSIONS/INTERPRETATION: We conclude that the JCR:LA-cp rat can be used as a model of postprandial lipemia to explore chylomicron metabolism during the onset and development of insulin-resistance, including the increased cardiovascular complications of the metabolic syndrome.     

Glibenclamide improves postprandial hypertriglyceridaemia in type 2 diabetic patients by reducing chylomicrons but not the very low-density lipoprotein subfraction levels.

AIM: There are scarce data dealing with the degree of postprandial lipaemia after sulphonylurea administration. The aim of this study was to examine the effect of acute glibenclamide administration on postprandial lipaemia in Type 2 diabetic patients. METHODS: Eight randomly selected Type 2 diabetic individuals, aged 43-65 years (mean, 54 years), who had never received any anti-diabetic drug, were included in the study. Each patient was given a 485 kcal mixed meal (45% fat, 40% carbohydrate and 15% protein) twice on separate days after an overnight fast: once with placebo and once with 5 mg glibenclamide, per os, in a random order. The two tests were performed with an interval of 7 days. Venous blood samples were drawn just before and 2 h, 4 h and 6 h after meal consumption. Total triglyceride levels in plasma, in chylomicrons (CM), in CM-deficient plasma, in very low-density lipoprotein (VLDL) subfractions (VLDL-1, VLDL-2) and in intermediate-density lipoprotein (IDL) were determined. Free fatty acid (FFA) and total cholesterol levels in plasma, as well as high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels in CM-deficient plasma, were also measured. Finally, serum glucose, insulin and C-peptide concentrations were measured in each sample. RESULTS: As expected there was a significant decrease in postprandial glycaemia after glibenclamide administration compared to placebo (mean area under the curve values: AUC = 53.3 +/- 18.2 and 69.1 +/- 21.6 mm/h, P = 0.00009). In addition, the mean AUC values of insulin and C-peptide were significantly greater after drug administration. The AUC values of total plasma triglyceride and of CM triglyceride following glibenclamide administration were significantly lower compared to placebo, while the AUC values of postprandial triglyceride in CM-deficient plasma and of postprandial triglyceride in VLDL-1, VLDL-2 and IDL were not different after drug administration compared to placebo. Finally, no significant differences were noted in the AUC values of total cholesterol, LDL cholesterol, HDL cholesterol and plasma FFA levels after glibenclamide administration. CONCLUSIONS: These results demonstrate that glibenclamide administration improves postprandial hypertriglyceridaemia acutely by reducing postprandial triglycerides of intestinal origin.     

Effect of type of alcoholic beverages on carbohydrate-deficient transferrin,sialic acid,and liver enzymes

BACKGROUND: There are only limited data obtained under well controlled conditions on the effects of moderate drinking on markers of alcohol use disorders. The aim of this study was to investigate the effects of moderate intake of different alcoholic beverages on these markers, including carbohydrate-deficient transferrin (CDT), sialic acid (SA), and the liver enzymes gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase. METHODS: Eleven apparently healthy, nonsmoking middle-aged men were included in a 12-week randomized, diet-controlled crossover trial according to a 4 x 4 Latin-square design. Changes in CDT, SA, gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase were analyzed after 3 weeks of daily intake of four glasses (40 g of alcohol) of red wine, beer, spirits (Dutch gin), or water (control). RESULTS: After 3 weeks' daily consumption of red wine, a significant decrease of serum CDT concentration was observed compared with water consumption. There was no effect of any alcoholic beverage on the other outcome measures. CONCLUSIONS: Daily consumption of 40 g of alcohol from different types of alcoholic beverages with dinner did not affect SA or liver enzymes. Further investigations to explore the mechanisms for the red wine-induced decreases of CDT, including changes in iron metabolism, are clearly needed.     

The increase in human plasma antioxidant capacity after red wine consumption is due to both plasma urate and wine polyphenols

By using red wine, dealcoholized red wine, polyphenols-stripped red wine, ethanol-water solution and water, the role of wine polyphenols and induction of plasma urate elevation on plasma antioxidant capacity was examined in humans (n=9 per beverage). Healthy males randomly consumed each beverage in a cross-over design. Plasma antioxidant capacity (measured by ferric reducing antioxidant power, FRAP), ethanol, catechin and urate concentrations were determined before and 30, 60, 90, 120 and 180 min after beverage intake. Dealcoholized red wine and polyphenols-stripped red wine induced similar increase in FRAP values which represented nearly half the effect of the original red wine. This indicates that consumption of red wine involves two separate mechanisms in elevation of plasma FRAP values and both wine phenols and plasma urate contribute to that effect.     

Alcohol and Estrogen Levels in Postmenopausal Women: The Spectrum of Effect

Compared with alcohol-abstaining normal postmenopausal women, estradiol levels are known to be statistically increased in normal postmenopausal women who consume alcoholic beverages moderately, and to be even further increased in alcoholic postmenopausal women with cirrhosis. This study was undertaken to evaluate whether or not there is a spectrum of changes in levels of sex steroids and pituitary hormones associated with alcohol abstinence, alcohol use, and alcohol-induced cirrhosis in the absence of current alcohol abuse. For levels of estradiol and testosterone, as well as for the estradiol to testosterone ratio, all three groups differed significantly from each other; for the pituitary hormones, levels in the abstainers and alcohol users were similar and statistically different from levels in the alcoholic cirrhotic women. Compared with the alcohol-abstaining women, the relationships of age and estradiol with levels of the other hormones were disturbed for 4 of 11 correlations examined among the alcohol users, and for 9 of 11 correlations evaluated among the alcoholic cirrhotic women. These findings suggest that not only are hormonal relationships markedly disrupted among alcoholic cirrhotics, but also that alcoholic beverage consumption in the range of 0.1-28 total weekly drinks results in detectable perturbations of the normal hormonal relationships expected in postmenopausal women.     

Acute combined effects of olive oil and wine on pressure wave reflections: another beneficial influence of the Mediterranean diet antioxidants?

OBJECTIVES: Combined consumption of olive oil and wine is common in the Mediterranean diet, but there are no data concerning their synergistic haemodynamic response. We sought to determine the combined postprandial effects of wine and olive oil on wave reflections and central haemodynamics. METHODS: Fifteen healthy subjects consumed four standard meals on different days, containing 50 g of olive oil and 250 ml of wine, in a randomized cross-over study design. Two types of wine [red (R) and white (W)] and two types of olive oil [green (G) and refined (O) (rich and poor in antioxidants, respectively)] were used in all possible combinations (RO, RG, WO and WG). Applanation tonometry and aortic pulse wave analysis were performed when fasting and 1, 2 and 3 h postprandially. A second group of 15 healthy individuals matched for age, gender and body mass index served as the control group. RESULTS: All meals decreased AIx (RO and RG, P < 0.001; WO, P = 0.007; and WG, P = 0.039). The AIx reduction after RG, RO, WO and WG was significantly different from the respective AIx response of the control group. No difference was observed in the reduction of AIx between sessions, but a significantly earlier peak decrease in AIx, as well as a more prolonged decreasing effect, was observed after RG and RO consumption compared to WO and WG. Central systolic and diastolic pressures were diminished after all four combinations of wine and olive oil (P < 0.05). CONCLUSIONS: Combined consumption of wine and olive oil provided beneficial postprandial effects on haemodynamics. These findings reveal an additional favourable effect of components of the Mediterranean diet on haemodynamics in the postprandial state.     

A daily glass of red wine induces a prolonged reduction in plasma viscosity: a randomized controlled trial.

Moderate red wine consumption has been associated with decreased risk of coronary heart disease. Reduced plasma viscosity and fibrinogen levels have been launched as possible contributors to this risk reduction. The effect of moderate red wine consumption on plasma viscosity, however, has not been investigated in a prospective, randomized trial. We wanted to evaluate the effect of moderate red wine consumption on plasma viscosity, fibrinogen concentration and fibrinogen subfractions. Healthy, nonsmoking volunteers were assigned to consume one glass of red wine daily for 3 weeks in a prospective, randomized cross-over study. In the second 3-week period the volunteers abstained from alcohol use. The plasma viscosity, fibrinogen concentration and the distribution of the main fibrinogen subfractions were determined at inclusion, after wine drinking and after abstention. Plasma viscosity was reduced by 0.026 and 0.024 mPa.s in the two groups following wine intake (95% confidence interval, 0.009-0.043, P = 0.004; 95% confidence interval, 0.0083-0.039, P = 0.003). The decrease in plasma viscosity was maintained following 3 weeks of abstention. The fibrinogen concentration was reduced by 0.17 g/l following wine drinking in the group starting with abstention (95% confidence interval, 0.04-0.29, P = 0.01). The distribution of the fibrinogen subfractions remained unaltered. We conclude that a daily glass of red wine for 3 weeks significantly reduces plasma viscosity. Fibrinogen concentrations are also significantly reduced, when preceded by an abstention period. The decreased viscosity levels are maintained after 3 weeks of abstention, suggesting a sustained viscosity lowering effect of red wine.     

Beneficial effects of a moderate consumption of red wine on cellular cholesterol efflux in young men

BACKGROUND AND AIM: Protection against coronary artery disease (CAD) by moderate alcohol consumption is thought to be partly mediated through an increase in high density lipoprotein (HDL) levels. The protective effect of HDL can be related to its role in reverse cholesterol transport. Some studies have shown that wine intake is associated with a lower CAD risk compared to other alcoholic beverages. METHODS AND RESULTS: In order to separate the possible beneficial effects of the alcoholic and the non-alcoholic components of red wine, three beverages were compared in a group of 56 healthy young men: red wine (W) (30 g alcohol/day), a solution with the same degree of alcohol (A) and alcohol-free red wine (AFW). Beverages were consumed in random order over a period of 14 days. W significantly increased serum HDL-C, Apo A-I, HDL3-C, LpA-I and LpA-I:A-II particles. With A, only ApoA-I, HDL3-C, LpA-I:A-II were increased, though triglycerides were also increased. AFW had no effect apart from decreasing HDL-C. Plasma CETP was never altered. Serum-promoted cellular cholesterol efflux was measured on 3H labelled Fu5AH cells. Fractional cholesterol efflux was increased only after W intake, by 7%. Efflux variations correlated positively with HDL-C, HDL3-C and HDL-phospholipid variations. CONCLUSIONS: A modest, specific beneficial effect of moderate red wine consumption was demonstrated in comparison to an alcoholic solution. This was due to its effects on lipoproteins and its stimulation of serum ability to induce efflux of cellular cholesterol.     

Alcohol consumption and mortality: is wine different from other alcoholic beverages?

BACKGROUND: Alcohol has been an integral part of the diets of many cultures for thousands of years, and formed the basis of early antiseptics. However, many health professionals have been loath to recommend its moderate consumption. Fears of increased risks of cancers, strokes and coronary heart disease (CHD), as well as its role in accidents, violence, psychological and social decline (when consumed in excess) meant that alcohol was viewed as generally detrimental to health. Recent reports have examined some of these fears and suggest that the moderate consumption of alcoholic beverages, particularly red wine, may actually protect against the development of CHD. Evidence for the influence of alcoholic drinks on strokes and cancer is less clear. OBJECTIVES: This review discusses the chemical differences between red wine and other alcoholic beverages and their possible effects on the development of CHD, stroke and cancer. DATA SYNTHESIS AND CONCLUSIONS: Both clinical and experimental evidence suggest that red wine does indeed offer a greater protection to health than other alcoholic beverages. This protection has been attributed to grape-derived antioxidant polyphenolic compounds found particularly in red wine.     

Effect of sitagliptin therapy on postprandial lipoprotein levels in patients with type 2 diabetes

Aim: Recent studies indicate that type 2 diabetes is associated with an increased secretion of both hepatic and intestinal lipoproteins, leading to the accumulation of atherogenic triglyceride (TG)‐rich lipoproteins. Sitagliptin is a selective inhibitor of dipeptidyl peptidase‐4 that has been shown to reduce fasting and postprandial glucose levels in patients with type 2 diabetes presumably through incretin hormone‐mediated improvements in islet function. The objective of the present study is to examine the effects of treatment with sitagliptin on postprandial lipid and incretin hormone levels as well as glucose homeostasis in patients with type 2 diabetes. Methods: Thirty‐six subjects with type 2 diabetes (30 men/6 postmenopausal women with a mean age of 58.1 ± 6.4 years and a body mass index of 30.7 ± 4.9 kg/m²) were recruited in this double‐blind cross‐over study using sitagliptin 100 mg/day or placebo for a 6‐week period each, with a 4‐week washout period between the two phases. At the end of each phase of treatment, patients underwent an oral lipid tolerance test providing 35 g of fat per m² of body surface area and blood samples were taken over an 8‐h period. Results: Sitagliptin therapy significantly decreased the postprandial area under the curves (AUCs) for plasma apolipoprotein (apo)B (?5.1%, p = 0.002), apoB‐48 (?7.8%, p = 0.03), TG (?9.4%, p = 0.006), very low‐density lipoprotein (VLDL)‐cholesterol (?9.3%, p = 0.001), free fatty acids (FFAs) (?7.6%, p = 0.005) and glucose (?9.7%, p < 0.0001). Furthermore, the postprandial AUCs for plasma intact glucagon‐like peptide‐1 (+67.8%, p < 0.0001) and glucose‐dependent insulinotropic polypeptide (+67.3%, p < 0.0001) were significantly increased following treatment with sitagliptin, whereas the AUC for plasma glucagon was reduced by ?9.7% (p = 0.001) with no significant changes in the AUCs for plasma insulin and C‐peptide. Sitagliptin therapy also improved homeostasis model assessment (HOMA) index for insulin resistance (?14.6%, p = 0.01) and β‐cell function (+32.3%, p = 0.007). Conclusions: Treatment with sitagliptin for 6 weeks reduced postprandial plasma levels of TG‐rich lipoproteins of both intestinal and hepatic origin, most likely by increasing incretin hormone levels, reducing circulating plasma FFA concentrations and improving insulin sensitivity and β‐cell function.