Intestinal calcium absorption during hyperinsulinemic euglycemic glucose clamp in healthy humans

Rümenapf, G.; Schmidtler, J.; Schwille, P. O.

doi:10.1007/bf02556090

Cited by 26 publications

(11 citation statements)

References 27 publications

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“…However, Ishida et al (1985) reported that 1, 25(OH)2 In an investigation of the variation of PTH level under hyperinsulinemia, Rumenapf et al (1990) found that serum PTH level did not change under euglycemic hyperinsulinemic condition. Although the subjects did not take a constant diet before experiment in their study, UCaV was three times higher than found in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of Hyperinsulinemia under the Euglycemic Condition on Calcium and Phosphate Metabolism in Non-Obese Normotensive Subjects.

Shimamoto

Higashiura

Nakagawa

et al. 1995

Tohoku J. Exp. Med.

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The effect of acute insulin infusion on the metabolism of calcium (Ca) and phosphate (P) was examined in 17 healthy subjects. They were hospitalized and kept on a constant diet for 5 days, and an euglycemic hyperinsulinemic glucose clamp was applied. Synthetic human insulin was infused at the rate of 40 mU/m2/min for 2 hr, and glucose was also infused to maintain basal glucose levels of each subject. The control study was performed in 8 of the 17 subjects, into whom 10% xylitol was infused for 2 hr at the rate of 100 ml/hr. The plasma insulin concentrations were 7.94±0.35 and 62.3± 14.3 mU/liter before and after the glucose clamp technique, but serum free Ca ion was increased significantly (p < 0.05), and serum P and serum parathyroid hormone (PTH) were decreased significantly (p <0.001). Creatinine clearance did not change during the glucose clamp technique. Urinary excretion of Ca (UCaV) was significantly higher after the glucose clamp than the control study. Fractional excretion of Ca (FECa) was increased significantly (p <0.05), and urinary excretion of P (UPV) and fractional excretion of P (FEP) were decreased significantly (p <0.05) under the hyperinsulinemic condition. The results suggested that, under the conditions of euglycemic hyperinsulinemia by glucose clamp technique, insulin increased the serum free Ca ion, and as a result, PTH was suppressed. Decreased PTH might induce calciuresis and enhance tubular P reabsorption under hyperinsulinemia. Insulin increased serum free Ca ion might relate to the vasodilating action of insulin by its decrease of intracellular free Ca ion in vascular smooth muscle.hyperinsulinemia; glucose clamp technique; Ca metabolism; P metabolism; PTH

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Section: Discussionmentioning

confidence: 99%

Effects of Hyperinsulinemia under the Euglycemic Condition on Calcium and Phosphate Metabolism in Non-Obese Normotensive Subjects.

Shimamoto

Higashiura

Nakagawa

et al. 1995

Tohoku J. Exp. Med.

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“…20,21 The mechanism(s) by which obesity increases the risk of stone formation is uncertain, with several hypothesized explanations, including an increased intake of lithogenic substances and higher rates of urinary oxalate excretion. [22][23][24] Renal stones are a major cause of morbidity and pose a significant economic burden. The identification and characterization of common modifiable risk factors may result in new approaches to treatment and prevention, benefiting patients and reducing healthcare expenditures.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of obesometric parameters associated with renal stone recurrence

Bos

Dason

Matsumoto

et al. 2016

CUAJ

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Introduction: Our aim was to evaluate whether obesometric serum hormones and body fat distribution are associated with renal stone recurrence. Methods: We conducted a prospective cohort study of participants undergoing renal stone (RS) intervention at a single institution from November 2009-June 2010 and followed them for a median 62 months. Obesometric parameters were measured at baseline, including body mass index (BMI), fasting serum leptin and adiponectin, and proportion of visceral adipose tissue (%VAT) averaged from three fixed axial computed tomography (CT) slices. The primary study outcome was stone recurrence. Results: A total of 110 participants were enrolled. Elevated %VAT was associated RS recurrence; participants with %VAT in the highest quartile had a five-year stone-free rate of 47.1% compared to 72.2% among other participants (p=0.004). Adjusting for gender, elevated %VAT was independently predictive of renal stone recurrence among initial stone formers (n=74; hazard ratio [HR] 4.53, 95% confidence interval [CI] 1.08-19.02), but not among recurrent stone formers (n=19; HR 0.51, 95% CI 0.054-4.72). Other obesometric factors, including leptin, adiponectin, and BMI, were not significantly predictive of recurrence. Conclusions: We report a novel association between an elevated %VAT and stone recurrence. These findings may inform patient counselling and followup regimens. The metabolic basis for these findings requires further investigation.

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“…[11][12][13] Clamp studies have also suggested that insulin increases the intestinal absorption of calcium. 35 Insulin-mediated postprandial increases in levels of urinary calcium, coupled with postprandial increases in levels of urinary oxalate, could create a urinary environment highly conducive to the formation of calciumcontaining stones.…”

Section: Commentmentioning

confidence: 99%

Obesity, Weight Gain, and the Risk of Kidney Stones

Taylor

Stampfer²,

Curhan³

2005

JAMA

986

566

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Context Larger body size may result in increased urinary excretion of calcium, oxalate, and uric acid, thereby increasing the risk for calcium-containing kidney stones. It is unclear if obesity increases the risk of stone formation, and it is not known if weight gain influences risk.Objective To determine if weight, weight gain, body mass index (BMI), and waist circumference are associated with kidney stone formation. Design, Setting, and ParticipantsA prospective study of 3 large cohorts: the Health Professionals Follow-up Study (N=45988 men; age range at baseline, 40-75 years), the Nurses' Health Study I (N=93758 older women; age range at baseline, 34-59 years), and the Nurses' Health Study II (N=101877 younger women; age range at baseline, 27-44 years).Main Outcome Measures Incidence of symptomatic kidney stones. ResultsWe documented 4827 incident kidney stones over a combined 46 years of follow-up. After adjusting for age, dietary factors, fluid intake, and thiazide use, the relative risk (RR) for stone formation in men weighing more than 220 lb (100.0 kg) vs men less than 150 lb (68.2 kg) was 1.44 (95% confidence interval [CI], 1.11-1.86; P=.002 for trend). In older and younger women, RRs for these weight categories were 1.89 (95% CI, 1.52-2.36; PϽ.001 for trend) and 1.92 (95% CI, 1.59-2.31; PϽ.001 for trend), respectively. The RR in men who gained more than 35 lb (15.9 kg) since age 21 years vs men whose weight did not change was 1.39 (95% CI, 1.14-1.70; P=.001 for trend). Corresponding RRs for the same categories of weight gain since age 18 years in older and younger women were 1.70 (95% CI, 1.40-2.05; PϽ.001 for trend) and 1.82 (95% CI, 1.50-2.21; PϽ.001 for trend). Body mass index was associated with the risk of kidney stone formation: the RR for men with a BMI of 30 or greater vs those with a BMI of 21 to 22.9 was 1.33 (95% CI, 1.08-1.63; PϽ.001 for trend). Corresponding RRs for the same categories of BMI in older and younger women were 1.90 (95% CI, 1.61-2.25; PϽ.001 for trend) and 2.09 (95% CI, 1.77-2.48; PϽ.001 for trend). Waist circumference was also positively associated with risk in men (P=.002 for trend) and in older and younger women (PϽ.001 for trend for both). ConclusionsObesity and weight gain increase the risk of kidney stone formation. The magnitude of the increased risk may be greater in women than in men.

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Intestinal calcium absorption during hyperinsulinemic euglycemic glucose clamp in healthy humans

Cited by 26 publications

References 27 publications

Effects of Hyperinsulinemia under the Euglycemic Condition on Calcium and Phosphate Metabolism in Non-Obese Normotensive Subjects.

Effects of Hyperinsulinemia under the Euglycemic Condition on Calcium and Phosphate Metabolism in Non-Obese Normotensive Subjects.

A prospective evaluation of obesometric parameters associated with renal stone recurrence

Obesity, Weight Gain, and the Risk of Kidney Stones

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