Is metabolic flexibility altered in multiple sclerosis patients?

<h4>Objectives</h4>Metabolic flexibility is defined as ability to adjust fuel oxidation to fuel availability. Multiple sclerosis (MS) results in reduced muscle strength and exercise intolerance. We tested the hypothesis that altered metabolic flexibility contributes to exercise intoleran...

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Autores principales:	Anja Mähler, Jochen Steiniger, Markus Bock, Alexander U Brandt, Verena Haas, Michael Boschmann, Friedemann Paul
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/829c09fa42244e89a6d9a17ef9b2da87
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spelling	oai:doaj.org-article:829c09fa42244e89a6d9a17ef9b2da872021-11-18T07:07:20ZIs metabolic flexibility altered in multiple sclerosis patients?1932-620310.1371/journal.pone.0043675https://doaj.org/article/829c09fa42244e89a6d9a17ef9b2da872012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22952735/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>Metabolic flexibility is defined as ability to adjust fuel oxidation to fuel availability. Multiple sclerosis (MS) results in reduced muscle strength and exercise intolerance. We tested the hypothesis that altered metabolic flexibility contributes to exercise intolerance in MS patients.<h4>Methods</h4>We studied 16 patients (all on glatiramer) and 16 matched healthy controls. Energy expenditure (EE), and carbohydrate (COX) and lipid oxidation (LOX) rates were determined by calorimetry, before and after an oral glucose load. We made measurements either at rest (canopy device) or during 40 min low-grade (0.5 W/kg) exercise (metabolic chamber). We also obtained plasma, and adipose tissue and skeletal muscle dialysate samples by microdialysis to study tissue-level metabolism under resting conditions.<h4>Results</h4>At rest, fasting and postprandial plasma glucose, insulin, and free fatty acid levels did not differ between patients and controls. Fasting and postprandial COX was higher and LOX lower in patients. In adipose, fasting and postprandial dialysate glucose, lactate, and glycerol levels were higher in patients vs. controls. In muscle, fasting and postprandial dialysate metabolite levels did not differ significantly between the groups. During exercise, EE did not differ between the groups. However, COX increased sharply over 20 min in patients, without reaching a steady state, followed by an immediate decrease within the next 20 min and fell even below basal levels after exercise in patients, compared to controls.<h4>Conclusions</h4>Glucose tolerance is not impaired in MS patients. At rest, there is no indication for metabolic inflexibility or mitochondrial dysfunction in skeletal muscle. The increased adipose tissue lipolytic activity might result from glatiramer treatment. Autonomic dysfunction might cause dysregulation of postprandial thermogenesis at rest and lipid mobilization during exercise.Anja MählerJochen SteinigerMarkus BockAlexander U BrandtVerena HaasMichael BoschmannFriedemann PaulPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e43675 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anja Mähler Jochen Steiniger Markus Bock Alexander U Brandt Verena Haas Michael Boschmann Friedemann Paul Is metabolic flexibility altered in multiple sclerosis patients?
description	<h4>Objectives</h4>Metabolic flexibility is defined as ability to adjust fuel oxidation to fuel availability. Multiple sclerosis (MS) results in reduced muscle strength and exercise intolerance. We tested the hypothesis that altered metabolic flexibility contributes to exercise intolerance in MS patients.<h4>Methods</h4>We studied 16 patients (all on glatiramer) and 16 matched healthy controls. Energy expenditure (EE), and carbohydrate (COX) and lipid oxidation (LOX) rates were determined by calorimetry, before and after an oral glucose load. We made measurements either at rest (canopy device) or during 40 min low-grade (0.5 W/kg) exercise (metabolic chamber). We also obtained plasma, and adipose tissue and skeletal muscle dialysate samples by microdialysis to study tissue-level metabolism under resting conditions.<h4>Results</h4>At rest, fasting and postprandial plasma glucose, insulin, and free fatty acid levels did not differ between patients and controls. Fasting and postprandial COX was higher and LOX lower in patients. In adipose, fasting and postprandial dialysate glucose, lactate, and glycerol levels were higher in patients vs. controls. In muscle, fasting and postprandial dialysate metabolite levels did not differ significantly between the groups. During exercise, EE did not differ between the groups. However, COX increased sharply over 20 min in patients, without reaching a steady state, followed by an immediate decrease within the next 20 min and fell even below basal levels after exercise in patients, compared to controls.<h4>Conclusions</h4>Glucose tolerance is not impaired in MS patients. At rest, there is no indication for metabolic inflexibility or mitochondrial dysfunction in skeletal muscle. The increased adipose tissue lipolytic activity might result from glatiramer treatment. Autonomic dysfunction might cause dysregulation of postprandial thermogenesis at rest and lipid mobilization during exercise.
format	article
author	Anja Mähler Jochen Steiniger Markus Bock Alexander U Brandt Verena Haas Michael Boschmann Friedemann Paul
author_facet	Anja Mähler Jochen Steiniger Markus Bock Alexander U Brandt Verena Haas Michael Boschmann Friedemann Paul
author_sort	Anja Mähler
title	Is metabolic flexibility altered in multiple sclerosis patients?
title_short	Is metabolic flexibility altered in multiple sclerosis patients?
title_full	Is metabolic flexibility altered in multiple sclerosis patients?
title_fullStr	Is metabolic flexibility altered in multiple sclerosis patients?
title_full_unstemmed	Is metabolic flexibility altered in multiple sclerosis patients?
title_sort	is metabolic flexibility altered in multiple sclerosis patients?
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/829c09fa42244e89a6d9a17ef9b2da87
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Is metabolic flexibility altered in multiple sclerosis patients?

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