title: Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: role of fat and carbohydrate meals.
abstract: OBJECTIVE
  To compare the effect of a high-fat meal and a high-carbohydrate meal (pizza), with and without antioxidant vitamins, on endothelial activation in healthy subjects and in patients with type 2 diabetes mellitus.
  
  
  BACKGROUND
  The postprandial state is becoming increasingly acknowledged to affect some early events of atherogenesis.
  
  
  METHODS
  In a randomized, observer-blinded, crossover study, 20 newly diagnosed type 2 diabetic patients and 20 age- and gender-matched healthy subjects received two meals at one-week intervals: a high-fat meal (760 calories) and an isoenergetic high-carbohydrate meal (non-cheese pizza). In all subjects, the same meals were repeated immediately following ingestion of vitamin E, 800 IU, and ascorbic acid, 1,000 mg.
  
  
  RESULTS
  In normal subjects, the high-fat meal increased the plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), which were prevented by vitamins. No change in these parameters occurred after pizza ingestion or pizza ingestion with vitamins. In diabetic patients, basal concentrations of glucose, cytokines and adhesion molecules were significantly higher than in nondiabetic controls. Both meals significantly increased cytokine and adhesion molecule levels, but the increase was more sustained following the high-fat meal. There was no significant change from baseline when vitamin supplementation accompanied each meal. There was a relationship between changes in serum triglycerides and changes in TNF-alpha (r = 0.39, p < 0.01), IL-6 (r = 0.28, p < 0.05) and VCAM-1 (r = 0.25, p < 0.05), and between changes in plasma glucose and changes in IL-6 (r = 0.36, p < 0.01) and ICAM-1 (r = 0.31, p < 0.02).
  
  
  CONCLUSIONS
  An oxidative mechanism mediates endothelial activation induced by post-meal hyperlipidemia and hyperglycemia.
authors.affiliation: Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nappo
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
authors.forename: Michele
authors.initials: M
authors.lastname: Cioffi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giugliano
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Molinari
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Marfella
authors.forename: Dario
authors.initials: D
authors.lastname: Giugliano
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage / Q000494:pharmacology; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000494:pharmacology; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000494:pharmacology*; D004041:Dietary Fats / Q000494:pharmacology*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014810:Vitamin E / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D000975:Antioxidants; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D014810:Vitamin E; D001205:Ascorbic Acid