Abstract | INTRODUCTION:
Narcolepsy is associated with obesity though it is uncertain whether this is caused by changes in glucose and fat metabolism. Therefore, we performed a detailed analysis of systemic energy homeostasis in narcolepsy patients, and additionally, investigated whether it was affected by three months of sodium oxybate (SXB) treatment. METHODS: Nine hypocretin deficient patients with narcolepsy- cataplexy, and nine healthy sex, age, and BMI matched controls were enrolled. A hyperinsulinemic-euglycemic clamp combined with stable isotopes ([6,6-(2)H2]- glucose and [(2)H5]- glycerol) was performed at baseline. In seven patients a second study was performed after three months of SXB treatment. RESULTS:
Glucose disposal rate (GDR) per unit serum insulin was significantly higher in narcolepsy patients compared to matched controls (1.6 ± 0.2 vs. 1.1 ± 0.3 μmol/kgFFM/min/mU×L; P = 0.024), whereas β-cell function was similar (P = 0.50). Basal steady state glycerol appearance rate tended to be lower in narcolepsy patients (5.2 ± 0.4 vs. 7.5 ± 1.3 μmol/kgFM/min; P = 0.058), suggesting a lower rate of lipolysis. SXB treatment induced a trend in reduction of the GDR (1.4 ± 0.1 vs. 1.1 ± 0.2 μmol/kgFFM/min/mU×L; P = 0.063) and a reduction in endogenous glucose production (0.24 ± 0.03 vs. 0.16 ± 0.03 μmol/kgFFM/min/mU×L: P = 0.028) per unit serum insulin. After SXB treatment lipolysis increased (4.9 ± 0.4 vs. 6.5 ± 0.6 μmol/kgFM/min; P = 0.018), and body weight decreased in narcolepsy patients (99.2 ± 6.0 vs. 94.0 ± 5.4 kg; P = 0.044). CONCLUSION:
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Authors | Claire E H M Donjacour, N Ahmad Aziz, Sebastiaan Overeem, Andries Kalsbeek, Hanno Pijl, Gert Jan Lammers |
Journal | Sleep
(Sleep)
Vol. 37
Issue 4
Pg. 795-801
(Apr 01 2014)
ISSN: 1550-9109 [Electronic] United States |
PMID | 24899766
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Intracellular Signaling Peptides and Proteins
- Neuropeptides
- Orexins
- Sodium Oxybate
- Glucose
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Topics |
- Adult
- Body Composition
(drug effects)
- Body Weight
(drug effects)
- Case-Control Studies
- Female
- Glucose
(metabolism)
- Glucose Clamp Technique
- Humans
- Insulin Resistance
- Intracellular Signaling Peptides and Proteins
(deficiency)
- Lipid Metabolism
(drug effects)
- Lipolysis
(drug effects)
- Male
- Narcolepsy
(drug therapy, metabolism)
- Neuropeptides
(deficiency)
- Orexins
- Sodium Oxybate
(administration & dosage, therapeutic use)
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