TY - JOUR A1 - Franz, Kristina A1 - Ost, Mario A1 - Otten, Lindsey A1 - Herpich, Catrin A1 - Coleman, Verena A1 - Endres, Anne-Sophie A1 - Klaus, Susanne A1 - Müller-Werdan, Ursula A1 - Norman, Kristina T1 - Higher serum levels of fibroblast growth factor 21 in old patients with cachexia JF - Nutrition : the international journal of applied and basic nutritional sciences N2 - Objective: Fibroblast growth factor (FGF)21 is promptly induced by short fasting in animal models to regulate glucose and fat metabolism. Data on FGF21 in humans are inconsistent and FGF21 has not yet been investigated in old patients with cachexia, a complex syndrome characterized by inflammation and weight loss. The aim of this study was to explore the association of FGF21 with cachexia in old patients compared with their healthy counterparts. Methods: Serum FGF21 and its inactivating enzyme fibroblast activation protein (FAP)-cc were measured with enzyme-linked immunoassays. Cachexia was defined as >= 5% weight loss in the previous 3 mo and concurrent anorexia (Council on Nutrition appetite questionnaire). Results: We included 103 patients with and without cachexia (76.9 +/- 5.2 y of age) and 56 healthy controls (72.9 +/- 5.9 y of age). Cachexia was present in 16.5% of patients. These patients had significantly higher total FGF21 levels than controls (952.1 +/- 821.3 versus 525.2 +/- 560.3 pg/mL; P= 0.012) and the lowest FGF21 levels (293.3 +/- 150.9 pg/mL) were found in the control group (global P < 0.001). Although FAP-alpha did not differ between the three groups (global P = 0.082), bioactive FGF21 was significantly higher in patients with cachexia (global P = 0.002). Risk factor-adjusted regression analyses revealed a significant association between cachexia and total ((beta = 649.745 pg/mL; P < 0.001) and bioactive FGF21 (beta = 393.200 pg/mL; P <0.001), independent of sex, age, and body mass index. Conclusions: Patients with cachexia exhibited the highest FGF21 levels. Clarification is needed to determine whether this is an adaptive response to nutrient deprivation in disease-related cachexia or whether the increased FGF21 values contribute to the catabolic state. (C) 2018 Elsevier Inc. All rights reserved. KW - Fibroblast growth factor 21 KW - Cachexia KW - Anorexia KW - Aging KW - Biomarker Y1 - 2018 U6 - https://doi.org/10.1016/j.nut.2018.11.004 SN - 0899-9007 SN - 1873-1244 VL - 63-64 SP - 81 EP - 86 PB - Elsevier CY - New York ER - TY - THES A1 - Herpich, Catrin T1 - Fibroblast growth factor 21 and its association with nutritional stimuli in older age N2 - Fibroblast growth differentiation factor 21 (FGF21) is known as a pivotal regulator of the glucose and lipid metabolism. As such, it is considered beneficial and has even been labelled a longevity hormone. Nevertheless, recent observational studies have shown that FGF21 is increased in higher age with possible negative effects such as loss of lean and bone mass as well as decreased survival. Hepatic FGF21 secretion can be induced by various nutritional stimuli such as starvation, high carbohydrate and fat intake as well as protein deficiency.. So far it is still unclear whether the FGF21 response to different macronutrients is altered in older age. An altered response would potentially contribute to explain the higher FGF21 concentrations found in older age. In this publication-based doctoral dissertation, a cross-sectional study as well as a dietary challenge were conducted to investigate the influence of nutrition on FGF21 concentrations and response in older age. In a cross-sectional study, FGF21 concentrations were assessed in older patients with and without cachexia anorexia syndrome anorexia syndrome compared to an older community-dwelling control group. Cachexia anorexia syndrome is a multifactorial syndrome frequently occurring in old age or in the context of an underlying disease. It is characterized by a severe involuntary weight loss, loss of appetite (anorexia) and reduced food intake, therefore representing a state of severe nutrient deficiency, in some aspects similar to starvation. The highest FGF21 concentrations were found in patients with cachexia anorexia syndrome. Moreover, FGF21 was positively correlated with weight loss and loss of appetite. In addition, cachexia anorexia syndrome itself was associated with FGF21 independent of sex, age and body mass index. As cachectic patients presumably exhibit protein malnutrition and FGF21 has been proposed a marker for protein insufficiency, the higher levels of FGF21 in patients with cachexia anorexia syndrome might be partly explained by insufficient protein intake. In order to investigate the acute response of FGF21 to different nutritional stimuli, a dietary challenge with a parallel group design was conducted. Here, healthy older (65-85 years) and younger (18-35 years) adults were randomized to one of four test meals: a dextrose drink, a high carbohydrate, high fat or high protein meal. Over the course of four hours, postprandial FGF21 concentrations (dynamics) were assessed and the FGF21 response (incremental area under the curve) to each test meal was examined.. In a sub-group of older and younger women, also the adiponectin response was investigated, as adiponectin is a known mediator of FGF21 effects on glucose and lipid metabolism. The dietary meal challenge revealed that dextrose and high carbohydrate intake result in higher FGF21 concentrations after four hours in older adults. This was partly explained by higher postprandial glucose concentrations in the old. For high fat ingestion no age differences were found. For the first time, acute FGF21 response to high protein intake was shown. Here, protein ingestion resulted in lower FGF21 concentrations in younger compared to older adults. Furthermore, sufficient protein intake, according to age-dependent recommendations, of the previous day, was associated with lower FGF21 concentrations in both age groups. The higher FGF21 response to dextrose ingestion resulted in a higher adiponectin response in older women, independent of fat mass, insulin resistance, triglyceride concentrations, inflammation and oxidative stress. Following the high fat meal, adiponectin concentrations declined in older women. Adiponectin response was not affected by meal composition in younger women. In summary, this thesis showed a positive association of FGF21 and cachexia anorexia syndrome with concomitant anorexia in older patients. Regarding the acute FGF21 response, a higher response following dextrose and carbohydrate ingestion was found in older compared with younger subjects. This might be attributed to a higher glucose response in older age. Furthermore, it was shown that the higher FGF21 response after dextrose ingestion possibly contributes to a higher adiponectin response in older women, independent of potential metabolic and inflammatory confounders. Acute protein ingestion resulted in a significant decrease in FGF21 concentrations. Moreover, protein intake of the previous day was inversely associated with fasting FGF21 concentrations. This might explain why FGF21 concentrations are higher in cachexia anorexia syndrome. These results therefore support the role of FGF21 as a sensor of protein restriction. N2 - Der Fibroblasten Wachstumsfaktor 21 (FGF21) gilt als wichtiger Regulator des Glukose- und Fettstoffwechsels. Es werden ihm verschiedene förderliche Eigenschaften zugeschrieben und er wurde darüber hinaus als Langlebigkeitshormon bezeichnet. Nichtsdestotrotz konnten Beobachtungsstudien zeigen, dass FGF21 Konzentration im Alter erhöht sind und möglicherweise mit negativen Auswirkungen, wie dem Verlust von Muskel- und Knochenmasse sowie einer geringeren Überlebenswahrscheinlichkeit, verbunden sind. FGF21 Sekretion in der Leber kann durch Hungern und verschiedene Makronährstoffe, wie hohe Kohlenhydrat- und Fettaufnahme, sowie einem Proteinmangel, induziert werden. Bisher ist jedoch unklar, ob sich die FGF21 Response auf verschiedene Makronährstoffe zwischen älteren und jüngeren Erwachsenen unterscheidet. Eine veränderte Response, könnte dazu beitragen die höheren FGF21 Konzentrationen im Alter zu erklären. In dieser vorliegenden kumulativen Dissertation wurden eine Querschnittsstudie sowie ein experimenteller Mahlzeitentest durchgeführt, um den Einfluss von Ernährung auf FGF21 Konzentrationen und die FGF21 Response im Alter zu untersuchen. In der Querschnittsstudie wurden FGF21 Konzentration von älteren PatientInnen mit und ohne Kachexie-Anorexie Syndrom sowie einer älteren Kontrollgruppe verglichen. Kachexie-Anorexie Syndrom ist ein multifaktorielles Syndrom, welches häufig im Alter und im Rahmen verschiedener Erkrankungen auftritt. Charakteristisch hierfür ist ein starker ungewollter Gewichtsverlust, Appetitverlust (Anorexie) sowie eine verminderte Nahrungsaufnahme. Daher repräsentiert das Kachexie-Anorexie Syndrom einen Zustand des schwerwiegenden Nährstoffmangels, der mit Unterernährung bei langanhaltenden Hungerphasen vergleichbar ist. Die höchsten FGF21 Konzentrationen wiesen PatientInnen mit Kachexie-Anorexie Syndrom auf. Des Weiteren korrelierte FGF21 positiv mit Gewichts- und Appetitverlust. Zusätzlich war das Kachexie-Anorexie Syndrom unabhängig von Alter, Geschlecht und BMI mit FGF21 assoziiert. Es ist davon auszugehen, dass PatientInnen mit Kachexie-Anorexie Syndrom eine unzureichende Proteinzufuhr aufweisen. Da FGF21 als Marker für Proteinrestriktion gilt, könnten die hohen FGF21 Konzentrationen bei Kachexie-Anorexie Syndrom teilweise durch eine zu geringe Proteinzufuhr erklärt werden. Um die akute Response von FGF21 auf verschiedene Makronährstoffe zu untersuchen, wurde ein Mahlzeitentest mit parallelen Gruppen durchgeführt. Hierfür erhielten ältere (65-85 Jahre) und jüngere (18-35 Jahre) Erwachsene eine von vier verschiedenen Testmahlzeiten (Dextrose Getränk, Kohlenhydrat-, Fett- und Proteinreiche Mahlzeit). Über vier Stunden wurden postprandiale FGF21 Konzentrationen (Dynamik) bestimmt und die FGF21 Response (inkrementelle Fläche unter der Kurve) auf jede Testmahlzeit untersucht. In einer Subgruppe von älteren und jüngeren Frauen wurde außerdem die Adiponektin Response bestimmt, da Adiponektin bekanntermaßen die Effekte von FGF21 auf den Glukose- und Fettstoffwechsel mediiert. Der Mahlzeitentest konnte zeigen, dass Dextrose und die kohlenhydratreiche Mahlzeit bei älteren Erwachsenen zu höheren FGF21 Konzentrationen nach vier Stunden führten. Dies könnte durch die höheren postprandialen Glukose Konzentrationen der Älteren erklärt werden. Die FGF21 Response auf die fettreiche Mahlzeit wies keine Altersunterschiede auf. Zum ersten Mal konnte die akute FGF21 Response auf eine proteinreiche Mahlzeit gezeigt werden. Hierbei führte die Mahlzeit bei jüngeren im Vergleich zu älteren Erwachsenen zu niedrigeren FGF21 Konzentration nach vier Stunden. Des Weiteren, war das Erreichen der altersspezifischen Proteinzufuhr des Vortrags bei beiden Altersgruppen mit niedrigeren nüchtern FGF21 Konzentrationen assoziiert. Bei älteren Frauen führte die höhere FGF21 Response nach Dextrose Aufnahme zu einer höheren Adiponektin Response, unabhängig von Fettmasse, Insulinresistenz, Triglyzeride Konzentrationen, Inflammation und oxidativem Stress. Nach Einnahme der fettreichen Mahlzeit sanken die Adiponektin Konzentrationen bei älteren Frauen, während bei jüngeren Frauen die Adiponektin Response nicht durch die Zusammensetzung der Mahlzeit beeinflusst wurde. Zusammenfassend konnte diese Dissertation eine positive Assoziation von FGF21 mit Kachexie-Anorexie Syndrom bei gleichzeitiger Anorexie bei älteren PatientInnen zeigen. Bezüglich der akuten Response von FGF21 zeigte sich eine höhere Response auf Dextrose und Kohlenhydrat-Aufnahme bei älteren im Vergleich zu jüngeren ProbandInnen. Dies ist vermutlich auf die erhöhte Glukose Response im Alter zurückzuführen. Des Weiteren konnte gezeigt werden, dass eine höhere FGF21 Response auf Dextrose bei älteren Frauen mit einer veränderten Adiponektin Response einhergingen, unabhängig von potentiellen metabolischen und inflammatorischen Einflussfaktoren. Eine akute hohe Proteinaufnahme führte zu einem deutlichen Abfall der postprandialen FGF21 Konzentrationen. Zudem bestand eine inverse Assoziation zwischen FGF21 Nüchternkonzentrationen und der Proteinzufuhr des Vortags. Dies könnte zum Teil erklären, warum FGF21 Konzentrationen bei Kachexie-Anorexie Syndrom erhöht sind. Demnach unterstützen diese Ergebnisse auch die Rolle von FGF21 als Sensor für Proteinrestriktion. KW - Ageing KW - FGF21 KW - protein KW - postprandial response Y1 - 2021 ER - TY - GEN A1 - Haß, Ulrike A1 - Herpich, Catrin A1 - Norman, Kristina T1 - Anti-Inflammatory Diets and Fatigue T2 - Postprints der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Accumulating data indicates a link between a pro-inflammatory status and occurrence of chronic disease-related fatigue. The questions are whether the observed inflammatory profile can be (a) improved by anti-inflammatory diets, and (b) if this improvement can in turn be translated into a significant fatigue reduction. The aim of this narrative review was to investigate the effect of anti-inflammatory nutrients, foods, and diets on inflammatory markers and fatigue in various patient populations. Next to observational and epidemiological studies, a total of 21 human trials have been evaluated in this work. Current available research is indicative, rather than evident, regarding the effectiveness of individuals’ use of single nutrients with anti-inflammatory and fatigue-reducing effects. In contrast, clinical studies demonstrate that a balanced diet with whole grains high in fibers, polyphenol-rich vegetables, and omega-3 fatty acid-rich foods might be able to improve disease-related fatigue symptoms. Nonetheless, further research is needed to clarify conflicting results in the literature and substantiate the promising results from human trials on fatigue. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 803 KW - chronic fatigue KW - cancer KW - fatigue reduction diet KW - probiotics KW - polyphenols KW - omega-3 fatty acids KW - anti-inflammatory nutrition KW - cytokines KW - inflammation KW - myalgic encephalomyelitis Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-441172 SN - 1866-8372 IS - 803 ER - TY - JOUR A1 - Haß, Ulrike A1 - Herpich, Catrin A1 - Norman, Kristina T1 - Anti-Inflammatory Diets and Fatigue JF - Nutrients N2 - Accumulating data indicates a link between a pro-inflammatory status and occurrence of chronic disease-related fatigue. The questions are whether the observed inflammatory profile can be (a) improved by anti-inflammatory diets, and (b) if this improvement can in turn be translated into a significant fatigue reduction. The aim of this narrative review was to investigate the effect of anti-inflammatory nutrients, foods, and diets on inflammatory markers and fatigue in various patient populations. Next to observational and epidemiological studies, a total of 21 human trials have been evaluated in this work. Current available research is indicative, rather than evident, regarding the effectiveness of individuals’ use of single nutrients with anti-inflammatory and fatigue-reducing effects. In contrast, clinical studies demonstrate that a balanced diet with whole grains high in fibers, polyphenol-rich vegetables, and omega-3 fatty acid-rich foods might be able to improve disease-related fatigue symptoms. Nonetheless, further research is needed to clarify conflicting results in the literature and substantiate the promising results from human trials on fatigue. KW - chronic fatigue KW - cancer KW - fatigue reduction diet KW - probiotics KW - polyphenols KW - omega-3 fatty acids KW - anti-inflammatory nutrition KW - cytokines KW - inflammation KW - myalgic encephalomyelitis Y1 - 2019 U6 - https://doi.org/10.3390/nu11102315 SN - 2072-6643 VL - 11 IS - 10 PB - MDPI CY - Basel ER - TY - JOUR A1 - Herpich, Catrin A1 - Haß, Ulrike A1 - Kochlik, Bastian Max A1 - Franz, Kristina A1 - Laeger, Thomas A1 - Klaus, Susanne A1 - Bosy-Westphal, Anja A1 - Norman, Kristina T1 - Postprandial dynamics and response of fibroblast growth factor 21 in older adults JF - Clinical Nutrition N2 - Background & aims: Fibroblast growth factor 21 (FGF21) plays a pivotal role in glucose and lipid metabolism and has been proposed as a longevity hormone. However, elevated plasma FGF21 concentrations are paradoxically associated with mortality in higher age and little is known about the postprandial regulation of FGF21 in older adults. In this parallel group study, we investigated postprandial FGF21 dynamics and response in older (65-85 years) compared to younger (18-35 years) adults following test meals with varying macronutrient composition. Methods: Participants (n = 60 older; n = 60 younger) were randomized to one of four test meals: dextrose, high carbohydrate (HC), high fat (HF) or high protein (HP). Blood was drawn before and 15, 30, 60, 120, 240 min after meal ingestion. Postprandial dynamics were evaluated using repeated measures ANCOVA. FGF21 response was assessed by incremental area under the curve. Results: Fasting FGF21 concentrations were significantly higher in older adults. FGF21 dynamics were affected by test meal (p < 0.001) and age (p = 0.013), when adjusted for BMI and fasting FGF21. Postprandial FGF21 concentrations steadily declined over 240 min in both age groups after HF and HP, but not after dextrose or HC ingestion. At 240 min, FGF21 concentrations were significantly higher in older than in younger adults following dextrose (133 pg/mL, 95%CI: 103, 172 versus 91.2 pg/mL, 95%CI: 70.4, 118; p = 0.044), HC (109 pg/mL, 95%CI: 85.1, 141 versus 70.3 pg/mL, 95%CI: 55.2, 89.6; p = 0.014) and HP ingestion (45.4 pg/mL, 95%CI: 34.4, 59.9 versus 27.9 pg/mL 95%CI: 20.9, 37.1; p = 0.018). FGF21 dynamics and response to HF were similar for both age groups. Conclusions: The age-specific differences in postprandial FGF21 dynamics and response in healthy adults, potentially explain higher FGF21 concentrations in older age. Furthermore, there appears to be a significant impact of acute and recent protein intake on FGF21 secretion. Y1 - 2021 U6 - https://doi.org/10.1016/j.clnu.2021.04.037 SN - 0261-5614 SN - 1532-1983 VL - 40 IS - 6 SP - 3765 EP - 3771 PB - Elsevier CY - Amsterdam ER -