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Context: Follistatin is a plasma protein recently reported to increase under conditions with negative energy balance, such as exercise and fasting in humans. Currently, the perception is that circulating follistatin is a result of para/autocrine actions from various tissues. The large and acute increase in circulating follistatin in response to exercise suggests that it may function as an endocrine signal. Objective: We assessed origin and regulation of circulating follistatin in humans. Design/Interventions: First, we assessed arterial-to-venous difference of follistatin over the splanchnic bed at rest and during exercise in healthy humans. To evaluate the regulation of plasma follistatin we manipulated glucagon-to-insulin ratio in humans at rest as well as in cultured hepatocytes. Finally, the impact of follistatin on human islets of Langerhans was assessed. Results: We demonstrate that in humans the liver is a major contributor to circulating follistatin both at rest and during exercise. Glucagon increases and insulin inhibits follistatin secretion both in vivo and in vitro, mediated via the secondary messenger cAMP in the hepatocyte. Short-term follistatin treatment reduced glucagon secretion from islets of Langerhans, whereas long-term follistatin treatment prevented apoptosis and induced proliferation of rat beta cells. Conclusions: In conclusion, in humans, the liver secretes follistatin at rest and during exercise, and the glucagon-to-insulin ratio is a key determinant of circulating follistatin levels. Circulating follistatin may be a marker of the glucagon-to-insulin tone on the liver.

In this article we report on a 43-year-old man, who had been treated with two cortisone injections containing soja bean oil for epicondylitis humeri radialis. Four weeks after the second injection necrotized fat which had been extracted surgically was sent to us for histological examination. We could show a calcifying collagen fibre necrosis being cleared by a granulomatous reaction and resorbed by granulation tissue. The calcifying necrosis of collagen fibres might have been induced by soja bean oil which were used as carrier of the drug.

Early weaned piglets were divided into eight groups of 6 animals each. The animals were fed diets differing in fat quality (4% soybean oil, POZ 5 or 176) and in the content of the vitamins A (5,000 or 20,000 I.U./kg) and E (25 or 125 I.U./kg) over a period of 7 weeks. At the beginning, on day 25 and 47 blood samples were taken and analysed for vitamin A and E. In liver, heart, M. longissimus dorsi and M. semitendinosus vitamin A, E and the TBA-reactive substances were analysed. Induced lipid peroxidation was assessed by the ethane and pentane production rate in the skeletal muscle. During the weaning period a decrease in the alpha-tocopherol level was observed. In groups with the lower doses of vitamin E this effect was more pronounced. After 47 days the alpha-tocopherol concentrations in plasma and heart and skeletal muscle fell about 25-30% by offering high doses of vitamin A compared to those groups fed low doses. Oxidized fats also led to lower tocopherol concentrations in muscle tissues. Hydrocarbon production in M. longissimus dorsi and M. semitendinosus was significantly reduced in groups with the high supplement of vitamin E. A tendentially opposite effect was seen in groups supplied with high levels of vitamin A or oxidized fat. Although retinyl esters in plasma are a minor fraction of the vitamin A activity, they present 99% of the vitamin A in the liver. The distribution pattern of the different retinyl esters was independent of the amount of supplementary vitamin A. In the present experiment 20,000 U of Vitamin A reduced plasma and tissue vitamin E levels. This effect led to an increase of lipid peroxidation indicated by the higher production of hydrocarbons. The results raise concerns about further increases of vitamin A supplementation in piglet feed.

Etomidate has become an important induction agent in high-risk patients because of its cardiovascular stability. Its unwanted side-effects such as pain on injection and thrombophlebitis could be significantly reduced by a new (medium chain triglyceride and soya bean) emulsion formulation. Propofol is solved in a mixture of long chain triglyceride and soya bean emulsion. In this double-blind, randomized study we compared the haemodynamic effects, the patients' sensations, signs of thrombophlebitis and postoperative nausea and vomiting (PONV) following injection of both drugs.Following premedication with 2 mg Lormetazepam p.o. in 50 patients per group, anaesthesia was induced with either 0.51 mg etomidate in lipid emulsion or 3.04 mg propofol per kg bw. No opioid or benzdiazepine was given i.v. before induction. After injection of the tested drug, the cannula was removed. Changes in blood pressure and heart rate were recorded as well as signs of discomfort during and after injection (pain, burning, tension, cold). Venous sequelae were assessed for 5 days after injection to register signs of thrombophlebitis.Demographic data showed no difference between the two groups. After propofol more often a fall in blood pressure was seen. Pain (25 vs 1 pt), burning 19 vs 1), tension 15 vs 3), cold (35 vs 17) after injection was registered significantly more often in the propofol group, whereas myocloni predominated in the etomidate group (13 vs 6) P0.05, chi-squared-test). No difference was seen in PONV in either groups.Etomidate formulated in a medium chain lipid emulsion causes significant less discomfort for the patients than propofol, which is solved in a long chain formulation. Myocloni, however, occur significantly more frequently after etomidate than after propofol.

The production of motor fuel from rapeseed oil forms large amounts of glycerol as a waste product (about 100 g per kg oil). The aim of this experiment was to test glycerol as a component in diets of fattening pigs. In two experiments received 48 pigs (Pietrain x F1, Landrace x German breed) up to 30% glycerol in barley-soya bean oil meal diets. Six pigs per group with an initial weight of 32 kg (experiment 1) and 31.2 kg (experiment 2) in average received the diets semi ad libitum during the whole fattening periods. Barley was replaced by glycerol, that the content of glycerol in diets amounted 5 and 10% (1st exp.) and 5; 10; 20 and 30% in the 2nd exp. respectively. The feed intake was in order of groups up to slaughtering in exp. 1: 1.98; 2.17 and 2.23 kg DM/animal and day and in exp. 2 over 71 days: 2.26; 2.44; 2.54; 2.32 and 2.37 kg DM/animal and day. The sweet taste and the better feed structure of diets with glycerol supplementation is the reason for the higher feed intake in the groups with a glycerol supplement. The daily live weight gain was in the same order 631; 719; 754; 731; 770; 819; 704 and 598 g/animal resp. The feed conversion ratio was only in the group with 30% glycerol significant different from all other groups (3.96 against 2.95-3.30 kg DM/kg live weight gain). 30 min. after feeding the glycerol concentration in blood rose evident with higher glycerol content in diets. It was also found a higher glycerol content in the urine in dependence on the glycerol concentration in the blood. Glycerol in diets changed not the carcass yield and the meat quality. Pathological changes of liver and kidney of animals were not found after glycerol feeding. Amounts of glycerol up to 10% in the diet are recommended.

The influence of an increasing protein supply in combination with soybean oil upon the IGF-I concentration in the serum in correlation with growth was measured on 8 x 10 male Wistar rats. With a casein content of 0% in the food, the IGF-I level was 0.13 +/- 0.02 rU/ml. An IGF-I plateau of 0.74 +/- 0.07 rU/ml was reached at some 15% casein. The additional application of 3% soybean oil increased the IGF-I concentration significantly (P less than 0.01) up to 0.95 +/- 0.16 rU/ml. The investigations show a specific increase of the IGF-I synthesis by the addition of oil, which is paralleled by a further stimulation of the growth of the rats. The nutrition-dependent IGF production in the peripheral tissues (mainly liver) represents the connection link between the growth hormone axis (genetically potential growth) and the growth realizable depending on the supply with nutrients.

In an experimental study with sprague-dawley-rats we tested the effect of parenteral substituted LCT-fats on tumor growth of the Yoshida sarcoma in its ascites form. Therefore we tested 4 groups with 10 tumor-bearing and 10 non-tumor-bearing rats. We added group 1-3 LCT-fats in different doses. Group 4 was fed enterally. We found that tumor-bearing rats had a higher nitrogen retention than non-tumor-bearing rats. Non-tumor-bearing rats showed a higher nitrogen concentration in the muscles. The portion of nitrogen increased with increasing portion of fat. The content of nitrogen in the ascites, the quantity and the number of tumor cells was reversed in proportion to the portion of fat. For the host we showed that he cannot make use of the energy directly. The tumor does not grow in proportion to the available energy but has to support itself from the catabolism of the host.

A new lipid emulsion for parenteral nutrition, Elolipid, was evaluated for in vitro stability as a component of an all-in-one nutrition solution and, in an open prospective investigation, for clinical tolerance and utilisation in intensive care patients with a broad spectrum of underlying diseases and organ dysfunctions. In vitro stability was determined by photon correlation spectroscopy (mean particle diameter) and Coulter Counter cell sizing (particle size distribution) after 0, 24, 48, 96 h of storage at temperatures of 4 degrees C and 25 degrees C. Mean particle diameter of 330 nm was not altered at any storage time or temperature. The portion of particles with an diameter of greater than 1,000 nm increased mildly during storage of 96 h at room temperature. 31 critically ill patients (mean age 55 +/- 3 years) entered the clinical study: 23 subjects were on artificial ventilation, 15 acquired septicemia, 9 renal insufficiency, and 7 acute or chronic hepatic failure. Fat was given as a component of an all-in-one solution at a rate of 1 g/kg b.w./day for a mean duration of 10 +/- 2 days. Plasma triglycerice concentrations rose mildly between days 3 and 5 only, but in none of the patients the infusion had to be stopped. Lipid-related disturbances of glucose or electrolyte metabolism, hepatic function, cholestasis, induction of disseminated coagulation, impairment of pulmonary gas exchange or renal function were not seen. 7 of 31 patients (22%) died. Side effects of complications attributable to the fat infusion could not be identified. It is concluded that the new lipid emulsion Elolipid is stable as a component of an all-in-one parenteral nutrition solution, is free of side effects and is well-tolerated and utilized even in critically ill patients with multiple organ dysfunctions.

Energetically differing rations which received ca. 45% of their crude protein from a supplement of soybean oil meal or urea were tested in a model experiment with adult wethers fitted with duodenal re-entrant cannulae or rumen cannulae resp. The N-equivalent exchange of soybean oil meal by urea in wethers resulted in a distinct increase of the NH3-N content of the rumen fluid, an increase of irreversible N losses and thus a worsening of the utilization of the available N for bacterial N-efficiency. A significant influence on duodenal NAN passage, on the apparent fermentation of the organic matter, on postruminal NAN digestibility and on the content of amino acid nitrogen as well as the amino acid composition of the duodenal NAN could not be detected. The increase of the energy level of the rations did not have a significant influence on the parameters of the ruminal N metabolism in the wethers. The studies with calves and adult wethers showed that a transposition of the parameters of ruminal N metabolism obtained to calves is not possible under the conditions given.

Two intravenous fat tolerance tests (IVFTT) were performed in 16 healthy volunteers and 8 patients suffering from hypertriglyceridemia (HTG). We compared Lipofundin S (Braun, Melsungen) with Intralipid (Kabi Vitrum, Stockholm), using both 10- and 20% concentrations. Time intervals between the tests were 1 h for the volunteers and 2 h for the patients with HTG, respectively. Fractional elimination rates were obtained from light scattering intensity of serum samples. They were significantly higher for Lipofundin S (9.61%/min for healthy men and 12.48%/min for healthy women) compared to Intralipid (7.09%/min for healthy men and 9.41%/min for healthy women). This difference occurred independently of (1) serum triglyceride concentrations and sex of the volunteers, (2) concentrations of lipid emulsions (10 vs. 20%), and (3) the test sequence (Lipofundin S or Intralipid first). This means that the elimination kinetics during an IVFTT are not influenced by a foregoing test. Similar features of both emulsion types were: (1) Faster elimination in women compared to men, and in healthy volunteers compared to HTG patients; (2) inverse correlation between fractional elimination rates and serum triglyceride concentrations. Fractional elimination rates of Lipofundin S and Intralipid were closely interrelated. Obviously there exists an intra-individually characteristic elimination capacity for exogenous triglycerides.