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Published in: Nutrition & Metabolism 1/2012

Open Access 01-12-2012 | Research

Jerusalem artichoke and chungkookjang additively improve insulin secretion and sensitivity in diabetic rats

Authors: Hye Jeong Yang, Dae Young Kwon, Min Jung Kim, Suna Kang, Da Sol Kim, Sunmin Park

Published in: Nutrition & Metabolism | Issue 1/2012

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Abstract

Jerusalem artichoke (Helianthus tuberosus Linne, HTL) and chungkookjang (CKJ; fermented soybeans) both modulate energy and glucose metabolism. However, the mechanism and their additive effects are unknown. We investigated whether the consumption of HTL and CKJ altered insulin sensitivity, insulin secretion capacity and β-cell survival in type 2 diabetic animals. Rats were divided into partially pancreatectomized (Px) diabetic rats, and sham operated non-diabetic control rats and all fed high fat diets. Diabetic rats were sub-divided into an untreated diabetic control group and those fed 5% HTL, 5% CKJ or 5% HTL+5% CKJ for 8 weeks. HTL+CKJ treatment reduced visceral fat without modulating energy intake compared to the diabetic-control. Glucose tolerance was improved in an ascending order of diabetic-control, CKJ, HTL, HTL+CKJ, and normal-control, but by different mechanisms. CKJ and CKJ+HTL, but not HTL, increased first and second phase insulin secretion in comparison to the diabetic-control at hyperglycemic clamp. However, glucose infusion rates (mg/kg bw/min) were increased by and CKJ+HTL (13.5), but not HTL (9.4) or CKJ (9.5) alone, and HTL and CKJ+ HTL decreased hepatic glucose compared to diabetic-control during the hyperinsulinemic euglycemic study and were associated with decreased triglyceride accumulation and increased glycogen storage. The improved hepatic insulin sensitivity by HTL and CKJ+HTL was explained by potentiated insulin signaling (tyrosine phosphorylation of insulin receptor substrate 2→phosphorylation of Akt) and phosphorylation of AMPK→phosphorykation of acetyl Co carboxlase in comparison to diabetic-control and decreased PEPCK expression. Absolute β-cell mass was increased by CKJ (23.4mg) and CKJ+HTL (26.3 mg) by increasing proliferation compared to the diabetic-control (21.26 mg). Although HTL lowered β-cell apoptosis, it did not increase β-cell mass (20.8 mg). In conclusions, HTL and CKJ enhanced glucose tolerance in different manners, and exhibited partially additive and complementary effects by reversing insulin resistance and enhancing β-cell function in diabetic rats.
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Literature
1.
go back to reference The division of National Nutrition Survey: 1993 National nutrition survey report in Korea. 1996, Seoul: Ministry of Health and Welfare The division of National Nutrition Survey: 1993 National nutrition survey report in Korea. 1996, Seoul: Ministry of Health and Welfare
2.
go back to reference Yajnik CS: Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries. J Nutr. 2004, 134: 205-210. Yajnik CS: Early life origins of insulin resistance and type 2 diabetes in India and other Asian countries. J Nutr. 2004, 134: 205-210.
3.
go back to reference McNeely MJ, Boyko EJ: Type 2 diabetes prevalence in Asian Americans: results of a national health survey. Diabetes Care. 2004, 27: 66-69. 10.2337/diacare.27.1.66.CrossRef McNeely MJ, Boyko EJ: Type 2 diabetes prevalence in Asian Americans: results of a national health survey. Diabetes Care. 2004, 27: 66-69. 10.2337/diacare.27.1.66.CrossRef
4.
go back to reference Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB: Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009, 301: 2129-2140. 10.1001/jama.2009.726.CrossRef Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB: Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009, 301: 2129-2140. 10.1001/jama.2009.726.CrossRef
5.
go back to reference DeFronzo RA, Bonadonna RC, Ferrannini E: Pathogenesis of NIDDM: A balanced overview. Diabetes Care. 1992, 15: 318-353. 10.2337/diacare.15.3.318.CrossRef DeFronzo RA, Bonadonna RC, Ferrannini E: Pathogenesis of NIDDM: A balanced overview. Diabetes Care. 1992, 15: 318-353. 10.2337/diacare.15.3.318.CrossRef
6.
go back to reference Kwon DY, Jang JS, Hong SM, Lee JE, Sung SR, Park HR, Park S: Long-term consumption of fermented soybean-derived Chungkookjang enhances insulinotropic action unlike soybeans in 90% pancreatectomized diabetic rats. Eur J Nutr. 2007, 46: 44-52. 10.1007/s00394-006-0630-y.CrossRef Kwon DY, Jang JS, Hong SM, Lee JE, Sung SR, Park HR, Park S: Long-term consumption of fermented soybean-derived Chungkookjang enhances insulinotropic action unlike soybeans in 90% pancreatectomized diabetic rats. Eur J Nutr. 2007, 46: 44-52. 10.1007/s00394-006-0630-y.CrossRef
7.
go back to reference Kwon DY, Hong SM, Lee JE, Sung SR, Park S: Long-term consumption of fermented soybean-derived Chungkookjang attenuates hepatic insulin resistance in 90% pancreatectomized diabetic rats. Horm Metab Res. 2007, 39: 752-757. 10.1055/s-2007-990287.CrossRef Kwon DY, Hong SM, Lee JE, Sung SR, Park S: Long-term consumption of fermented soybean-derived Chungkookjang attenuates hepatic insulin resistance in 90% pancreatectomized diabetic rats. Horm Metab Res. 2007, 39: 752-757. 10.1055/s-2007-990287.CrossRef
8.
go back to reference Kaur N, Gupta AK: Applications of inulin and oligofructose in health and nutrition. J Biosci. 2002, 27: 703-714. 10.1007/BF02708379.CrossRef Kaur N, Gupta AK: Applications of inulin and oligofructose in health and nutrition. J Biosci. 2002, 27: 703-714. 10.1007/BF02708379.CrossRef
9.
go back to reference Boillot J, Alamowitch C, Berger AM, Luo J, Bruzzo F: Effect of dietary propionate on hepatic glucose production, whole body glucose utilization, carbohydrate and lipid metabolism in normal rats. Br J Nutr. 1995, 73: 241-255. 10.1079/BJN19950026.CrossRef Boillot J, Alamowitch C, Berger AM, Luo J, Bruzzo F: Effect of dietary propionate on hepatic glucose production, whole body glucose utilization, carbohydrate and lipid metabolism in normal rats. Br J Nutr. 1995, 73: 241-255. 10.1079/BJN19950026.CrossRef
10.
go back to reference Luo J, Rizkalla SW, Alamovitch C, Boussairi A, Blayo A: Chronic consumption of short chain fructooligosaccharides by healthy subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism. Am J Clin Nutr. 1996, 63: 639-645. Luo J, Rizkalla SW, Alamovitch C, Boussairi A, Blayo A: Chronic consumption of short chain fructooligosaccharides by healthy subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism. Am J Clin Nutr. 1996, 63: 639-645.
11.
go back to reference Jang CH, Lim JK, Kim JH, Park CS, Kwon DY, Kim YS, Kim JS: Change of isoflavone content during manufacturing of Cheonggukjang, a traditional Korean fermented soyfood. Food Sci Biotech. 2006, 15: 643-646. Jang CH, Lim JK, Kim JH, Park CS, Kwon DY, Kim YS, Kim JS: Change of isoflavone content during manufacturing of Cheonggukjang, a traditional Korean fermented soyfood. Food Sci Biotech. 2006, 15: 643-646.
12.
go back to reference Kim J, Choi JN, Kang D, Son GH, Kim YS, Choi HK, Kwon DY, Lee CH: Correlation between antioxidative activities and metabolite changes during Cheonggukjang fermentation. Biosci Biotech Biochemy. 2011, 75: 732-739. 10.1271/bbb.100858.CrossRef Kim J, Choi JN, Kang D, Son GH, Kim YS, Choi HK, Kwon DY, Lee CH: Correlation between antioxidative activities and metabolite changes during Cheonggukjang fermentation. Biosci Biotech Biochemy. 2011, 75: 732-739. 10.1271/bbb.100858.CrossRef
13.
go back to reference Schwartz TB, Engel FL: A photometric ninhydrin method for the measurement of proteolysis. J Biol Chem. 1950, 184: 197-202. Schwartz TB, Engel FL: A photometric ninhydrin method for the measurement of proteolysis. J Biol Chem. 1950, 184: 197-202.
14.
go back to reference Hosokawa YA, Hosokawa H, Chen C, Leahy JL: Mechanism of impaired glucose-potentiated insulin secretion in diabetic 90% pancreatectomy rats. Study using glucagons like peptide-1(7–37). J Clin Invest. 1996, 97: 180-186. 10.1172/JCI118387.CrossRef Hosokawa YA, Hosokawa H, Chen C, Leahy JL: Mechanism of impaired glucose-potentiated insulin secretion in diabetic 90% pancreatectomy rats. Study using glucagons like peptide-1(7–37). J Clin Invest. 1996, 97: 180-186. 10.1172/JCI118387.CrossRef
15.
go back to reference Cordera R, Andraghetti G, DeFronzo RA, Rossetti L: Effect of in vivo vanadate treatment on insulin receptor tyrosine kinase activity in partially pancreatectomized diabetic rats. Endocrinology. 1990, 126: 2177-2183. 10.1210/endo-126-4-2177.CrossRef Cordera R, Andraghetti G, DeFronzo RA, Rossetti L: Effect of in vivo vanadate treatment on insulin receptor tyrosine kinase activity in partially pancreatectomized diabetic rats. Endocrinology. 1990, 126: 2177-2183. 10.1210/endo-126-4-2177.CrossRef
16.
go back to reference Choi SB, Jang JS, Park S: Estrogen and exercise may enhance β-cell function and mass via IRS2 induction in ovariectomized diabetic rats. Endocrinology. 2005, 146: 4786-4794. 10.1210/en.2004-1653.CrossRef Choi SB, Jang JS, Park S: Estrogen and exercise may enhance β-cell function and mass via IRS2 induction in ovariectomized diabetic rats. Endocrinology. 2005, 146: 4786-4794. 10.1210/en.2004-1653.CrossRef
17.
go back to reference Report of the American Institute of Nutrition: Ad Hoc committee on standards for nutritional studies. J Nutr. 1997, 107: 1340-1348. Report of the American Institute of Nutrition: Ad Hoc committee on standards for nutritional studies. J Nutr. 1997, 107: 1340-1348.
18.
go back to reference Dobbins RL, Szczepaniak LS, Myhill J, Tamura Y, Uchino H, Giacca A, McGarry JD: The composition of dietary fat directly influences glucose-stimulated insulin secretion in rats. Diabetes. 2002, 51: 1825-1833. 10.2337/diabetes.51.6.1825.CrossRef Dobbins RL, Szczepaniak LS, Myhill J, Tamura Y, Uchino H, Giacca A, McGarry JD: The composition of dietary fat directly influences glucose-stimulated insulin secretion in rats. Diabetes. 2002, 51: 1825-1833. 10.2337/diabetes.51.6.1825.CrossRef
19.
go back to reference Kim JK, Kim YJ, Fillmore JJ, Chen Y, Moore I, Lee J, Yuan M, Li ZW, Karin M, Perret P, Shoelson SE, Shulman GI: Prevention of fat-induced insulin resistance by salicylate. J Clin Invest. 2001, 108: 437-446.CrossRef Kim JK, Kim YJ, Fillmore JJ, Chen Y, Moore I, Lee J, Yuan M, Li ZW, Karin M, Perret P, Shoelson SE, Shulman GI: Prevention of fat-induced insulin resistance by salicylate. J Clin Invest. 2001, 108: 437-446.CrossRef
20.
go back to reference Rooman I, Lardon J, Bouwen L: Gastrin stimulates β-cell neogenesis and increases islet mass from transdifferentiated but not from normal exocrine pancreas tissue. Diabetes. 2002, 51: 686-690. 10.2337/diabetes.51.3.686.CrossRef Rooman I, Lardon J, Bouwen L: Gastrin stimulates β-cell neogenesis and increases islet mass from transdifferentiated but not from normal exocrine pancreas tissue. Diabetes. 2002, 51: 686-690. 10.2337/diabetes.51.3.686.CrossRef
21.
go back to reference Frontoni S, Choi SB, Banduch D, Rossetti L: In vivo insulin resistance induced by amylin primarily through inhibition of insulin-stimulated glycogen synthesis in skeletal muscle. Diabetes. 1991, 40: 568-573. 10.2337/diabetes.40.5.568.CrossRef Frontoni S, Choi SB, Banduch D, Rossetti L: In vivo insulin resistance induced by amylin primarily through inhibition of insulin-stimulated glycogen synthesis in skeletal muscle. Diabetes. 1991, 40: 568-573. 10.2337/diabetes.40.5.568.CrossRef
22.
go back to reference Sebokova E, Klimes I, Moss R, Stolba P, Wiersma MM, Mitkova A: Muscle GLUT 4 protein levels and impaired triglyceride metabolism in streptozotocin diabetic rats. Effect of a high sucrose diet and fish oil supplementation. Ann NY Acad Sci. 1993, 683: 218-227. 10.1111/j.1749-6632.1993.tb35710.x.CrossRef Sebokova E, Klimes I, Moss R, Stolba P, Wiersma MM, Mitkova A: Muscle GLUT 4 protein levels and impaired triglyceride metabolism in streptozotocin diabetic rats. Effect of a high sucrose diet and fish oil supplementation. Ann NY Acad Sci. 1993, 683: 218-227. 10.1111/j.1749-6632.1993.tb35710.x.CrossRef
23.
go back to reference Sugatani J, Sadamitsu S, Wada T, Yamazaki Y, Ikari A, Miwa M: Effects of dietary inulin, statin, and their co-treatment on hyperlipidemia, hepatic steatosis and changes in drug-metabolizing enzymes in rats fed a high-fat and high-sucrose diet. Nutr Metab. 2012, 9: 23-10.1186/1743-7075-9-23.CrossRef Sugatani J, Sadamitsu S, Wada T, Yamazaki Y, Ikari A, Miwa M: Effects of dietary inulin, statin, and their co-treatment on hyperlipidemia, hepatic steatosis and changes in drug-metabolizing enzymes in rats fed a high-fat and high-sucrose diet. Nutr Metab. 2012, 9: 23-10.1186/1743-7075-9-23.CrossRef
24.
go back to reference Yamashita K, Kawai K, Itakurqa K: Effect of fructooligosaccharides on blood glucose and serum lipids in diabetic subjects. Nutr Res. 1984, 4: 961-966. 10.1016/S0271-5317(84)80075-5.CrossRef Yamashita K, Kawai K, Itakurqa K: Effect of fructooligosaccharides on blood glucose and serum lipids in diabetic subjects. Nutr Res. 1984, 4: 961-966. 10.1016/S0271-5317(84)80075-5.CrossRef
25.
go back to reference Aslan M, Orhan N, Orhan DD, Ergun F: Hypoglycemic activity and antioxidant potential of some medicinal plants traditionally used in Turkey for diabetes. J Ethnopharmacol. 2010, 128: 384-389. 10.1016/j.jep.2010.01.040.CrossRef Aslan M, Orhan N, Orhan DD, Ergun F: Hypoglycemic activity and antioxidant potential of some medicinal plants traditionally used in Turkey for diabetes. J Ethnopharmacol. 2010, 128: 384-389. 10.1016/j.jep.2010.01.040.CrossRef
26.
go back to reference Dewulf EM, Cani PD, Neyrinck AM, Possemiers S, Van Holle A, Muccioli GG, Deldicque L, Bindels LB, Pachikian BD, Sohet FM, Mignolet E, Francaux M, Larondelle Y, Delzenne NM: Inulin-type fructans with prebiotic properties counteract GPR43 overexpression and PPARγ-related adipogenesis in the white adipose tissue of high-fat diet-fed mice. J Nutr Biochem. 2011, 22: 712-722. 10.1016/j.jnutbio.2010.05.009.CrossRef Dewulf EM, Cani PD, Neyrinck AM, Possemiers S, Van Holle A, Muccioli GG, Deldicque L, Bindels LB, Pachikian BD, Sohet FM, Mignolet E, Francaux M, Larondelle Y, Delzenne NM: Inulin-type fructans with prebiotic properties counteract GPR43 overexpression and PPARγ-related adipogenesis in the white adipose tissue of high-fat diet-fed mice. J Nutr Biochem. 2011, 22: 712-722. 10.1016/j.jnutbio.2010.05.009.CrossRef
27.
go back to reference Dewulf EM, Cani PD, Claus SP, Fuentes S, Puylaert PG, Neyrinck AM, Bindels LB, de Vos WM, Gibson GR, Thissen JP, Delzenne NM: Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women. Gut. 2012, Epub ahead of print Dewulf EM, Cani PD, Claus SP, Fuentes S, Puylaert PG, Neyrinck AM, Bindels LB, de Vos WM, Gibson GR, Thissen JP, Delzenne NM: Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women. Gut. 2012, Epub ahead of print
28.
go back to reference Kang SI, Han JI, Kim KY, Oh SU, Kim SI: Changes in soluble neutral carbohydrates composition of Jerusalem artichoke (Helianthus tuberosus Linne) tubers according to harvest date and storage temperature. J Kr Agric Chem Soc. 1993, 36: 304-309. Kang SI, Han JI, Kim KY, Oh SU, Kim SI: Changes in soluble neutral carbohydrates composition of Jerusalem artichoke (Helianthus tuberosus Linne) tubers according to harvest date and storage temperature. J Kr Agric Chem Soc. 1993, 36: 304-309.
29.
go back to reference Lim KB, Lee HJ: Effect of planting date and cutting management on Jerusalem artichoke (Helianthus tuberosus Linne). J Kr Grassl Sci. 1983, 4: 147-151. Lim KB, Lee HJ: Effect of planting date and cutting management on Jerusalem artichoke (Helianthus tuberosus Linne). J Kr Grassl Sci. 1983, 4: 147-151.
30.
go back to reference Roberfroid M: Dietary fiber, inulin and oligofructose: a review comparing their physiological effects. Crit Rev Food Sci Nutr. 1993, 33: 103-148. 10.1080/10408399309527616.CrossRef Roberfroid M: Dietary fiber, inulin and oligofructose: a review comparing their physiological effects. Crit Rev Food Sci Nutr. 1993, 33: 103-148. 10.1080/10408399309527616.CrossRef
31.
go back to reference Parnell JA, Reimer RA: Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults. Am J Clin Nutr. 2009, 89: 1751-1759. 10.3945/ajcn.2009.27465.CrossRef Parnell JA, Reimer RA: Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults. Am J Clin Nutr. 2009, 89: 1751-1759. 10.3945/ajcn.2009.27465.CrossRef
32.
go back to reference Drucker DJ: Biological actions and therapeutic potential of the glucagon-like peptides. Gastroenterology. 2002, 122: 531-544. 10.1053/gast.2002.31068.CrossRef Drucker DJ: Biological actions and therapeutic potential of the glucagon-like peptides. Gastroenterology. 2002, 122: 531-544. 10.1053/gast.2002.31068.CrossRef
33.
go back to reference Park S, Hong SM, Sung SR: Exendin-4 and exercise promotes β-cell function and mass through IRS2 induction in islets of diabetic rats. Life Sci. 2008, 82: 503-511. 10.1016/j.lfs.2007.12.018.CrossRef Park S, Hong SM, Sung SR: Exendin-4 and exercise promotes β-cell function and mass through IRS2 induction in islets of diabetic rats. Life Sci. 2008, 82: 503-511. 10.1016/j.lfs.2007.12.018.CrossRef
34.
go back to reference Kwon DY, Hong SM, Ahn IS, Kim MJ, Yang HJ, Park S: Isoflavonoids and peptides from Meju, a long-term fermented soy food, increase insulin sensitivity and exert insulinotropic effects in vitro. Nutrition. 2011, 27: 244-252. 10.1016/j.nut.2010.02.004.CrossRef Kwon DY, Hong SM, Ahn IS, Kim MJ, Yang HJ, Park S: Isoflavonoids and peptides from Meju, a long-term fermented soy food, increase insulin sensitivity and exert insulinotropic effects in vitro. Nutrition. 2011, 27: 244-252. 10.1016/j.nut.2010.02.004.CrossRef
35.
go back to reference Fu Z, Zhang W, Zhen W, Lum H, Nadler J, Bassaganya-Riera J, Jia Z, Wang Y, Misra H, Liu D: Genistein induces pancreatic beta-cell proliferation through activation of multiple signaling pathways and prevents insulin-deficient diabetes in mice. Endocrinology. 2010, 151: 3026-3037. 10.1210/en.2009-1294.CrossRef Fu Z, Zhang W, Zhen W, Lum H, Nadler J, Bassaganya-Riera J, Jia Z, Wang Y, Misra H, Liu D: Genistein induces pancreatic beta-cell proliferation through activation of multiple signaling pathways and prevents insulin-deficient diabetes in mice. Endocrinology. 2010, 151: 3026-3037. 10.1210/en.2009-1294.CrossRef
36.
go back to reference Ronis MJ, Chen Y, Badeaux J, Badger TM: Dietary soy protein isolate attenuates metabolic syndrome in rats via effects on PPAR, LXR, and SREBP signaling. J Nutr. 2009, 139: 1431-1438. 10.3945/jn.109.107029.CrossRef Ronis MJ, Chen Y, Badeaux J, Badger TM: Dietary soy protein isolate attenuates metabolic syndrome in rats via effects on PPAR, LXR, and SREBP signaling. J Nutr. 2009, 139: 1431-1438. 10.3945/jn.109.107029.CrossRef
37.
go back to reference Gobert CP, Duncan AM: Consumption, perceptions and knowledge of soy among adults with type 2 diabetes. J Am Coll Nutr. 2009, 28: 203-218.CrossRef Gobert CP, Duncan AM: Consumption, perceptions and knowledge of soy among adults with type 2 diabetes. J Am Coll Nutr. 2009, 28: 203-218.CrossRef
38.
go back to reference Kwon DY, Jang JS, Lee JE, Kim YS, Shin DW, Park S: The isoflavonoid aglycone-rich fractions of Chungkookjang, fermented unsalted soybeans, enhance insulin signaling and peroxisome proliferator-activated receptor-γ activity in vitro. Biofactors. 2006, 26: 245-258. 10.1002/biof.5520260403.CrossRef Kwon DY, Jang JS, Lee JE, Kim YS, Shin DW, Park S: The isoflavonoid aglycone-rich fractions of Chungkookjang, fermented unsalted soybeans, enhance insulin signaling and peroxisome proliferator-activated receptor-γ activity in vitro. Biofactors. 2006, 26: 245-258. 10.1002/biof.5520260403.CrossRef
Metadata
Title
Jerusalem artichoke and chungkookjang additively improve insulin secretion and sensitivity in diabetic rats
Authors
Hye Jeong Yang
Dae Young Kwon
Min Jung Kim
Suna Kang
Da Sol Kim
Sunmin Park
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Nutrition & Metabolism / Issue 1/2012
Electronic ISSN: 1743-7075
DOI
https://doi.org/10.1186/1743-7075-9-112

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