Moderate red wine consumption has been linked to reduced chronic disease risk. Thus far, little has been known about the physicochemical properties and potential biological effects of high-molecular-weight polyphenolic complexes (HPPCs), a major fraction of red wine polyphenols. In this work, the stability and biochemical properties of HPPCs under simulated gastrointestinal conditions in vitro were studied. The results showed that HPPCs were resistant to simulated gastric digestion (SGD) and simulated intestinal digestion (SID). They exhibited significant inhibitory activity against key metabolic syndrome-associated digestive enzymes, achieving 17.1-90.9% inhibition of pancreatic α-amylase, lipase, and cholesterol esterase at 0.02-0.45 mg/mL. HPPCs were metabolized by gut microbiota (GM), leading to significantly enhanced antioxidant capacity when compared with the original, SGD, and SID samples. Furthermore, they favorably modulated GM profiles, which was accompanied by significantly increased short-chain fatty acid generation during the early colonic fermentation phase. These findings suggest that HPPCs are a promising modulator of human metabolic disease risk.
Abstract The relationship between the structural properties of natural polyphenols and their affinities for α-amylase were investigated by fluorescence titration analysis. The binding process with α-amylase was strongly influenced by the structural differences of the compounds under study. For instance, the methylation of the hydroxylgroup in flavonoids increased their binding affinities for α-amylase by 2.14 to 7.76 times. The hydroxylation on rings A, B, and C of flavonoids also significantly affected their affinities for α-amylase. The glycosylation of isoflavones and flavanones reduced their affinities for α-amylase and the glycosylation of flavones and flavonols enhanced their affinities for α-amylase. Hydrogenation of the C2C3 double bond of flavonoids decreased the binding affinities. The galloylated catechins had higher binding affinities with α-amylase than non-galloylated catechins and the pyrogallol-type catechins had higher affinities than the catechol-type catechins. The presence of the galloyl moiety is the most decisive factor. The glycosylation of resveratrol decreased its affinity for α-amylase. The esterification of gallic acid significantly reduced the affinity for α-amylase. The binding interaction between polyphenols and α-amylase was mainly caused by hydrophobic forces.
The evaluation of predictable variability in blood pressure (BP) and heart rate (HR) by the use of ambulatory devices, and the proper processing of the time series thus obtained, can be useful for the early assessment of hypertensive complications in pregnancy. The authors have used this approach to analyze 759 series of BP and HR sampled by ambulatory monitoring for about 48 hours every four weeks after the first obstetric visit in 71 women with uncomplicated pregnancies and 42 women with gestational hypertension or preeclampsia. The pattern of variation along gestation of the 24-hour mean of BP for each group of pregnant women was established by polynomial regression analysis. This method revealed a BP predictable pattern of variation with gestational age: for normotensive pregnant women, results indicate a steady decrease in BP up to the 21st week of pregnancy, followed by an increase in BP up to the day of delivery. In pregnancies complicated with gestational hypertension or preeclampsia, the 24-hour mean of BP is stable until the 22nd week of pregnancy, and then correlated with gestational age indicating a significant linear increase of BP in the second half of pregnancy. These differences between uncomplicated and complicated pregnancies offer new endpoints for an early identification of gestational hypertension and preeclampsia.
Currently recommended ambulatory blood pressure (BP) monitoring (ABPM) thresholds for diagnosis of hypertension do not differentiate, as international guidelines do for clinic BP, uncomplicated persons at low risk from those at higher risk, e.g., patients with diabetes, for target injury and cardiovascular disease (CVD) risk. We aimed to derive diagnostic thresholds for the awake and asleep systolic (SBP) and diastolic (DBP) BP means based upon CVD outcomes (death from all causes, myocardial infarction, angina pectoris, coronary revascularization, heart failure, acute arterial occlusion of the lower extremities, thrombotic occlusion of the retinal artery, hemorrhagic stroke, ischemic stroke, and transient ischemic attack) for patients with and without diabetes. We prospectively studied 3344 subjects (1718 men/1626 women), 52.6 ± 14.5 (mean ± SD) yrs of age, 607 with type 2 diabetes, during a median follow-up of 5.6 yrs. Those with hypertension at baseline were randomized to ingest all their prescribed hypertension medications upon awakening or the entire daily dose of ≥1 of them at bedtime. At baseline, BP was measured at 20-min intervals from 07:00 to 23:00 h and at 30-min intervals at night for 48 h, and physical activity was simultaneously monitored every minute by wrist actigraphy to accurately derive the awake and asleep BP means. Identical assessment was scheduled annually and more frequently (quarterly) if treatment adjustment was required. Cox regression analysis was used to derive outcome-based reference thresholds for ABPM in subjects with and without diabetes. CVD risk was consistently greater in patients with than without diabetes for awake SBP/DBP means ≥130/75 mm Hg and asleep means ≥110/65 mm Hg. Derived outcome-based reference thresholds for persons without diabetes were 135/85 mm Hg for the awake and 120/70 mm Hg for the asleep SBP/DBP means. In terms of CVD outcome, the equivalent cutoff threshold values for patients with diabetes were 120/75 mm Hg for the awake and 105/60 mm Hg for the asleep SBP/DBP means. Outcome-based reference thresholds for the diagnosis of hypertension were 15/10 mm Hg lower for ambulatory SBP/DBP in patients with than without diabetes. This marked difference indicates the need for revision of current guidelines that propose diagnostic thresholds for ambulatory BP without differentiation between the presence/absence of diabetes.
