galactomannan and Obesity

Our aim was to evaluate the performance of two galactomannan (GM) assays (Platelia Aspergillus EIA, Bio-Rad. We included critically ill patients, performed GM-EIA and GM-Lateral Flow Assay (GM-LFA) in TA and followed them until development of COVID-19-associated pulmonary aspergillosis (CAPA) or alternate diagnosis. CAPA was defined according to the modified AspICU criteria in patients with SARS-CoV-2 infection. We estimated sensitivity, specificity, positive and negative predictive values for GM-EIA, GM-LFA, the combination of both or either positive results for GM-EIA and GM-LFA. We explored accuracy using different breakpoints, through ROC analysis and Youden index to identify the optimal cut-offs. We described antifungal treatment and 30-day mortality.. We identified 14/144 (9.7%) patients with CAPA, mean age was 50.35 (SD 11.9), the median time from admission to CAPA was 8 days; 28.5% received tocilizumab and 30-day mortality was 57%. ROC analysis and Youden index identified 2.0 OD as the best cut-off, resulting in sensitivity and specificity of 57.1% and 81.5% for GM-EIA and 60% and 72.6% for GM-LFA, respectively.. The diagnostic performance of GM in tracheal aspirates improved after using a cut-off of 2 OD. Although bronchoalveolar lavage testing is the ideal test, centres with limited access to bronchoscopy may consider this approach to identify or rule out CAPA.

Topics: Adult; Antifungal Agents; COVID-19; Diabetes Complications; Female; Galactose; Humans; Male; Mannans; Middle Aged; Obesity; Pulmonary Aspergillosis; Sensitivity and Specificity; Trachea

Galactomannan, a soluble fiber, has been reported to reduce postprandial blood glucose response. Using this fiber, extracted from Canadian-grown fenugreek seeds (Trigonella foenum graecum L), we conducted an in vitro study to determine if galactomannan affects intestinal glucose uptake in genetically determined lean and obese rats. The segments of jejunum and ileum from these animals were incubated with labeled glucose (2 or 32 mmol/L) in the presence of different concentrations of galactomannan ranging from 0.1% to 0.5% (wt/wt). The uptake of low or high concentration of glucose was significantly and progressively reduced by increasing concentrations of galactomannan in both lean and obese rats. No significant difference was observed in the uptake of glucose between the 2 groups. The viscosity of various concentrations of galactomannan solutions was determined after stirring for 60 minutes at a temperature-controlled (37 degrees C) fixed sheer rate of 1.29 (1/s). The inhibitory effect of galactomannan on glucose uptake was found to be in parallel with the degree of viscosity of the fiber solutions. These results suggest that the galactomannan, because of its viscous property, has the potential to reduce intestinal absorption of low or high concentrations of glucose and hence for the benefit of blood glucose management.

Topics: Animals; Body Weight; Galactose; Glucose; Intestinal Absorption; Intestine, Small; Mannans; Metabolic Syndrome; Obesity; Phytotherapy; Plant Extracts; Rats; Rats, Inbred Strains; Seeds; Trigonella; Viscosity