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Kvist AAS, Sharma A, Sommer C, Qvigstad E, Gulseth HL, Sollid ST, Nermoen I, Sattar N, Gill J, Tannæs TM, Birkeland KI, Lee-Ødegård S. Adipose Tissue Insulin Resistance in South Asian and Nordic Women after Gestational Diabetes Mellitus. Metabolites 2024; 14:288. [PMID: 38786765 PMCID: PMC11123011 DOI: 10.3390/metabo14050288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
South Asians (SAs) have a higher risk of developing type 2 diabetes (T2D) than white Europeans, especially following gestational diabetes mellitus (GDM). Despite similar blood glucose levels post-GDM, SAs exhibit more insulin resistance (IR) than Nordics, though the underlying mechanisms are unclear. This study aimed to assess markers of adipose tissue (AT) IR and liver fat in SA and Nordic women post-GDM. A total of 179 SA and 108 Nordic women in Norway underwent oral glucose tolerance tests 1-3 years post-GDM. We measured metabolic markers and calculated the AT IR index and non-alcoholic fatty liver disease liver fat (NAFLD-LFS) scores. Results showed that normoglycaemic SAs had less non-esterified fatty acid (NEFA) suppression during the test, resembling prediabetes/T2D responses, and higher levels of plasma fetuin-A, CRP, and IL-6 but lower adiponectin, indicating AT inflammation. Furthermore, normoglycaemic SAs had higher NAFLD-LFS scores, lower insulin clearance, and higher peripheral insulin than Nordics, indicating increased AT IR, inflammation, and liver fat in SAs. Higher liver fat markers significantly contributed to the ethnic disparities in glucose metabolism, suggesting a key area for intervention to reduce T2D risk post-GDM in SAs.
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Affiliation(s)
- Ahalya Anita Suntharalingam Kvist
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Archana Sharma
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Elisabeth Qvigstad
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | | | - Stina Therese Sollid
- Department of Medicine, Drammen Hospital, Vestre Viken Health Trust, 3004 Drammen, Norway
| | - Ingrid Nermoen
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow G12 8TA, UK
| | - Jason Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow G12 8TA, UK
| | - Tone Møller Tannæs
- EpiGen, Medical Division, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Kåre Inge Birkeland
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Sindre Lee-Ødegård
- Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, 0424 Oslo, Norway
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de Brito JN, McDonough DJ, Mathew M, VanWagner LB, Schreiner PJ, Gabriel KP, Jacobs DR, Terry JG, Carr JJ, Pereira MA. Young Adult Physical Activity Trajectories and Midlife Nonalcoholic Fatty Liver Disease. JAMA Netw Open 2023; 6:e2338952. [PMID: 37862012 PMCID: PMC10589812 DOI: 10.1001/jamanetworkopen.2023.38952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023] Open
Abstract
Importance Physical activity (PA) is recommended for preventing and treating nonalcoholic fatty liver disease (NAFLD). Yet, how long-term patterns of intensity-based physical activity, including moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), might affect the prevalence of NAFLD in middle age remains unclear. Objective To identify distinct intensity-based PA trajectories from young to middle adulthood and examine the associations between PA trajectories and NAFLD prevalence in midlife. Design, Setting, and Participants This population-based cohort of 2833 participants used the Coronary Artery Risk Development in Young Adults study data. The setting included field clinics in Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. Data analysis was completed in March 2023. Exposures PA was self-reported at 8 examinations over 25 years (1985-1986 to 2010-2011) and separately scored for MPA and VPA. Main Outcomes and Measures NAFLD was defined as liver attenuation values less than 51 Hounsfield units after exclusion of other causes of liver fat, measured using computed tomography in year 25 (2010-2011). Results Among a total of 2833 participants included in the sample, 1379 (48.7%) self-identified as Black, 1454 (51.3%) as White, 1206 (42.6%) as male, and 1627 (57.4%) as female from baseline (1985-1986) (mean [SD] age, 25.0 [3.6] years) to year 25 (2010-2011) (mean [SD] age, 50.1 [3.6] years). Three MPA trajectories were identified: very low stable (1514 participants [53.4%]), low increasing (1096 [38.7%]), and moderate increasing (223 [7.9%]); and 3 VPA trajectories: low stable (1649 [58.2%]), moderate decreasing (1015 [35.8%]), and high decreasing (169 [6.0%]). After adjustment for covariates (sex, age, race, study center, education, smoking status, and alcohol consumption), participants in the moderate decreasing (risk ratio [RR], 0.74; 95% CI, 0.54-0.85) and the high decreasing (RR, 0.59; 95% CI, 0.44-0.80) VPA trajectories had a lower risk of NAFLD in middle age, relative to participants in the low stable VPA trajectory. Adjustments for baseline body mass index and waist circumference attenuated these estimates, but the results remained statistically significant. The adjusted RRs across the MPA trajectories were close to null and not statistically significant. Conclusions and Relevance This cohort study of Black and White participants found a reduced risk of NAFLD in middle age for individuals with higher levels of VPA throughout young to middle adulthood compared with those with lower VPA levels. These results suggest the need for promoting sustainable and equitable prevention programs focused on VPA over the life course to aid in lowering NAFLD risk.
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Affiliation(s)
- Junia N. de Brito
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis
| | - Daniel J. McDonough
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Mahesh Mathew
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Lisa B. VanWagner
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas
| | - Pamela J. Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham
| | - David R. Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - James G. Terry
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark A. Pereira
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
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Vianna P, Calce SI, Boustros P, Larocque-Rigney C, Patry-Beaudoin L, Luo YH, Aslan E, Marinos J, Alamri TM, Vu KN, Murphy-Lavallée J, Billiard JS, Montagnon E, Li H, Kadoury S, Nguyen BN, Gauthier S, Therien B, Rish I, Belilovsky E, Wolf G, Chassé M, Cloutier G, Tang A. Comparison of Radiologists and Deep Learning for US Grading of Hepatic Steatosis. Radiology 2023; 309:e230659. [PMID: 37787678 DOI: 10.1148/radiol.230659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Screening for nonalcoholic fatty liver disease (NAFLD) is suboptimal due to the subjective interpretation of US images. Purpose To evaluate the agreement and diagnostic performance of radiologists and a deep learning model in grading hepatic steatosis in NAFLD at US, with biopsy as the reference standard. Materials and Methods This retrospective study included patients with NAFLD and control patients without hepatic steatosis who underwent abdominal US and contemporaneous liver biopsy from September 2010 to October 2019. Six readers visually graded steatosis on US images twice, 2 weeks apart. Reader agreement was assessed with use of κ statistics. Three deep learning techniques applied to B-mode US images were used to classify dichotomized steatosis grades. Classification performance of human radiologists and the deep learning model for dichotomized steatosis grades (S0, S1, S2, and S3) was assessed with area under the receiver operating characteristic curve (AUC) on a separate test set. Results The study included 199 patients (mean age, 53 years ± 13 [SD]; 101 men). On the test set (n = 52), radiologists had fair interreader agreement (0.34 [95% CI: 0.31, 0.37]) for classifying steatosis grades S0 versus S1 or higher, while AUCs were between 0.49 and 0.84 for radiologists and 0.85 (95% CI: 0.83, 0.87) for the deep learning model. For S0 or S1 versus S2 or S3, radiologists had fair interreader agreement (0.30 [95% CI: 0.27, 0.33]), while AUCs were between 0.57 and 0.76 for radiologists and 0.73 (95% CI: 0.71, 0.75) for the deep learning model. For S2 or lower versus S3, radiologists had fair interreader agreement (0.37 [95% CI: 0.33, 0.40]), while AUCs were between 0.52 and 0.81 for radiologists and 0.67 (95% CI: 0.64, 0.69) for the deep learning model. Conclusion Deep learning approaches applied to B-mode US images provided comparable performance with human readers for detection and grading of hepatic steatosis. Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Tuthill in this issue.
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Affiliation(s)
- Pedro Vianna
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Sara-Ivana Calce
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Pamela Boustros
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Cassandra Larocque-Rigney
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Laurent Patry-Beaudoin
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Yi Hui Luo
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Emre Aslan
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - John Marinos
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Talal M Alamri
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Kim-Nhien Vu
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Jessica Murphy-Lavallée
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Jean-Sébastien Billiard
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Emmanuel Montagnon
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Hongliang Li
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Samuel Kadoury
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Bich N Nguyen
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Shanel Gauthier
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Benjamin Therien
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Irina Rish
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Eugene Belilovsky
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Guy Wolf
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Michaël Chassé
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - Guy Cloutier
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
| | - An Tang
- From the Department of Imaging and Engineering (P.V., S.I.C., C.L.R., L.P.B., E.M., H.L., S.K., M.C., G.C., A.T.), Laboratory of Biorheology and Medical Ultrasonics (P.V., G.C.), and Clinical Laboratory of Image Processing (E.M., A.T.), Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Institute of Biomedical Engineering (P.V., G.C.) and Department of Computer Science and Operations Research (S.G., I.R., G.W.), Université de Montréal, Montréal, Canada; Departments of Radiology (S.I.C., P.B., C.L.R., L.P.B., Y.H.L., E.A., J.M., T.M.A., K.N.V., J.M.L., J.S.B., A.T.) and Pathology (B.N.N.), Centre Hospitalier de l'Université de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4; Department of Computer Engineering, École Polytechnique de Montréal, Montréal, Canada (S.K.); Mila-Quebec Artificial Intelligence Institute, Montréal, Canada (S.G., B.T., I.R., E.B., G.W.); and Department of Computer Science and Software Engineering, Concordia University, Montréal, Canada (B.T., E.B.)
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Ikewaki N, Ikeue Y, Nagataki M, Kurosawa G, Dedeepiya VD, Rajmohan M, Vaddi S, Senthilkumar R, Preethy S, Abraham SJK. Beneficial effects of 1,3-1,6 β-glucans produced by Aureobasidium pullulans on non-esterified fatty acid levels in diabetic KKAy mice and their potential implications in metabolic dysregulation. J Diabetes Metab Disord 2023; 22:487-494. [PMID: 37255831 PMCID: PMC10225397 DOI: 10.1007/s40200-022-01170-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 11/30/2022] [Indexed: 06/01/2023]
Abstract
Objectives In this study, we used an obese and diabetic mouse model to compare two strains of Aureobasidium pullulans (AFO-202 and N-163) produced beta-glucans (β-glucans), which alleviate lipotoxicity. Methods Four groups of KK-Ay mice were used, with six subjects in each group. Group 1: sacrificed on day 0 for baseline values; Group 2: control (drinking water); Group 3: AFO-202 beta glucan-200 mg/kg/day; Group 4: N-163 beta glucan-300 mg/kg/day for 28 consecutive days. Results Group 4 (N-163) had the lowest non-esterified fatty acids (NEFA) levels and marginally decreased triglyceride levels compared to the other groups. There were no significant differences in blood glucose, hemoglobin A1c (HbA1c), triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol levels. N-163 β-glucans decreased NEFA levels after 28 days. Conclusion These results, although modest, warrant further in-depth research into lipotoxicity and associated inflammatory cascades in both healthy and diseased subjects for the prevention and management of metabolic dysregulation and associated diseases such as non-alcoholic fatty liver disease (NAFLD).
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Affiliation(s)
- Nobunao Ikewaki
- Department of Medical Life Science, Kyushu University of Health and Welfare, Nobeoka, Japan
- Institute of Immunology, Junsei Educational Institute, Nobeoka, Miyazaki Japan
| | | | | | - Gene Kurosawa
- Department of Academic Research Support Promotion Facility, Center for Research Promotion and Support, Fujita Health University, Aichi, Japan
- MabGenesis KK, Nagoya, Japan
| | | | - Mathaiyan Rajmohan
- Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | | | - Rajappa Senthilkumar
- Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | - Senthilkumar Preethy
- Fujio-Eiji Academic Terrain (FEAT), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
| | - Samuel J. K. Abraham
- Sophy Inc., Kochi, Japan
- Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Chennai, India
- Centre for Advancing Clinical Research (CACR), University of Yamanashi - School of Medicine, Chuo, Japan
- Antony- Xavier Interdisciplinary Scholastics (AXIS), GN Corporation Co. Ltd., 3-8, Wakamatsu, Kofu, Yamanashi 400-0866 Japan
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Barboza TK, Susta L, zur Linden A, Gardhouse S, Beaufrère H. Association of plasma metabolites and diagnostic imaging findings with hepatic lipidosis in bearded dragons (Pogona vitticeps) and effects of gemfibrozil therapy. PLoS One 2023; 18:e0274060. [PMID: 36735707 PMCID: PMC9897564 DOI: 10.1371/journal.pone.0274060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/21/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To evaluate the association between plasma metabolites, biochemical analytes, diagnostic imaging findings, and the histologic diagnosis of hepatic lipidosis in bearded dragons. To assess the effects of gemfibrozil therapy on hepatic lipid accumulation and associated diagnostic tests. ANIMALS Fourteen bearded dragons (Pogona vitticeps) with varying severity of hepatic lipid accumulation (with and without hepatic lipidosis) were included. PROCEDURES Animals underwent coelomic ultrasound, computed tomography (CT) scans, and coelioscopic hepatic biopsies. Clinical pathology tests included lipidologic tests, hepatic biomarkers, and mass spectrometry-based metabolomics. Animals were medicated with gemfibrozil 6mg/kg orally once a day for 2 months in a randomized blinded clinical trial prior to repeating previous diagnostic testing. RESULTS Hounsfield units on CT were negatively associated with increased hepatic vacuolation, while ultrasound and gross evaluation of the liver were not reliable. Beta-hydroxybutyric-acid (BHBA) concentrations were significantly associated with hepatic lipidosis. Metabolomics and lipidomics data found BHBA and succinic acid to be potential biomarkers for diagnosing hepatic lipidosis in bearded dragons. Succinic acid concentrations were significantly lower in the gemfibrozil treatment group. There was a tendency for improvement in the biomarkers and reduced hepatic fat in bearded dragons with hepatic lipidosis when treated with gemfibrozil, though the improvement was not statistically significant. CONCLUSIONS These findings provide information on the antemortem assessment of hepatic lipidosis in bearded dragons and paves the way for further research in diagnosis and treatment of this disease.
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Affiliation(s)
- Trinita K. Barboza
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Leonardo Susta
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alex zur Linden
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sara Gardhouse
- Health Sciences Center, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Hugues Beaufrère
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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6
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Non-alcoholic fatty liver disease and liver secretome. Arch Pharm Res 2022; 45:938-963. [PMCID: PMC9703441 DOI: 10.1007/s12272-022-01419-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022]
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Zhang GH, Yuan TH, Yue ZS, Wang L, Dou GR. The presence of diabetic retinopathy closely associated with the progression of non-alcoholic fatty liver disease: A meta-analysis of observational studies. Front Mol Biosci 2022; 9:1019899. [PMID: 36458094 PMCID: PMC9706004 DOI: 10.3389/fmolb.2022.1019899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/01/2022] [Indexed: 07/30/2023] Open
Abstract
Background and Objective: Although growing evidence indicates that non-alcoholic fatty liver disease is related to diabetic retinopathy (DR), research results significantly vary. Therefore, we conducted a meta-analysis to assess the association between the progression of non-alcoholic fatty liver disease and the onset of DR. Methods: PubMed, Embase, and Cochrane databases were searched until 7 November 2021. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the association. Results: We identified 18 studies involving 12,757 patients. The pooled effect assessment showed that liver fibrosis was positively correlated with DR (OR = 1.69, 95%CI 1.30-2.20; p < 0.0001); non-alcoholic fatty liver disease was not associated with the risk of DR (OR = 1.15, 95%CI 0.75-1.76; p = 0.51); non-alcoholic fatty liver disease was positively correlated with DR in patients with type 1 diabetes (OR = 2.96, 95%CI 1.48-5.94; p = 0.002). In patients with type 2 diabetes, there was no association between non-alcoholic fatty liver disease and DR (OR = 0.92, 95%CI 0.59-1.43; p = 0.70). Subgroup analysis showed no correlation in both Asian and Caucasian races. Conclusion: There is a significant correlation between liver fibrosis and DR. This suggests that the ocular examination of DR could be helpful in predicting whether patients with non-alcoholic fatty liver disease would progress to liver fibrosis.
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Affiliation(s)
- Guo-heng Zhang
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Ophthalmology, 942 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Yin’chuan, China
| | - Tian-hao Yuan
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of The Cadet Team 6 of School of Basic Medicine, Fourth Military Medical University, Xi’an, China
| | - Zhen-sheng Yue
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lin Wang
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Guo-Rui Dou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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Paul B, Lewinska M, Andersen JB. Lipid alterations in chronic liver disease and liver cancer. JHEP Rep 2022; 4:100479. [PMID: 35469167 PMCID: PMC9034302 DOI: 10.1016/j.jhepr.2022.100479] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Lipids are a complex and diverse group of molecules with crucial roles in many physiological processes, as well as in the onset, progression, and maintenance of cancers. Fatty acids and cholesterol are the building blocks of lipids, orchestrating these crucial metabolic processes. In the liver, lipid alterations are prevalent as a cause and consequence of chronic hepatitis B and C virus infections, alcoholic hepatitis, and non-alcoholic fatty liver disease and steatohepatitis. Recent developments in lipidomics have also revealed that dynamic changes in triacylglycerols, phospholipids, sphingolipids, ceramides, fatty acids, and cholesterol are involved in the development and progression of primary liver cancer. Accordingly, the transcriptional landscape of lipid metabolism suggests a carcinogenic role of increasing fatty acids and sterol synthesis. However, limited mechanistic insights into the complex nature of the hepatic lipidome have so far hindered the development of effective therapies.
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Nagarajan SR, Cross E, Sanna F, Hodson L. Dysregulation of hepatic metabolism with obesity: factors influencing glucose and lipid metabolism. Proc Nutr Soc 2022; 81:1-11. [PMID: 34726148 DOI: 10.1017/s0029665121003761] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The liver is a key metabolic organ that undertakes a multitude of physiological processes over the course of a day, including intrahepatic lipid and glucose metabolism which plays a key role in the regulation of systemic lipid and glucose concentrations. It serves as an intermediary organ between exogenous (dietary) and endogenous energy supply to extrahepatic organs. Thus, perturbations in hepatic metabolism can impact widely on metabolic disease risk. For example, the accumulation of intra-hepatocellular TAG (IHTG), for which adiposity is almost invariably a causative factor may result in dysregulation of metabolic pathways. Accumulation of IHTG is likely due to an imbalance between fatty acid delivery, synthesis and removal (via oxidation or export as TAG) from the liver; insulin plays a key role in all of these processes.
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Affiliation(s)
- S R Nagarajan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - E Cross
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - F Sanna
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - L Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
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10
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Miyake T, Miyazaki M, Yoshida O, Kanzaki S, Nakaguchi H, Nakamura Y, Watanabe T, Yamamoto Y, Koizumi Y, Tokumoto Y, Hirooka M, Furukawa S, Takeshita E, Kumagi T, Ikeda Y, Abe M, Toshimitsu K, Matsuura B, Hiasa Y. Relationship between body composition and the histology of non-alcoholic fatty liver disease: a cross-sectional study. BMC Gastroenterol 2021; 21:170. [PMID: 33849437 PMCID: PMC8045325 DOI: 10.1186/s12876-021-01748-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background Causes of non-alcoholic fatty liver disease and its progression include visceral fat accumulation and loss of muscle mass; however, which of the two phenomena is more critical is unclear. Therefore, we intended to examine the relationship between body composition and non-alcoholic fatty liver disease progression as indicated by fibrosis and the non-alcoholic fatty liver disease activity score. Methods This cross-sectional study comprised 149 patients (55 men; age, 20–76 years) treated for non-alcoholic fatty liver disease between December 2010 and January 2020. Body composition measurements, histological examinations of liver samples, and comprehensive blood chemistry tests were performed. The relationship between body composition and non-alcoholic fatty liver disease histology findings was analyzed using the logistic regression model. Results Fibrosis was significantly and inversely correlated with muscle mass and appendicular skeletal muscle mass and significantly and positively correlated with fat mass, fat mass/height squared, visceral fat area, and waist-hip ratio (P < 0.05). After adjustment for sex, blood chemistry measurements, and body composition indices, fibrosis remained associated with appendicular skeletal muscle mass, fat mass, fat mass/height squared, and visceral fat area (P < 0.05). Non-alcoholic fatty liver disease activity score ≥ 5 significantly correlated with fat mass and fat mass/height squared in a univariate but not multivariate analysis. Conclusions Fibrosis in non-alcoholic fatty liver disease, an indicator of unfavorable long-term outcomes, is associated with more indices of fat mass than of those of muscle mass. Hence, fat mass should be controlled to prevent non-alcoholic fatty liver disease progression. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01748-y.
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Affiliation(s)
- Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Masumi Miyazaki
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Osamu Yoshida
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Sayaka Kanzaki
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Hironobu Nakaguchi
- Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Ehime, Shitsukawa, Toon, Japan
| | - Yoshiko Nakamura
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Takao Watanabe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Yasunori Yamamoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Yohei Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Yoshio Tokumoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Shinya Furukawa
- Health Service Center, Ehime University, Ehime, Bunkyo, Matsuyama, Japan
| | - Eiji Takeshita
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Teru Kumagi
- Post Graduate Medical Education Center, Ehime University Graduate School of Medicine, Ehime, Shitsukawa, Toon, Japan
| | - Yoshio Ikeda
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Masanori Abe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan
| | - Kumiko Toshimitsu
- Nutrition Division, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan
| | - Bunzo Matsuura
- Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Ehime, Shitsukawa, Toon, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, 791-0295, Shitsukawa, Toon, Ehime, Japan.
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11
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Hajduch E, Lachkar F, Ferré P, Foufelle F. Roles of Ceramides in Non-Alcoholic Fatty Liver Disease. J Clin Med 2021; 10:jcm10040792. [PMID: 33669443 PMCID: PMC7920467 DOI: 10.3390/jcm10040792] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 12/12/2022] Open
Abstract
Non-alcoholic fatty liver disease is one of the most common chronic liver diseases, ranging from simple steatosis to steatohepatitis, fibrosis, and cirrhosis. Its prevalence is rapidly increasing and presently affects around 25% of the general population of Western countries, due to the obesity epidemic. Liver fat accumulation induces the synthesis of specific lipid species and particularly ceramides, a sphingolipid. In turn, ceramides have deleterious effects on hepatic metabolism, a phenomenon called lipotoxicity. We review here the evidence showing the role of ceramides in non-alcoholic fatty liver disease and the mechanisms underlying their effects.
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Affiliation(s)
- Eric Hajduch
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, 75006 Paris, France; (E.H.); (F.L.); (P.F.)
- Institute of Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Floriane Lachkar
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, 75006 Paris, France; (E.H.); (F.L.); (P.F.)
- Institute of Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Pascal Ferré
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, 75006 Paris, France; (E.H.); (F.L.); (P.F.)
- Institute of Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Fabienne Foufelle
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, 75006 Paris, France; (E.H.); (F.L.); (P.F.)
- Institute of Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
- Correspondence: ; Tel.: +33-1-44-27-24-25
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12
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Baek J, Jung SJ, Shim JS, Jeon YW, Seo E, Kim HC. Comparison of Computed Tomography-based Abdominal Adiposity Indexes as Predictors of Non-alcoholic Fatty Liver Disease Among Middle-aged Korean Men and Women. J Prev Med Public Health 2020; 53:256-265. [PMID: 32752595 PMCID: PMC7411244 DOI: 10.3961/jpmph.20.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions: Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.
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Affiliation(s)
- Jongmin Baek
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Woo Jeon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Eunsun Seo
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Public Health, Yonsei University Graduate School, Seoul, Korea
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13
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Kalyesubula M, Mopuri R, Rosov A, Alon T, Edery N, Moallem U, Dvir H. Hyperglycemia-stimulating diet induces liver steatosis in sheep. Sci Rep 2020; 10:12189. [PMID: 32699301 PMCID: PMC7376193 DOI: 10.1038/s41598-020-68909-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/02/2020] [Indexed: 01/15/2023] Open
Abstract
Hepatic steatosis is strongly associated with chronic liver disease and systemic metabolic disorder. Adipose lipolysis is a recognized principal source of intrahepatic fat in various metabolic disorders, including non-alcoholic fatty liver disease. We hypothesized that, in the premorbid state, hepatic de novo lipogenesis (DNL) driven by excess carbohydrates abundance might play a more significant role. We employed a novel nutritional model in sheep of two distinct carbohydrates abundances. During 4 months of the dietary treatment, lambs were monitored for metabolic and terminal liver parameters. Lambs grown on the high-calorie (HC) diet were consistently more hyperglycemic and hyperinsulinemic than lambs grown on the lower-calorie (LC) diet (P < 0.0001). As a result, the HC lambs developed systemic- (HOMA-IR of 7.3 vs. 3.1; P < 0.0001), and adipose- (ADIPO-IR of 342.7 vs. 74.4; P < 0.0001) insulin resistance, significant adiposity (P < 0.0001), and higher plasma triglycerides (P < 0.05). Circulating leukocytes in the HC lambs had higher mRNA expression levels of the proinflammatory markers CCL2 (P < 0.01) and TNF-alpha (P < 0.04), and IL1B trended higher (P < 0.1). Remarkably, lambs on the HC diet developed substantial liver steatosis (mean fat content of 8.1 vs. 5.3% in the LC group; P < 0.0001) with a higher histological steatosis score (2.1 vs. 0.4; P < 0.0002). Hepatic steatosis was most-strongly associated with blood glucose and insulin levels but negatively correlated with circulating fatty acids-indicating a more significant contribution from hepatic DNL than from adipose lipolysis. Sheep may prove an attractive large-animal model of fatty liver and metabolic comorbidities resulting from excess carbohydrate-based energy early in life.
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Affiliation(s)
- Mugagga Kalyesubula
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel
- Department of Animal Science, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ramgopal Mopuri
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel
| | - Alexander Rosov
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel
| | - Tamir Alon
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel
- Department of Animal Science, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Nir Edery
- Pathology Laboratory, Kimron Veterinary Institute, Veterinary Services, Rishon LeZion, Israel
| | - Uzi Moallem
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel
| | - Hay Dvir
- Institute of Animal Science, Volcani Center - ARO, Rishon LeZion, Israel.
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14
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Ichihara K, Kohsaka C, Tomari N, Yamamoto Y, Masumura T. Determination of free fatty acids in plasma by gas chromatography. Anal Biochem 2020; 603:113810. [PMID: 32511966 DOI: 10.1016/j.ab.2020.113810] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 11/26/2022]
Abstract
A method was developed for determination of free fatty acids (FFAs) in plasma by gas chromatography. Plasma was extracted with 3 vol of methanol. Most cholesterol esters and triacylglycerols did not dissolve in the aqueous methanol. FFAs in the crude lipid solution were directly and selectively methylated with (trimethylsilyl)diazomethane at room temperature. Fatty acid methyl esters (FAMEs) formed were extracted with hexane, and nonreactive phospholipids were washed out with 95% methanol. The partially purified FAME preparation was analyzed by gas chromatography. The composition and amount of plasma FFAs closely approximated those obtained using two different methods.
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Affiliation(s)
- Ken'ichi Ichihara
- Kyoto Integrated Science & Technology Bio-Analysis Center, Kyoto Municipal Institute of Industrial Technology and Culture, 134 Cyudoji-Minamicho, Kyoto, 600-8813, Japan.
| | - Chihiro Kohsaka
- Kyoto Integrated Science & Technology Bio-Analysis Center, Kyoto Municipal Institute of Industrial Technology and Culture, 134 Cyudoji-Minamicho, Kyoto, 600-8813, Japan
| | - Naohiro Tomari
- Kyoto Integrated Science & Technology Bio-Analysis Center, Kyoto Municipal Institute of Industrial Technology and Culture, 134 Cyudoji-Minamicho, Kyoto, 600-8813, Japan
| | - Yoshihiro Yamamoto
- Kyoto Integrated Science & Technology Bio-Analysis Center, Kyoto Municipal Institute of Industrial Technology and Culture, 134 Cyudoji-Minamicho, Kyoto, 600-8813, Japan
| | - Takehiro Masumura
- Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Shimogamo, Kyoto, 606-8522, Japan
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15
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Byrne CD, Targher G. NAFLD as a driver of chronic kidney disease. J Hepatol 2020; 72:785-801. [PMID: 32059982 DOI: 10.1016/j.jhep.2020.01.013] [Citation(s) in RCA: 213] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/27/2019] [Accepted: 01/10/2020] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, affecting up to 25-30% (NAFLD), and up to 10-15% (CKD) of the general population. Recently, it has also been established that there is a strong association between NAFLD and CKD, regardless of the presence of potential confounding diseases such as obesity, hypertension and type 2 diabetes. Since NAFLD and CKD are both common diseases that often occur alongside other metabolic conditions, such as type 2 diabetes or metabolic syndrome, elucidating the relative impact of NAFLD on the risk of incident CKD presents a substantial challenge for investigators working in this research field. A growing body of epidemiological evidence suggests that NAFLD is an independent risk factor for CKD and recent evidence also suggests that associated factors such as metabolic syndrome, dysbiosis, unhealthy diets, platelet activation and processes associated with ageing could also contribute mechanisms linking NAFLD and CKD. This narrative review provides an overview of the literature on: a) the evidence for an association and causal link between NAFLD and CKD and b) the underlying mechanisms by which NAFLD (and factors strongly linked with NAFLD) may increase the risk of developing CKD.
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Affiliation(s)
- Christopher D Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, UK.
| | - Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
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16
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High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths. Nutrients 2019; 11:nu11122985. [PMID: 31817648 PMCID: PMC6950466 DOI: 10.3390/nu11122985] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation within the liver affecting 1 in 4 people worldwide. As the new silent killer of the twenty-first century, NAFLD impacts on both the request and the availability of new liver donors. The liver is the first line of defense against endogenous and exogenous metabolites and toxins. It also retains the ability to switch between different metabolic pathways according to food type and availability. This ability becomes a disadvantage in obesogenic societies where most people choose a diet based on fats and carbohydrates while ignoring vitamins and fiber. The chronic exposure to fats and carbohydrates induces dramatic changes in the liver zonation and triggers the development of insulin resistance. Common believes on NAFLD and different diets are based either on epidemiological studies, or meta-analysis, which are not controlled evidences; in most of the cases, they are biased on test-subject type and their lifestyles. The highest success in reverting NAFLD can be attributed to diets based on high protein instead of carbohydrates. In this review, we discuss the impact of NAFLD on body metabolic plasticity. We also present a detailed analysis of the most recent studies that evaluate high-protein diets in NAFLD with a special focus on the liver and the skeletal muscle protein metabolisms.
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17
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Zhang X, Han Z, Zhong H, Yin Q, Xiao J, Wang F, Zhou Y, Luo Y. Regulation of triglyceride synthesis by estradiol in the livers of hybrid tilapia (Oreochromis niloticus ♀ × O. aureus ♂). Comp Biochem Physiol B Biochem Mol Biol 2019; 238:110335. [DOI: 10.1016/j.cbpb.2019.110335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/16/2019] [Accepted: 08/27/2019] [Indexed: 02/08/2023]
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18
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Hodson L, Gunn PJ. The regulation of hepatic fatty acid synthesis and partitioning: the effect of nutritional state. Nat Rev Endocrinol 2019; 15:689-700. [PMID: 31554932 DOI: 10.1038/s41574-019-0256-9] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is an increasing global public health burden. NAFLD is strongly associated with type 2 diabetes mellitus, obesity and cardiovascular disease and begins with intrahepatic triacylglycerol accumulation. Under healthy conditions, the liver regulates lipid metabolism to meet systemic energy needs in the fed and fasted states. The processes of fatty acid uptake, fatty acid synthesis and the intracellular partitioning of fatty acids into storage, oxidation and secretion pathways are tightly regulated. When one or more of these processes becomes dysregulated, excess lipid accumulation can occur. Although genetic and environmental factors have been implicated in the development of NAFLD, it remains unclear why an imbalance in these pathways begins. The regulation of fatty acid partitioning occurs at several points, including during triacylglycerol synthesis, lipid droplet formation and lipolysis. These processes are influenced by enzyme function, intake of dietary fats and sugars and whole-body metabolism, and are further affected by the presence of obesity or insulin resistance. Insight into how the liver controls fatty acid metabolism in health and how these processes might be affected in disease would offer the potential for new therapeutic treatments for NAFLD to be developed.
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Affiliation(s)
- Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Headington, Oxford, UK.
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Headington, Oxford, UK.
| | - Pippa J Gunn
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Headington, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Headington, Oxford, UK
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19
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Hodson L, Karpe F. Hyperinsulinaemia: does it tip the balance toward intrahepatic fat accumulation? Endocr Connect 2019; 8:R157-R168. [PMID: 31581129 PMCID: PMC6826170 DOI: 10.1530/ec-19-0350] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 12/12/2022]
Abstract
In health, the liver is metabolically flexible over the course of the day, as it undertakes a multitude of physiological processes including the regulation of intrahepatic and systemic glucose and lipid levels. The liver is the first organ to receive insulin and through a cascade of complex metabolic processes, insulin not only plays a key role in the intrahepatic regulation of glucose and lipid metabolism, but also in the regulation of systemic glucose and lipid concentrations. Thus, when intrahepatic insulin signalling becomes aberrant then this may lead to perturbations in intrahepatic metabolic processes that have the potential to impact on metabolic health. For example, obesity is associated with intrahepatic fat accumulation (known as nonalcoholic liver disease (NAFLD)) and hyperinsulinaemia, the latter as a result of insulin hypersecretion or impaired hepatic insulin extraction. Although insulin signalling directly alters intra- and extrahepatic metabolism, the regulation of hepatic glucose and fatty acid metabolism is also indirectly driven by substrate availability. Here we discuss the direct and indirect effects of insulin on intrahepatic processes such as the synthesis of fatty acids and peripherally regulating the flux of fatty acids to the liver; processes that may play a role in the development of insulin resistance and/or intrahepatocellular triacylglycerol (IHTAG) accumulation in humans.
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Affiliation(s)
- Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford and National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospital Trusts, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford and National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospital Trusts, Oxford, UK
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20
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Fasting Whole-Body Energy Homeostasis and Hepatic Energy Metabolism in Nondiabetic Humans with Fatty Liver. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9796175. [PMID: 31097978 PMCID: PMC6487077 DOI: 10.1155/2019/9796175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/27/2018] [Accepted: 03/18/2019] [Indexed: 01/17/2023]
Abstract
Background Fatty liver is believed to be sustained by a higher than normal adipose-derived NEFA flux to the liver. Also, hepatic energy metabolism may be a rate-limiting step of intrahepatic fat (IHF) accumulation. Aims To assess whole-body energy metabolism and hepatic high-energy phosphates (HEPs) in individuals with fatty liver. Methods We studied 22 individuals with fatty liver and 22 control individuals matched for anthropometric features by means of (1) hepatic 1H-magnetic resonance spectroscopy (MRS) to measure the IHF content, (2) hepatic 31P-MRS to assess the relative content of HEPs (phosphomonoesters, phosphodiesters, inorganic phosphorus, and ATP), and (3) indirect calorimetry to assess whole-body resting energy expenditure and substrate oxidation. Results Patients with newly diagnosed fatty liver and controls were not different for anthropometric parameters. Based on HOMA2%-S, individuals with fatty liver were more insulin resistant than controls. Resting energy expenditure and the pattern of substrate oxidation were not different between groups. Relative content of HEPs was not different between groups; in particular, the Pi/γ-ATP ratio, the most important signals in terms of monitoring energy homeostasis, was not different even if it was associated with indirect calorimetry-derived parameters of oxidative substrate disposal. Conclusions These data demonstrate that fasting whole-body energy metabolism and the relative content of HEPs in nondiabetic patients with fatty liver are not different than those in controls when they are matched for anthropometric features.
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21
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Singh M, Bittner S, Li Y, Bittner A, Han L, Cortez Y, Inayathullah M, Arif Z, Parthasarathi R, Rajadas J, Shen WJ, Nicolls MR, Kraemer FB, Azhar S. Anti-hyperlipidaemic effects of synthetic analogues of nordihydroguaiaretic acid in dyslipidaemic rats. Br J Pharmacol 2018; 176:369-385. [PMID: 30374952 DOI: 10.1111/bph.14528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/07/2018] [Accepted: 10/03/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND PURPOSE Previous studies have shown that Creosote bush-derived nordihydroguaiaretic acid (NDGA) exerts beneficial actions on the key components of metabolic syndrome including dyslipidaemia, insulin resistance and hypertension in several relevant rodent models. Here, we synthesized and screened a total of 6 anti-hyperlipidaemic analogues of NDGA and tested their efficacy against hepatic lipid metabolism in a high-fructose diet (HFrD) fed dyslipidaemic rat model. EXPERIMENTAL APPROACH HFrD fed Sprague-Dawley rats treated with NDGA or one of the six analogues were used. Serum samples were analysed for blood metabolites, whereas liver samples were quantified for changes in various mRNA levels by real-time RT-PCR. KEY RESULTS Oral gavage of HFrD-fed rats for 4 days with NDGA analogues 1 and 2 (100 mg·kg-1 ·day-1 ) suppressed the hepatic triglyceride content, whereas the NDGA analogues 2, 3 and 4, like NDGA, decreased the plasma triglyceride levels by 70-75%. qRT-PCR measurements demonstrated that among NDGA analogues 1, 2, 4 and 5, analogue 4 was the most effective at inhibiting the mRNA levels of some key enzymes and transcription factors involved in lipogenesis. All four analogues almost equally inhibited the key genes involved in triglyceride synthesis and fatty acid elongation. Unlike NDGA, none of the analogues affected the genes of hepatic fatty acid oxidation or transport. CONCLUSIONS AND IMPLICATIONS Our data suggest that NDGA analogues 1, 2, 4 and 5, particularly analogue 4, exert their anti-hyperlipidaemic actions by negatively targeting genes of key enzymes and transcription factors involved in lipogenesis, triglyceride synthesis and fatty acid elongation. These analogues have therapeutic potential.
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Affiliation(s)
- Madhurima Singh
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
| | - Stefanie Bittner
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Yihang Li
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
| | - Alex Bittner
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Lu Han
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
| | - Yuan Cortez
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Zeeshan Arif
- Computational Toxicology Facility, CSIR-Indian Institute of Toxicology Research, Lucknow, India
| | | | - Jayakumar Rajadas
- Division of Cardiovascular Pharmacology CVI, BioADD Laboratory, Stanford, CA, USA
| | - Wen-Jun Shen
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
| | - Mark R Nicolls
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | - Fredric B Kraemer
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
| | - Salman Azhar
- Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Endocrinology, Gerontology and Metabolism, Standford, CA, USA
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22
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Changes of the Fatty Acid Profile in Erythrocyte Membranes of Patients following 6-Month Dietary Intervention Aimed at the Regression of Nonalcoholic Fatty Liver Disease (NAFLD). Can J Gastroenterol Hepatol 2018; 2018:5856201. [PMID: 30631760 PMCID: PMC6304595 DOI: 10.1155/2018/5856201] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/16/2018] [Accepted: 11/22/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is closely related to the metabolism disorders of fatty acids. The pathogenesis of the disease includes an increased concentration of FFA in blood, an increase in the biosynthesis of fatty acids, and disorders in the process of β-oxidation. OBJECTIVE The aim of the study was to analyze the fatty acids in erythrocyte membranes among 55 patients with NAFLD who were subjected to a 6-month dietary intervention in order to reduce fatty liver. MATERIALS AND METHODS Basic anthropometric and biochemical measurements were performed. The profile of fatty acids was measured in the membranes of erythrocytes and analyzed by gas chromatography. The dietary compliance was evaluated using 72-diary questionnaires, anthropometric measurements. RESULTS With the reduction of fatty liver (p<0.01), the patients' biochemical and anthropometric parameters were significantly improved. A significant decrease in the concentration of alanine aminotransferase (p<0.01) and asparagine aminotransferase (p<0.01) was observed, along with a decrease in the amount of insulin (p<0.05) and insulin resistance (p<0.05). Significant changes in terms of the fatty acid profile were observed among patients who followed the dietary intervention. There was a noticeable tendency in terms of the reduction palmitic acid (p<0.055) and a significant reduction of stearic acid (p<0.05). Significant changes in the profile of fatty acids were also associated with the reductionof palmitoleic (p<0.05) and oleic acids (p<0.05). Another statistically significant change observed was the increase in polyunsaturated fatty acids. In particular (p<0.01) the rise of eicosapentaenoic (p<0.055) and docosahexaenoic acids (p<0.55) was noted. CONCLUSION The profile of fatty acids turned out to be a potential biomarker of the liver changes during NAFLD regression. Further research is needed to fully elucidate the usefulness and applicability of our findings in the management of NAFLD.
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McCommis KS, Finck BN. Treating Hepatic Steatosis and Fibrosis by Modulating Mitochondrial Pyruvate Metabolism. Cell Mol Gastroenterol Hepatol 2018; 7:275-284. [PMID: 30686780 PMCID: PMC6352854 DOI: 10.1016/j.jcmgh.2018.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 12/12/2022]
Abstract
A hepatic comorbidity of metabolic syndrome, known as nonalcoholic fatty liver disease (NAFLD), is increasing in prevalence in conjunction with the pandemics of obesity and diabetes. The spectrum of NAFLD ranges from simple hepatic fat accumulation to a more severe disease termed nonalcoholic steatohepatitis (NASH), involving inflammation, hepatocyte death, and fibrosis. Importantly, NASH is linked to a much higher risk of cirrhosis, liver failure, and hepatocellular carcinoma, as well as an increased risk for nonhepatic malignancies and cardiovascular disease. Interest in the understanding of the disease processes and search for treatments for the spectrum of NAFLD-NASH has increased exponentially, but there are no approved pharmacologic therapies. In this review, we discuss the existing literature supporting insulin-sensitizing thiazolidinedione compounds as potential drug candidates for the treatment of NASH. In addition, we put these results into new context by summarizing recent studies suggesting these compounds alter mitochondrial metabolism by binding and inhibiting the mitochondrial pyruvate carrier.
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Affiliation(s)
| | - Brian N. Finck
- Correspondence Address correspondence to: Brian N. Finck, 660 South Euclid Avenue, Campus Box 8031, St. Louis, Missouri 63110. fax: (314) 362-8230.
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24
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Abstract
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH) and ultimately may lead to cirrhosis. Hepatic steatosis or fatty liver is defined as increased accumulation of lipids in hepatocytes and results from increased production or reduced clearance of hepatic triglycerides or fatty acids. Fatty liver can progress to NASH in a significant proportion of subjects. NASH is a necroinflammatory liver disease governed by multiple pathways that are not completely elucidated. This review describes the main mechanisms that have been reported to contribute to the pathophysiology of NAFLD and NASH.
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25
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Mitochondrial adaptation in steatotic mice. Mitochondrion 2017; 40:1-12. [PMID: 28935446 DOI: 10.1016/j.mito.2017.08.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/19/2017] [Accepted: 08/31/2017] [Indexed: 12/13/2022]
Abstract
Western lifestyle-associated malnutrition causes steatosis that may progress to liver inflammation and mitochondrial dysfunction has been suggested as a key factor in promoting this disease. Here we have molecularly, biochemically and biophysically analyzed mitochondria from steatotic wild type and immune-compromised mice fed a Western diet (WD) - enriched in saturated fatty acids (SFAs). WD-mitochondria demonstrated lipidomic changes, a decreased mitochondrial ATP production capacity and a significant sensitivity to calcium. These changes preceded hepatocyte damage and were not associated with enhanced ROS production. Thus, WD-mitochondria do not promote steatohepatitis per se, but demonstrate bioenergetic deficits and increased sensitivity to stress signals.
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26
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Nieuwoudt S, Fealy CE, Foucher JA, Scelsi AR, Malin SK, Pagadala M, Rocco M, Burguera B, Kirwan JP. Functional high-intensity training improves pancreatic β-cell function in adults with type 2 diabetes. Am J Physiol Endocrinol Metab 2017; 313:E314-E320. [PMID: 28512155 PMCID: PMC5625086 DOI: 10.1152/ajpendo.00407.2016] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes (T2D) is characterized by reductions in β-cell function and insulin secretion on the background of elevated insulin resistance. Aerobic exercise has been shown to improve β-cell function, despite a subset of T2D patients displaying "exercise resistance." Further investigations into the effectiveness of alternate forms of exercise on β-cell function in the T2D patient population are needed. We examined the effect of a novel, 6-wk CrossFit functional high-intensity training (F-HIT) intervention on β-cell function in 12 sedentary adults with clinically diagnosed T2D (54 ± 2 yr, 166 ± 16 mg/dl fasting glucose). Supervised training was completed 3 days/wk, comprising functional movements performed at a high intensity in a variety of 10- to 20-min sessions. All subjects completed an oral glucose tolerance test and anthropometric measures at baseline and following the intervention. The mean disposition index, a validated measure of β-cell function, was significantly increased (PRE: 8.4 ± 3.1, POST: 11.5 ± 3.5, P = 0.02) after the intervention. Insulin processing inefficiency in the β-cell, expressed as the fasting proinsulin-to-insulin ratio, was also reduced (PRE: 2.40 ± 0.37, POST: 1.78 ± 0.30, P = 0.04). Increased β-cell function during the early-phase response to glucose correlated significantly with reductions in abdominal body fat (R2 = 0.56, P = 0.005) and fasting plasma alkaline phosphatase (R2 = 0.55, P = 0.006). Mean total body-fat percentage decreased significantly (Δ: -1.17 0.30%, P = 0.003), whereas lean body mass was preserved (Δ: +0.05 ± 0.68 kg, P = 0.94). We conclude that F-HIT is an effective exercise strategy for improving β-cell function in adults with T2D.
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Affiliation(s)
- Stephan Nieuwoudt
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
| | - Ciarán E Fealy
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Biomedical Sciences, Kent State University, Kent, Ohio
| | - Julie A Foucher
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amanda R Scelsi
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steven K Malin
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mangesh Pagadala
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Michael Rocco
- Department of Cardiology, Cleveland Clinic, Cleveland, Ohio; and
| | - Bartolome Burguera
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - John P Kirwan
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
- Department of Biomedical Sciences, Kent State University, Kent, Ohio
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27
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Rachakonda V, Wills R, DeLany JP, Kershaw EE, Behari J. Differential Impact of Weight Loss on Nonalcoholic Fatty Liver Resolution in a North American Cohort with Obesity. Obesity (Silver Spring) 2017; 25:1360-1368. [PMID: 28605159 DOI: 10.1002/oby.21890] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 03/18/2017] [Accepted: 04/19/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease (NAFLD) is closely associated with obesity. In this study, a North American cohort with obesity enrolled in a lifestyle modification program was examined to determine the impact of weight loss on NAFLD resolution and sarcopenia. METHODS Nondiabetic individuals with World Health Organization Class II/III obesity enrolled in a 6-month weight loss intervention were included. Steatosis was measured using computed tomography (CT)-derived liver:spleen attenuation ratio. Body composition was assessed using dual X-ray absorptiometry, air-displacement plethysmography, and CT anthropometry. RESULTS At baseline, participants with NAFLD had greater visceral adipose tissue (VAT) but similar skeletal muscle area compared to those without NAFLD. After intervention, weight loss was similar in the two groups, but participants with NAFLD lost more VAT than those without NAFLD (-38.81 [-55.98 to -21.63] cm2 vs. -13.82 [-29.65 to -2.02] cm2 ; P = 0.017). In the subset with NAFLD at baseline, participants with NAFLD resolution after intervention lost more VAT than those with persistent NAFLD (-57.23 [-88.63 to -25.84) cm2 vs. -26.92 [-52.14 to -26.92] cm2 , P = 0.039). CONCLUSIONS In a Western cohort with obesity, NAFLD was not associated with sarcopenia. After lifestyle modification, there was a differential impact on NAFLD resolution, with twofold greater VAT loss in participants who resolved NAFLD compared with those with persistent NAFLD despite similar weight loss.
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Affiliation(s)
- Vikrant Rachakonda
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel Wills
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - James P DeLany
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Erin E Kershaw
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jaideep Behari
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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28
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Brouwers B, Hesselink MKC, Schrauwen P, Schrauwen-Hinderling VB. Effects of exercise training on intrahepatic lipid content in humans. Diabetologia 2016; 59:2068-79. [PMID: 27393135 PMCID: PMC5016557 DOI: 10.1007/s00125-016-4037-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/08/2016] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver (NAFL) is the most common liver disorder in western society. Various factors may play a role in determining hepatic fat content, such as delivery of lipids to the liver, de novo lipogenesis, hepatic lipid oxidation, secretion of intrahepatic lipids to the circulation or a combination of these. If delivery of lipids to the liver outweighs the sum of hepatic lipid oxidation and secretion, the intrahepatic lipid (IHL) content starts to increase and NAFL may develop. NAFL is closely related to obesity and insulin resistance and a fatty liver increases the vulnerability to type 2 diabetes development. Exercise training is a cornerstone in the treatment and prevention of type 2 diabetes. There is a large body of literature describing the beneficial metabolic consequences of exercise training on skeletal muscle metabolism. Recent studies have started to investigate the effects of exercise training on liver metabolism but data is still limited. Here, first, we briefly discuss the routes by which IHL content is modulated. Second, we review whether and how these contributing routes might be modulated by long-term exercise training. Third, we focus on the effects of acute exercise on IHL metabolism, since exercise also might affect hepatic metabolism in the physically active state. This will give insight into whether the effect of exercise training on IHL could be explained by the accumulated effect of acute bouts of exercise, or whether adaptations might occur only after long-term exercise training. The primary focus of this review will be on observations made in humans. Where human data is missing, data obtained from well-accepted animal models will be used.
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Affiliation(s)
- Bram Brouwers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center +, Maastricht, the Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center +, Maastricht, the Netherlands
| | - Matthijs K C Hesselink
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center +, Maastricht, the Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center +, Maastricht, the Netherlands
| | - Patrick Schrauwen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center +, Maastricht, the Netherlands
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center +, Maastricht, the Netherlands
| | - Vera B Schrauwen-Hinderling
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center +, Maastricht, the Netherlands.
- Department of Human Biology and Human Movement Sciences, Maastricht University Medical Center +, Maastricht, the Netherlands.
- Department of Radiology, Maastricht University Medical Center +, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
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29
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Effect of exercise on the development of new fatty liver and the resolution of existing fatty liver. J Hepatol 2016; 65:791-797. [PMID: 27255583 DOI: 10.1016/j.jhep.2016.05.026] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 04/26/2016] [Accepted: 05/14/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Guidelines about recommendations for amounts of exercise/physical activity are variable in non-alcoholic fatty liver disease. Our aim was to determine the amount of exercise that was associated with two outcomes: a) development of incident liver fat and b) resolution of baseline liver fat, at five-year follow-up. METHODS In an occupational health screening program, weekly frequency of exercise was assessed using the validated Korean version of the International Physical Activity Questionnaire Short Form (IPAQ-SF). Liver fat was identified by ultrasonography (3.5MHz probe) at baseline and at five-year follow-up. Fully adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs and 95% confidence intervals [CI]) for incident fatty liver and resolution of fatty liver at follow-up. RESULTS 233,676 men and women were studied between 2002 and 2014. 126,811 individuals were identified without fatty liver, and of these subjects, 29,014 subjects developed incident fatty liver during follow-up. At baseline, there were 42,536 individuals with liver fat and of these individuals, fatty liver resolved in 14,514, during follow-up. After full adjustment, compared to no exercise, exercise was associated with benefit for both outcomes; for exercise ⩾5times per week for incident fatty liver: HR 0.86 (95% CI 0.80,0.92), p<0.001, and for resolution of fatty liver HR 1.40 (95% CI 1.25,1.55), p<0.001. CONCLUSIONS Moderate to vigorous exercise is beneficial in decreasing risk of development of new fatty liver or improving resolution of existing fatty liver during 5years of follow-up. LAY SUMMARY The amount of exercise/physical activity to benefit fatty liver disease in non-alcoholic fatty liver disease is not known. In a large study of free-living people, our aim was to determine the amount of exercise that was linked with a decrease in new fatty liver and also improvement of existing fatty liver over 5years of follow-up. Compared to no exercise, exercise ⩾5times per week (lasting at least 10min on each occasion) was linked to a highly significantly benefit for both a decrease in new fatty liver and also improvement of existing fatty liver.
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30
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Yang KC, Hung HF, Lu CW, Chang HH, Lee LT, Huang KC. Association of Non-alcoholic Fatty Liver Disease with Metabolic Syndrome Independently of Central Obesity and Insulin Resistance. Sci Rep 2016; 6:27034. [PMID: 27246655 PMCID: PMC4887873 DOI: 10.1038/srep27034] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/13/2016] [Indexed: 02/08/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is an emerging chronic liver disease that may lead to liver cirrhosis and hepatocellular carcinoma. We aimed to determine the association between the prevalence of metabolic syndrome (MetS) and NAFLD severity using semi-quantitative ultrasonography (US). A total of 614 participants were recruited from the community. NAFLD was evaluated according to the ultrasonographic Fatty Liver Indicator (US-FLI), which is a semi-quantitative liver ultrasound score. Insulin resistance was estimated with the homeostasis model assessment index for insulin resistance (HOMA-IR). NAFLD and MetS were found in 53.7 and 17.3% of the participants, respectively. Linear relationships were found between the severity of NAFLD and waist circumference, fasting glucose, HOMA-IR, triglycerides, HDL-C and blood pressure. After adjusting for confounding factors, i.e., body mass index and HOMA-IR, the odds ratios for MetS were 3.64 (95% confidence interval (CI): 1.5-8.83) for those with mild NAFLD and 9.4 (95% CI: 3.54-24.98) for those with moderate-to-severe NAFLD compared to those without NAFLD. The combination of the HOMA-IR and US-FLI scores better differentiated MetS than the HOMA-IR alone. In addition to obesity, the severity of NAFLD and the HOMA-IR both play important roles in MetS. Whether NAFLD is a component of MetS warrants further research.
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Affiliation(s)
- Kuen Cheh Yang
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan.,Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Fang Hung
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan.,Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Long-Teng Lee
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.,Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Abstract
BACKGROUND & AIMS Some studies have examined correlations between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with nonalcoholic fatty liver disease (NAFLD) or between VAT and NAFLD. We investigated the longitudinal association between body fat distribution (VAT vs SAT) and incidence and regression of NAFLD, adjusting for risk factors, in a large population-based cohort. METHODS We collected data from adults who underwent abdominal ultrasonography (to identify liver fat), abdominal fat computed tomography scan, and blood tests from March 2007 through December 2008. Each patient underwent an anthropometric assessment and completed a questionnaire about their medical history, physical activity, and diet. Our final analysis involved 2017 subjects from the initial cohort who participated in a voluntary follow-up health screen performed in 2011 and 2013. The median follow-up time was 4.43 years. RESULTS We found 288 incident cases of NAFLD; 159 patients had NAFLD regression during the follow-up period. An increasing area of VAT was associated with higher incidence of NAFLD in the multivariable analysis (highest quintile vs lowest quintile of VAT hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.28-3.89; P for trend = .002; HR, 1.36 [per 1 standard deviation]; 95% CI, 1.16-1.59). An increased area of SAT was significantly associated with regression of NAFLD (highest quintile vs lowest quintile of SAT HR, 2.30; 95% CI, 1.28-4.12; P for trend = .002; HR, 1.36 [per 1 standard deviation]; 95% CI, 1.08-1.72). CONCLUSIONS In a large cohort study, larger areas of VAT were longitudinally associated with higher risk of incident NAFLD (during a period of approximately 4 years). In contrast, larger areas of SAT were longitudinally associated with regression of NAFLD. These data indicate that certain types of body fat are risk factors for NAFLD, whereas other types could reduce risk for NAFLD.
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Nobili V, Alisi A, Musso G, Scorletti E, Calder PC, Byrne CD. Omega-3 fatty acids: Mechanisms of benefit and therapeutic effects in pediatric and adult NAFLD. Crit Rev Clin Lab Sci 2015; 53:106-20. [PMID: 26463349 DOI: 10.3109/10408363.2015.1092106] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently considered the most common liver disease in industrialized countries, and it is estimated that it will become the most frequent indication for liver transplantation in the next decade. NAFLD may be associated with moderate (i.e. steatosis) to severe (i.e. steatohepatitis and fibrosis) liver damage and affects all age groups. Furthermore, subjects with NAFLD may be at a greater risk of other obesity-related complications later in life, and people with obesity and obesity-related complications (e.g. metabolic syndrome, type 2 diabetes and cardiovascular disease) are at increased risk of developing NAFLD. To date, there is no licensed treatment for NAFLD and therapy has been mainly centered on weight loss and increased physical activity. Unfortunately, it is often difficult for patients to adhere to the advised lifestyle changes. Therefore, based on the known pathogenesis of NAFLD, several clinical trials with different nutritional supplementation and prescribed drugs have been undertaken or are currently underway. Experimental evidence has emerged about the health benefits of omega-3 fatty acids, a group of polyunsaturated fatty acids that are important for a number of health-related functions. Omega-3 fatty acids are present in some foods (oils, nuts and seeds) that also contain omega-6 fatty acids, and the best sources of exclusively omega-3 fatty acids are oily fish, krill oil and algae. In this review, we provide a brief overview of the pathogenesis of NAFLD, and we also discuss the molecular and clinical evidence for the benefits of different omega-3 fatty acid preparations in NAFLD.
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Affiliation(s)
| | - Anna Alisi
- b Liver Research Unit, "Bambino Gesù" Children's Hospital and IRCCS , Rome , Italy
| | - Giovanni Musso
- c Gradenigo Hospital, University of Turin , Turin , Italy
| | - Eleonora Scorletti
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
| | - Philip C Calder
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
| | - Christopher D Byrne
- d Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton , Southampton , UK , and.,e National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton , Southampton , UK
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Bril F, Cusi K. Response to do ultrasonographic semiquantitative indices predict histological changes in NASH irrespective of steatosis extent? Liver Int 2015; 35:2341-2. [PMID: 25964992 DOI: 10.1111/liv.12869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Fernando Bril
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA.,Malcom Randall Veterans Administration Medical Center, Gainesville, FL, USA
| | - Kenneth Cusi
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA.,Malcom Randall Veterans Administration Medical Center, Gainesville, FL, USA.,Division of Diabetes, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX, USA.,Audie L. Murphy Veterans Administration Medical Center San Antonio, San Antonio, TX, USA
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McCue ME, Geor RJ, Schultz N. Equine Metabolic Syndrome: A Complex Disease Influenced by Genetics and the Environment. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2015.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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35
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Ballestri S, Romagnoli D, Nascimbeni F, Francica G, Lonardo A. Role of ultrasound in the diagnosis and treatment of nonalcoholic fatty liver disease and its complications. Expert Rev Gastroenterol Hepatol 2015; 9:603-27. [PMID: 25694178 DOI: 10.1586/17474124.2015.1007955] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We review the role of liver ultrasonography (US) and related techniques as non-invasive tools in predicting metabolic derangements, liver histology, portal hypertension and cardiovascular risk as well as allowing early diagnosis and management of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease. In this setting, US detects fatty changes as low as ≥20% and hepatic steatosis identified ultrasonographically, in its turn, closely mirrors coronary and carotid atherosclerosis burden. Semi-quantitative US indices (to exclude nonalcoholic steatohepatitis) and sonoelastography (to quantify fibrosis) help in predicting liver histology and selecting patients to submit to liver biopsy. Surveillance for hepatocellular carcinoma conducted through biannual US is mandatory and US has a role in guiding locoregional treatment and in evaluating the efficacy of treatment. High-intensity focused ultrasound can be delivered with precision resulting in coagulative necrosis of hepatocellular carcinoma without puncturing the liver. Costs and inconveniences have so far hampered its diffusion.
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Affiliation(s)
- Stefano Ballestri
- Division of Internal Medicine, Hospital of Pavullo - Department of Internal Medicine, Azienda USL, Pavullo, Modena 41126, Italy
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Byrne CD, Targher G. NAFLD: a multisystem disease. J Hepatol 2015; 62:S47-64. [PMID: 25920090 DOI: 10.1016/j.jhep.2014.12.012] [Citation(s) in RCA: 1790] [Impact Index Per Article: 198.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 11/06/2014] [Accepted: 12/09/2014] [Indexed: 12/11/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries that is predicted to become also the most frequent indication for liver transplantation by 2030. Over the last decade, it has been shown that the clinical burden of NAFLD is not only confined to liver-related morbidity and mortality, but there is now growing evidence that NAFLD is a multisystem disease, affecting extra-hepatic organs and regulatory pathways. For example, NAFLD increases risk of type 2 diabetes mellitus (T2DM), cardiovascular (CVD) and cardiac diseases, and chronic kidney disease (CKD). Although the primary liver pathology in NAFLD affects hepatic structure and function to cause morbidity and mortality from cirrhosis, liver failure and hepatocellular carcinoma, the majority of deaths among NAFLD patients are attributable to CVD. This narrative review focuses on the rapidly expanding body of clinical evidence that supports the concept of NAFLD as a multisystem disease. The review discusses the factors involved in the progression of liver disease in NAFLD and the factors linking NAFLD with other extra-hepatic chronic diseases, such as T2DM, CVD, cardiac diseases and CKD. The review will not discuss NAFLD treatments as these are discussed elsewhere in this issue of the Journal. For this review, PubMed was searched for articles using the keywords "non-alcoholic fatty liver disease" or "fatty liver" combined with "diabetes", "cardiovascular (or cardiac) disease", "cardiovascular mortality" or "chronic kidney disease" between 1990 and 2014. Articles published in languages other than English were excluded.
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Affiliation(s)
- Christopher D Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research, Biomedical Research Centre, University Hospital Southampton, UK.
| | - Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Byrne CD, Targher G. Ectopic fat, insulin resistance, and nonalcoholic fatty liver disease: implications for cardiovascular disease. Arterioscler Thromb Vasc Biol 2014; 34:1155-61. [PMID: 24743428 DOI: 10.1161/atvbaha.114.303034] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ectopic fat accumulation in the liver causes nonalcoholic fatty liver disease (NAFLD), which is the most common cause of chronic liver disease in Western countries. Ectopic liver lipid, particularly diacylglycerol, exacerbates hepatic insulin resistance, promotes systemic inflammation, and increases risk of developing both type 2 diabetes mellitus and cardiovascular disease. Increasing evidence suggests that NAFLD is an emerging risk factor for cardiovascular disease, and although there are currently no licensed treatments for NAFLD per se, current evidence suggests that statin treatment is safe in NAFLD. Presently, there is insufficient evidence to indicate that statins or other cardioprotective agents, such as angiotensin receptor blockers, are effective in treating NAFLD. In this brief narrative review, we discuss the diagnosis of NAFLD and the role of ectopic liver fat to cause insulin resistance and to increase risk of both type 2 diabetes mellitus and cardiovascular disease. For this review, PubMed was searched for articles using the key words non-alcoholic fatty liver disease or fatty liver combined with diabetes risk, cardiovascular risk, and cardiovascular mortality between 1990 and 2014. Articles published in languages other than English were excluded.
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Affiliation(s)
- Christopher D Byrne
- From Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (C.D.B.); Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom (C.D.B.); and Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (G.T.).
| | - Giovanni Targher
- From Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (C.D.B.); Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom (C.D.B.); and Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (G.T.)
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Kawano Y, Cohen DE. Mechanisms of hepatic triglyceride accumulation in non-alcoholic fatty liver disease. J Gastroenterol 2013; 48:434-41. [PMID: 23397118 PMCID: PMC3633701 DOI: 10.1007/s00535-013-0758-5] [Citation(s) in RCA: 600] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/15/2013] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic lipid accumulation in the absence of excess alcohol intake. NAFLD is the most common chronic liver disease, and ongoing research efforts are focused on understanding the underlying pathobiology of hepatic steatosis with the anticipation that these efforts will identify novel therapeutic targets. Under physiological conditions, the low steady-state triglyceride concentrations in the liver are attributable to a precise balance between acquisition by uptake of non-esterified fatty acids from the plasma and by de novo lipogenesis, versus triglyceride disposal by fatty acid oxidation and by the secretion of triglyceride-rich lipoproteins. In NAFLD patients, insulin resistance leads to hepatic steatosis by multiple mechanisms. Greater uptake rates of plasma non-esterified fatty acids are attributable to increased release from an expanded mass of adipose tissue as a consequence of diminished insulin responsiveness. Hyperinsulinemia promotes the transcriptional upregulation of genes that promote de novo lipogenesis in the liver. Increased hepatic lipid accumulation is not offset by fatty acid oxidation or by increased secretion rates of triglyceride-rich lipoproteins. This review discusses the molecular mechanisms by which hepatic triglyceride homeostasis is achieved under normal conditions, as well as the metabolic alterations that occur in the setting of insulin resistance and contribute to the pathogenesis of NAFLD.
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Affiliation(s)
- Yuki Kawano
- Division of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115 USA
| | - David E. Cohen
- Division of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115 USA
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Marcus Y, Shefer G, Sasson K, Kohen F, Limor R, Pappo O, Nevo N, Biton I, Bach M, Berkutzki T, Fridkin M, Benayahu D, Shechter Y, Stern N. Angiotensin 1-7 as means to prevent the metabolic syndrome: lessons from the fructose-fed rat model. Diabetes 2013; 62:1121-30. [PMID: 23250359 PMCID: PMC3609575 DOI: 10.2337/db12-0792] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We studied the effects of chronic angiotensin 1-7 (Ang 1-7) treatment in an experimental model of the metabolic syndrome, i.e., rats given high-fructose/low-magnesium diet (HFrD). Rats were fed on HFrD for 24 weeks with and without Ang 1-7 (576 µg/kg/day, s.c., Alzet pumps). After 6 months, Ang 1-7-treated animals had lower body weight (-9.5%), total fat mass (detected by magnetic resonance imaging), and serum triglycerides (-51%), improved glucose tolerance, and better insulin sensitivity. Similar metabolic effects were also evident, albeit in the absence of weight loss, in rats first exposed to HFrD for 5 months and then subjected to short-term (4 weeks) treatment with Ang 1-7. Six months of Ang 1-7 treatment were associated with lower plasma renin activity (-40%) and serum aldosterone (-48%), less hepatosteatatitis, and a reduction in epididymal adipocyte volume. The marked attenuation of macrophage infiltration in white adipose tissue (WAT) was associated with reduced levels of the pP65 protein in the epididymal fat tissue, suggesting less activation of the nuclear factor-κB (NFκB) pathway in Ang 1-7-treated rats. WAT from Ang 1-7-treated rats showed reduced NADPH-stimulated superoxide production. In single muscle fibers (myofibers) harvested and grown ex vivo for 10 days, myofibers from HFrD rats gave rise to 20% less myogenic cells than the Ang 1-7-treated rats. Fully developed adipocytes were present in most HFrD myofiber cultures but entirely absent in cultures from Ang 1-7-treated rats. In summary, Ang 1-7 had an ameliorating effect on insulin resistance, hypertriglyceridemia, fatty liver, obesity, adipositis, and myogenic and adipogenic differentiation in muscle tissue in the HFrD rats.
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Affiliation(s)
- Yonit Marcus
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, Israel
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Gabi Shefer
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Sasson
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, Israel
| | - Fortune Kohen
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Rona Limor
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Orit Pappo
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Nava Nevo
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Inbal Biton
- Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, Israel
| | - Michal Bach
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamara Berkutzki
- Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, Israel
| | - Matityahu Fridkin
- Department of Organic Chemistry, Weizmann Institute of Science, Rehovot, Israel
| | - Dafna Benayahu
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoram Shechter
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, Israel
| | - Naftali Stern
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Corresponding author: Naftali Stern,
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Sirota JC, McFann K, Targher G, Johnson RJ, Chonchol M, Jalal DI. Elevated serum uric acid levels are associated with non-alcoholic fatty liver disease independently of metabolic syndrome features in the United States: Liver ultrasound data from the National Health and Nutrition Examination Survey. Metabolism 2013; 62:392-9. [PMID: 23036645 PMCID: PMC3565047 DOI: 10.1016/j.metabol.2012.08.013] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 08/23/2012] [Accepted: 08/24/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Experimental and observational studies suggest a role for uric acid in non-alcoholic fatty liver disease (NAFLD). We examined the association between serum uric acid levels and NAFLD in a large population-based study from the United States. MATERIALS/METHODS A cross-sectional analysis of 10,732 nondiabetic adults who participated in the National Health and Nutrition Examination Survey 1988-1994. Sex specific uric acid quartiles were defined: ≤5.2, 5.3-6.0, 6.1-6.9, and >6.9mg/dL for men and ≤3.7, 3.8-4.5, 4.6-5.3, and >5.3mg/dL for women. NAFLD presence and severity were defined by ultrasonographic detection of steatosis in the absence of other liver diseases. We modeled the probability that more severe NAFLD would be associated with the highest quartiles of uric acid. RESULTS Compared to the 1st quartile, the odds ratio for NAFLD was 1.79 (95% C.I. 1.49-2.15, p<0.001) and 3.14 (95% C.I. 2.63-3.75, p<0.001) for the 3rd and 4th quartiles, respectively. After adjusting for demographics, hypertension, waist circumference, triglycerides, high-density lipoprotein-cholesterol, homeostasis model assessment-estimated insulin resistance, estimated glomerular filtration rate, and aspartate aminotransferase, uric acid (4th quartile) was significantly associated with NAFLD (odds ratio 1.43; 95% C.I. 1.16-1.76, p<0.001). Positive parameter estimates suggest increasing uric acid is associated with greater severity of NAFLD. CONCLUSIONS Elevated uric acid level is independently associated with ultrasound-diagnosed NAFLD in a nationally representative sample of United States nondiabetic adults. Increasing uric acid is associated with increasing severity of NAFLD on ultrasonography. These findings warrant further studies on the role of uric acid in NAFLD.
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Affiliation(s)
- Jeffrey C. Sirota
- Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Kim McFann
- Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Giovanni Targher
- Section of Endocrinology and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona,Verona, Italy
| | - Richard J. Johnson
- Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Michel Chonchol
- Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Diana I. Jalal
- Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA
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Finucane FM, Sharp SJ, Hatunic M, Sleigh A, De Lucia Rolfe E, Sayer AA, Cooper C, Griffin SJ, Savage DB, Wareham NJ. Intrahepatic Lipid Content and Insulin Resistance Are More Strongly Associated with Impaired NEFA Suppression after Oral Glucose Loading Than with Fasting NEFA Levels in Healthy Older Individuals. Int J Endocrinol 2013; 2013:870487. [PMID: 23737780 PMCID: PMC3659510 DOI: 10.1155/2013/870487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 03/17/2013] [Accepted: 04/11/2013] [Indexed: 12/21/2022] Open
Abstract
Introduction. The mechanisms underlying the association between insulin resistance and intrahepatic lipid (IHL) accumulation are not completely understood. We sought to determine whether this association was explained by differences in fasting non-esterified fatty acid (NEFA) levels and/or NEFA suppression after oral glucose loading. Materials and Methods. We performed a cross-sectional analysis of 70 healthy participants in the Hertfordshire Physical Activity Trial (39 males, age 71.3 ± 2.4 years) who underwent oral glucose tolerance testing with glucose, insulin, and NEFA levels measured over two hours. IHL was quantified with magnetic resonance spectroscopy. Insulin sensitivity was measured with the oral glucose insulin sensitivity (OGIS) model, the leptin: adiponectin ratio (LAR), and the homeostasis model assessment (HOMA). Results. Measures of insulin sensitivity were not associated with fasting NEFA levels, but OGIS was strongly associated with NEFA suppression at 30 minutes and strongly inversely associated with IHL. Moreover, LAR was strongly inversely associated with NEFA suppression and strongly associated with IHL. This latter association (beta = 1.11 [1.01, 1.21], P = 0.026) was explained by reduced NEFA suppression (P = 0.24 after adjustment). Conclusions. Impaired postprandial NEFA suppression, but not fasting NEFA, contributes to the strong and well-established association between whole body insulin resistance and liver fat accumulation.
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Affiliation(s)
- Francis M. Finucane
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285 Hills Road, Cambridge CB20QQ, UK
- Galway Diabetes Research Centre, School of Medicine, Clinical Science Institute, NUI Galway, Galway, Ireland
- *Francis M. Finucane:
| | - Stephen J. Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285 Hills Road, Cambridge CB20QQ, UK
| | - Mensud Hatunic
- Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge CB20QQ, UK
| | - Alison Sleigh
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge CB20QQ, UK
| | - Ema De Lucia Rolfe
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285 Hills Road, Cambridge CB20QQ, UK
| | - Avan Aihie Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO166YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO166YD, UK
| | - Simon J. Griffin
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285 Hills Road, Cambridge CB20QQ, UK
| | - David B. Savage
- Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge CB20QQ, UK
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, P.O. Box 285 Hills Road, Cambridge CB20QQ, UK
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Ballestri S, Lonardo A, Romagnoli D, Carulli L, Losi L, Day CP, Loria P. Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD. Liver Int 2012; 32:1242-52. [PMID: 22520641 DOI: 10.1111/j.1478-3231.2012.02804.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 03/12/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Differentiating steatosis from NASH is key in deciding treatment and follow-up schedules. We hypothesized that sonographic grading of steatosis will correlate with metabolic and pathologic changes of NASH. METHODS Fifty-three non-consecutive patients had a semi-quantitative evaluation of hepatic steatosis through ultrasonographic Fatty Liver Indicator (US-FLI) just prior to liver biopsy. All biopsies demonstrated NAFLD. US-FLI is a new scoring system ranging 2-8 based on the intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focal sparing. NAFLD is diagnosed by the minimum score ≥2. Ultrasonographic findings were correlated with metabolic and histological data. Inter-observer US-FLI score agreement, evaluated by three different operators in 31 consecutive patients with steatosis, showed "almost perfect/substantial" agreement (P < 0.001). RESULTS US-FLI showed a positive correlation with HOMA, insulin, uric acid, ferritin, ALT and bilirubin and was associated with steatosis extent assessed histologically and histological features of NASH, except for fibrosis. US-FLI was an independent predictor of NASH (OR 2.236; P = 0.007) and a US-FLI < 4 had a high negative predictive value (94%) in ruling out the diagnosis of severe NASH according to Kleiner's criteria. CONCLUSION Data confirm the hypothesis that US-FLI significantly correlates with metabolic derangements and individual pathologic criteria for NASH and may better select patients for liver biopsy.
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Affiliation(s)
- Stefano Ballestri
- Unit of Internal Medicine, Department of Internal Medicine, Endocrinology, Metabolism and Geriatrics, University of Modena and Reggio Emilia, Modena, Italy.
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Byrne CD. Dorothy Hodgkin Lecture 2012: non-alcoholic fatty liver disease, insulin resistance and ectopic fat: a new problem in diabetes management. Diabet Med 2012; 29:1098-107. [PMID: 22672330 DOI: 10.1111/j.1464-5491.2012.03732.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease is now recognized as the hepatic component of the metabolic syndrome. Non-alcoholic fatty liver disease is a spectrum of fat-associated liver conditions that can result in end-stage liver disease and the need for liver transplantation. Simple steatosis, or fatty liver, occurs early in non-alcoholic fatty liver disease and may progress to non-alcoholic steatohepatitis, fibrosis and cirrhosis with increased risk of hepatocellular carcinoma. Prevalence estimates for non-alcoholic fatty liver disease range from 17 to 33% in the general populations and it has been estimated that non-alcoholic fatty liver disease exists in up to 70% of people with Type 2 diabetes. Non-alcoholic fatty liver disease increases risk of Type 2 diabetes and cardiovascular disease. In people with Type 2 diabetes, non-alcoholic fatty liver disease is the most frequent cause (∼80%) of fatty liver diagnosed by ultrasound. As non-alcoholic fatty liver disease is strongly associated with insulin resistance, the presence of non-alcoholic fatty liver disease with diabetes often contributes to poor glycaemic control. Consequently, strategies that decrease liver fat and improve whole-body insulin sensitivity may both contribute to prevention of Type 2 diabetes and to better glycaemic control in people who already have developed diabetes. This review summarizes the Dorothy Hodgkin lecture given by the author at the 2012 Diabetes UK annual scientific conference, proposing that fatty acid fluxes through the liver are crucial for the pathogenesis of non-alcoholic fatty liver disease and for increasing insulin resistance.
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Affiliation(s)
- C D Byrne
- Nutrition and Metabolism and NIHR Southampton Biomedical Research Centre, University Hospital Southampton and Faculty of Medicine, University of Southampton, Southampton, UK.
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Sung KC, Kim BS, Cho YK, Park DI, Woo S, Kim S, Wild SH, Byrne CD. Predicting incident fatty liver using simple cardio-metabolic risk factors at baseline. BMC Gastroenterol 2012; 12:84. [PMID: 22770479 PMCID: PMC3502272 DOI: 10.1186/1471-230x-12-84] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 06/28/2012] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non alcoholic fatty liver disease (NAFLD) is associated with increased risk of type 2 diabetes and chronic liver disease but identifying patients who have NAFLD without resorting to expensive imaging tests is challenging. In order to help identify people for imaging investigation of the liver who are at high risk of NAFLD, our aim was to: a) identify easily measured risk factors at baseline that were independently associated with incident fatty liver at follow up, and then b) to test the diagnostic performance of thresholds of these factors at baseline, to predict or to exclude incident fatty liver at follow up. METHODS 2589 people with absence of fatty liver on ultrasound examination at baseline were re-examined after a mean of 4.4 years in a Korean occupational cohort study. Multi-variable logistic regression analyses were used to identify baseline factors that were independently associated with incident fatty liver at follow up. The diagnostic performance of thresholds of these baseline factors to identify people with incident fatty liver at follow-up was assessed using receiver operating characteristic (ROC) curves. RESULTS 430 incident cases of fatty liver were identified. Several factors were independently associated with incident fatty liver: increased triglyceride (per mmol/l increase) OR 1.378 [95%CIs 1.179, 1.611], p < 0.0001; glucose (per mmol/l increase) OR 1.215 [95%CIs 1.042, 1.416], p = 0.013; waist (per cm increase) OR 1.078 [95%CIs 1.057, 1.099], p < 0.001; ALT (per IU/L increase) OR 1.009 [95%CIs 1.002, 1.017], p = 0.016; and platelets (per 1x10⁹/L increase) OR 1.004 [1.001, 1.006], p = 0.001; were each independently associated with incident fatty liver. Binary thresholds of the five factors were applied and the area under the ROC curve for incident fatty liver was 0.75 (95%CI 0.72-0.78) for the combination of all five factors above these thresholds. CONCLUSION Simple risk factors that overlap considerably with risk factors for type 2 diabetes allow identification of people at high risk of incident fatty liver at who use of hepatic imaging could be targeted.
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Affiliation(s)
- Ki-Chul Sung
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Mehta SR, Godsland IF, Thomas EL, Pavitt DV, Morin SX, Bell JD, Taylor-Robinson SD, Johnston DG. Intrahepatic insulin exposure, intrahepatocellular lipid and regional body fat in nonalcoholic fatty liver disease. J Clin Endocrinol Metab 2012; 97:2151-9. [PMID: 22442265 DOI: 10.1210/jc.2011-2430] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT Insulin is pivotal in regulating hepatic lipid synthesis, metabolism, and export. OBJECTIVE We tested the hypothesis that intrahepatic insulin exposure is an important determinant of intrahepatocellular lipid (IHCL), taking into account regional adiposity and both glucoregulatory and antilipolytic insulin sensitivity. RESEARCH DESIGN AND METHODS We compared 21 European males with known nonalcoholic fatty liver disease (NAFLD) with 19 healthy male controls. Insulin sensitivity, secretion, and percentage hepatic extraction were derived from iv glucose tolerance test (IVGTT) glucose, insulin, and C-peptide concentrations. Intrahepatic insulin exposure was calculated as percentage hepatic insulin extraction multiplied by basal or IVGTT insulin secretion. IHCL was quantified by proton magnetic resonance spectroscopy. Total and regional adipose tissue was measured using whole body magnetic resonance imaging. RESULTS Percentage hepatic extraction of newly secreted insulin differed between cases with NAFLD and controls at borderline significance (median, 76 vs. 83%; P = 0.07). Cases had higher intrahepatic insulin exposure than controls, both in the basal (34 vs. 18 pmol; P = 0.0002) and glucose-stimulated states (58 vs. 24 pmol; P = 0.01). IHCL was significantly related to both basal (r(s) = 0.62; P < 0.0001) and IVGTT intrahepatic insulin exposure (r(s) = 0.47; P = 0.002). As predictors of IHCL, both basal and IVGTT intrahepatic insulin exposure were dependent on the waist-to-hip ratio and homeostasis model assessment insulin resistance, but not on magnetic resonance imaging fat measures or IVGTT insulin sensitivity. CONCLUSIONS Men with NAFLD have higher intrahepatic insulin exposure than controls. This correlates with IHCL, but the principal determinants of IHCL were fat distribution and hepatic rather than peripheral insulin resistance.
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Affiliation(s)
- Sanjeev R Mehta
- Division of Diabetes Endocrinology and Metabolism, Department of Medicine, Imperial College London, Mary's Hospital, Praed Street, London W2 1NY, United Kingdom.
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Clark MH, Hoenig M, Ferguson DC, Dirikolu L. Pharmacokinetics of pioglitazone in lean and obese cats. J Vet Pharmacol Ther 2012; 35:428-36. [PMID: 22612529 DOI: 10.1111/j.1365-2885.2011.01341.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pioglitazone is a thiazolidinedione insulin sensitizer that has shown efficacy in Type 2 diabetes and nonalcoholic fatty liver disease in humans. It may be useful for treatment of similar conditions in cats. The purpose of this study was to investigate the pharmacokinetics of pioglitazone in lean and obese cats, to provide a foundation for assessment of its effects on insulin sensitivity and lipid metabolism. Pioglitazone was administered intravenously (median 0.2 mg/kg) or orally (3 mg/kg) to 6 healthy lean (3.96 ± 0.56 kg) and 6 obese (6.43 ± 0.48 kg) cats, in a two by two Latin Square design with a 4-week washout period. Blood samples were collected over 24 h, and pioglitazone concentrations were measured via a validated high-performance liquid chromatography assay. Pharmacokinetic parameters were determined using two-compartmental analysis for IV data and noncompartmental analysis for oral data. After oral administration, mean bioavailability was 55%, t(1/2) was 3.5 h, T(max) was 3.6 h, C(max) was 2131 ng/mL, and AUC(0-∞) was 15 556 ng/mL · h. There were no statistically significant differences in pharmacokinetic parameters between lean and obese cats following either oral or intravenous administration. Systemic exposure to pioglitazone in cats after a 3 mg/kg oral dose approximates that observed in humans with therapeutic doses.
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Affiliation(s)
- M H Clark
- Department of Comparative Biosciences Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
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Stears A, O'Rahilly S, Semple RK, Savage DB. Metabolic insights from extreme human insulin resistance phenotypes. Best Pract Res Clin Endocrinol Metab 2012; 26:145-57. [PMID: 22498245 DOI: 10.1016/j.beem.2011.09.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
As well as improving diagnostic and clinical outcomes for affected patients, understanding the genetic basis of rare human metabolic disorders has resulted in several fundamental biological insights. In some cases understanding extreme phenotypes has also informed thinking about more prevalent metabolic diseases. Insulin resistance underpins the twin epidemics of obesity and type 2 diabetes as well as accounting for many of the metabolic problems encompassed by the term metabolic syndrome. This review provides a brief update on current understanding of human severe insulin resistance syndromes, before highlighting recent insights provided by studies in these rare syndromes into the molecular pathogenesis of elements of the metabolic syndrome.
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Affiliation(s)
- Anna Stears
- Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, University of Cambridge, UK
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48
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Sung KC, Jeong WS, Wild SH, Byrne CD. Combined influence of insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes. Diabetes Care 2012; 35:717-22. [PMID: 22338098 PMCID: PMC3308286 DOI: 10.2337/dc11-1853] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There is dissociation between insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes, suggesting that different mechanisms are involved. Our aim was to 1) quantify risk of incident diabetes at follow-up with different combinations of these risk factors at baseline and 2) determine whether each is an independent risk factor for diabetes. RESEARCH DESIGN AND METHODS We examined 12,853 subjects without diabetes from a South Korean occupational cohort, and insulin resistance (IR) (homeostasis model assessment-IR ≥75th centile, ≥2.0), fatty liver (defined by standard ultrasound criteria), and overweight/obesity (BMI ≥25 kg/m(2)) identified at baseline. Odds ratios (ORs) and 95% confidence intervals (CIs) for incident diabetes at 5-year follow-up were estimated using logistic regression. RESULTS We identified 223 incident cases of diabetes from which 26 subjects had none of the three risk factors, 37 had one, 56 had two, and 104 had three. In the fully adjusted model, the OR and CI for diabetes were 3.92 (2.86-5.37) for IR, 1.62 (1.17-2.24) for overweight/obesity, and 2.42 (1.74-3.36) for fatty liver. The OR for the presence of all three factors in a fully adjusted model was 14.13 (8.99-22.21). CONCLUSIONS The clustering of IR, overweight/obesity, and fatty liver is common and markedly increases the odds of developing type 2 diabetes, but these factors also have effects independently of each other and of confounding factors. The data suggest that treatment for each factor is needed to decrease risk of type 2 diabetes.
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Affiliation(s)
- Ki-Chul Sung
- Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Chen WL, Wei HW, Chiu WZ, Kang CH, Lin TH, Hung CC, Chen MC, Shieh MS, Lee CC, Lee HM. Metformin regulates hepatic lipid metabolism through activating AMP-activated protein kinase and inducing ATGL in laying hens. Eur J Pharmacol 2011; 671:107-12. [PMID: 21958877 DOI: 10.1016/j.ejphar.2011.09.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 09/06/2011] [Accepted: 09/11/2011] [Indexed: 12/25/2022]
Abstract
Although many clinical trials have showed that metformin improves non-alcoholic fatty liver disease, which is a common liver disease associated with hepatic enzyme abnormalities, an animal model is required to investigate the effects of altered gene expression and post-translational processing (proteins) in mediating the observed responses. Laying hens appear to develop fatty livers, as in the case in human beings, when ingesting energy in excess of maintenance, and they can be used as an animal model for observing hepatic steatosis. The aim of this study was to investigate whether metformin could improve the non-alcoholic fatty liver of laying hens and to examine the possible mechanisms of lipid-lowering effects. Forty-eight Leghorn laying hens of Hy-Line variety W-36 - 44 weeks with 64.8% hen-day egg production - were randomly assigned into 4 treatments, each receiving 0, 10, 30, or 100mg of metformin with saline per kg body weight by daily wing vein injection. Results showed that, compared with the control, significant decreases existed in the laying rates; plasma triglyceride, cholesterol, and insulin levels; body weights; abdominal fat weights; hepatic lipid contents; and hepatic fatty acid synthase expression of layers receiving 30 or 100mg per kg body weight, whereas significant increases in their hepatic 5'adenosine monophosphate-activated protein kinase, acyl-CoA carboxylase phosphorylation, adipose triglyceride lipase, and carnitine palmitoyl transferase-1 expression were observed. These data suggest that metformin could reduce lipid deposits in the liver and that the laying hen is a valuable animal model for studying hepatic steatosis.
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Affiliation(s)
- Wei-Lu Chen
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Ahmed MH, Abu EO, Byrne CD. Non-Alcoholic Fatty Liver Disease (NAFLD): new challenge for general practitioners and important burden for health authorities? Prim Care Diabetes 2010; 4:129-137. [PMID: 20299294 DOI: 10.1016/j.pcd.2010.02.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 02/18/2010] [Accepted: 02/19/2010] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of hepatic dysfunction encountered in general practice. A large proportion of individuals with type 2 diabetes and the metabolic syndrome develop NAFLD. NAFLD is associated with severe insulin resistance and increased risk of cardiovascular disease and can progress to non-alcoholic steato-hepatitis, liver cirrhosis and cancer. Currently the only known effective treatments for NAFLD are lifestyle changes including stable weight loss and a diet low in calories. General practitioners will increasingly play a key role in dealing with this evolving but serious epidemic of NAFLD and associated metabolic complications. However, success will depend on the appropriate systems and mechanisms being in place in primary care and the proper motivation, support and education of the patient. This review provides the primary care physician with: (a) a step-by step guide of how to identify NAFLD, (b) information to exclude common other causes of liver fat accumulation and (c) additional insight into relationships between NAFLD and other conditions such as obesity, cardiovascular disease and type 2 diabetes.
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Affiliation(s)
- Mohamed H Ahmed
- Chemical Pathology Department, Southampton University Hospital NHS Trust, Southampton, UK
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