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Green CJ, Marjot T, Walsby-Tickle J, Charlton C, Cornfield T, Westcott F, Pinnick KE, Moolla A, Hazlehurst JM, McCullagh J, Tomlinson JW, Hodson L. Metformin maintains intrahepatic triglyceride content through increased hepatic de novo lipogenesis. Eur J Endocrinol 2022; 186:367-377. [PMID: 35038311 PMCID: PMC8859923 DOI: 10.1530/eje-21-0850] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/17/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE Metformin is a first-line pharmacotherapy in the treatment of type 2 diabetes, a condition closely associated with non-alcoholic fatty liver disease (NAFLD). Although metformin promotes weight loss and improves insulin sensitivity, its effect on intrahepatic triglyceride (IHTG) remains unclear. We investigated the effect of metformin on IHTG, hepatic de novo lipogenesis (DNL), and fatty acid (FA) oxidation in vivo in humans. DESIGN AND METHODS Metabolic investigations, using stable-isotope tracers, were performed in ten insulin-resistant, overweight/obese human participants with NAFLD who were treatment naïve before and after 12 weeks of metformin treatment. The effect of metformin on markers of s.c. adipose tissue FA metabolism and function, along with the plasma metabolome, was investigated. RESULTS Twelve weeks of treatment with metformin resulted in a significant reduction in body weight and improved insulin sensitivity, but IHTG content and FA oxidation remained unchanged. Metformin treatment was associated with a significant decrease in VLDL-triglyceride (TG) concentrations and a significant increase in the relative contribution of DNL-derived FAs to VLDL-TG. There were subtle and relatively few changes in s.c. adipose tissue FA metabolism and the plasma metabolome with metformin treatment. CONCLUSIONS We demonstrate the mechanisms of action of metformin whereby it improves insulin sensitivity and promotes weight loss, without improvement in IHTG; these observations are partly explained through increased hepatic DNL and a lack of change in FA oxidation.
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Affiliation(s)
- Charlotte J Green
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Thomas Marjot
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | | | - Catriona Charlton
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Thomas Cornfield
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Felix Westcott
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Katherine E Pinnick
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Ahmad Moolla
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
| | - Jonathan M Hazlehurst
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - James McCullagh
- Chemistry Research Laboratory, University of Oxford, Oxford, UK
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospital Trusts, Oxford, UK
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospital Trusts, Oxford, UK
- Correspondence should be addressed to L Hodson;
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Jesuthasan A, Zhyzhneuskaya S, Peters C, Barnes AC, Hollingsworth KG, Sattar N, Lean MEJ, Taylor R, Al-Mrabeh AH. Sex differences in intraorgan fat levels and hepatic lipid metabolism: implications for cardiovascular health and remission of type 2 diabetes after dietary weight loss. Diabetologia 2022; 65:226-233. [PMID: 34657182 PMCID: PMC8660759 DOI: 10.1007/s00125-021-05583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes confers a greater relative increase in CVD risk in women compared with men. We examined sex differences in intraorgan fat and hepatic VLDL1-triacylglycerol (VLDL1-TG) export before and after major dietary weight loss. METHODS A group with type 2 diabetes (n = 64, 30 male/34 female) and a group of healthy individuals (n = 25, 13 male/12 female) were studied. Intraorgan and visceral fat were quantified by magnetic resonance and VLDL1-TG export by intralipid infusion techniques. RESULTS Triacylglycerol content of the liver and pancreas was elevated in people with diabetes with no sex differences (liver 16.4% [9.3-25.0%] in women vs 11.9% [7.0-23.1%] in men, p = 0.57, and pancreas 8.3 ± 0.5% vs 8.5 ± 0.4%, p = 0.83, respectively). In the absence of diabetes, fat levels in both organs were lower in women than men (1.0% [0.9-1.7%] vs 4.5% [1.9-8.0%], p = 0.005, and 4.7 ± 0.4% vs 7.6 ± 0.5%, p< 0.0001, respectively). Women with diabetes had higher hepatic VLDL1-TG production rate and plasma VLDL1-TG than healthy women (559.3 ± 32.9 vs 403.2 ± 45.7 mg kg-1 day-1, p = 0.01, and 0.45 [0.26-0.77] vs 0.25 [0.13-0.33] mmol/l, p = 0.02), whereas there were no differences in men (548.8 ± 39.8 vs 506.7 ± 29.2 mg kg-1 day-1, p = 0.34, and 0.72 [0.53-1.15] vs 0.50 [0.32-0.68] mmol/l, p = 0.26). Weight loss decreased intraorgan fat and VLDL1-TG production rates regardless of sex, and these changes were accompanied by similar rates of diabetes remission (65.4% vs 71.0%) and CVD risk reduction (59.8% vs 41.5%) in women and men, respectively. CONCLUSIONS/INTERPRETATION In type 2 diabetes, women have liver and pancreas fat levels as high as those of men, associated with raised hepatic VLDL1-TG production rates. Dynamics of triacylglycerol turnover differ between sexes in type 2 diabetes and following weight loss. These changes may contribute to the disproportionately raised cardiovascular risk of women with diabetes.
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Affiliation(s)
- Aaron Jesuthasan
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sviatlana Zhyzhneuskaya
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Carl Peters
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Alison C Barnes
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Kieren G Hollingsworth
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Michael E J Lean
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Roy Taylor
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Ahmad H Al-Mrabeh
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
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Anni NS, Jung SJ, Shim JS, Jeon YW, Lee GB, Kim HC. Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea. Epidemiol Health 2021; 43:e2021042. [PMID: 34126706 PMCID: PMC8289470 DOI: 10.4178/epih.e2021042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/09/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population. METHODS We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL. RESULTS Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men. CONCLUSIONS Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.
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Affiliation(s)
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Seon Shim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Woo Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Ga Bin Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
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Lee SY, Koo BK, Moon MK. Non-fasting triglyceride levels in the Korean population with and without ischemic heart disease and cerebrovascular disease. Korean J Intern Med 2019; 34:353-364. [PMID: 29132199 PMCID: PMC6406091 DOI: 10.3904/kjim.2016.285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/19/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/AIMS Associations between non-fasting triglyceride (TG) levels and a risk of ischemic heart disease (IHD) and cerebrovascular accident (CVA) have been suggested in Caucasians. We aimed to investigate whether non-fasting TG levels reflect the risk of IHD/CVA in Koreans. METHODS We conducted an analysis of patients aged ≥ 30 years from the nationwide survey database. Fasting TG was defined as a measurement taken ≥ 12 hours since the last meal. Non-fasting TG was categorized by fasting duration of 0 to 3, 4 to 7, and 8 to 11 hours. RESULTS In subjects without history of IHD/CVA, diabetes, or lipid-lowering medication, the TG level was significantly elevated for 7 hours in men compared to fasting TG levels (p = 0.011); the mean TG levels were 154.9 mg/dL (standard error [SE], 13.0), 177.0 mg/dL (SE, 12.1), 148.8 mg/dL (SE, 2.8), and 141.5 mg/dL (SE, 1.4) for 0 to 3, 4 to 7, 8 to 11, and ≥12 hours' fasting, respectively. In women, there was no difference in TG level according to fasting duration after adjustment for confounders. In men without diabetes, the TG level from 4 to 7 hours' fasting showed a significant difference between subjects with or without IHD/CVA even after adjustments for age, body mass index, lipid medication, exercise, and dietary factors (215.1 mg/dL vs. 177.3 mg/dL, p < 0.001). CONCLUSION In men, non-fasting TG levels from 4 to 7 hours' fasting were significantly associated with IHD/CVA, and were superior to fasting TG levels level in the significant association with the history of IHD or CVA.
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Affiliation(s)
- Seo Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Correspondence to Min Kyong Moon, M.D. Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea Tel: +82-2-870-2226 Fax: +82-2-831-2826 E-mail:
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Yamashita M, Iwata A, Kato Y, Futami M, Imaizumi S, Kuwano T, Ike A, Sugihara M, Nishikawa H, Zhang B, Yasunaga S, Saku K, Miura SI. Impact of the triglyceride level on coronary plaque components in female patients with coronary artery disease treated with statins. Heart Vessels 2018; 33:1175-84. [PMID: 29696358 DOI: 10.1007/s00380-018-1173-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/20/2018] [Indexed: 01/13/2023]
Abstract
Several studies have reported that elevated triglyceride (TG) levels may be more strongly associated with an increased risk of coronary artery disease (CAD) in females than in males. We examined gender differences in the relationship between TG levels and coronary atherosclerosis using integrated backscatter intravascular ultrasound (IB IVUS) in CAD patients treated with statins. Three hundred seventy-eight CAD patients (105 females and 273 males) who underwent percutaneous coronary intervention using IB IVUS, and who were already receiving statin treatment, were included. Gray-scale and IB IVUS examinations were performed for the non-culprit segment of a coronary artery and fasting serum TG concentrations were measured. We found that TG levels were significantly correlated with increased lipid (r = 0.40, p < 0.001) and decreased fibrous (r = - 0.37, p < 0.001) plaque components in females, but not in males. Low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were not related to either the gray-scale or IB IVUS parameters in both genders. After adjustment for conventional coronary risk factors by a multivariate stepwise regression analysis, higher TG levels in females were independently associated with increased lipid (β = 0.31, p< 0.001) contents in coronary plaques. In conclusion, among CAD patients treated with statins, TG levels were associated with lipid-rich coronary plaques in females, but not in males. TG levels may be more important indicators of residual risk after statin treatment in females than in males.
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Umpleby AM, Shojaee-Moradie F, Fielding B, Li X, Marino A, Alsini N, Isherwood C, Jackson N, Ahmad A, Stolinski M, Lovegrove JA, Johnsen S, Jeewaka R Mendis AS, Wright J, Wilinska ME, Hovorka R, Bell JD, Thomas EL, Frost GS, Griffin BA. Impact of liver fat on the differential partitioning of hepatic triacylglycerol into VLDL subclasses on high and low sugar diets. Clin Sci (Lond) 2017; 131:2561-73. [PMID: 28923880 DOI: 10.1042/CS20171208] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/11/2017] [Accepted: 09/15/2017] [Indexed: 01/07/2023]
Abstract
Dietary sugars are linked to the development of non-alcoholic fatty liver disease (NAFLD) and dyslipidaemia, but it is unknown if NAFLD itself influences the effects of sugars on plasma lipoproteins. To study this further, men with NAFLD (n = 11) and low liver fat ‘controls’ (n = 14) were fed two iso-energetic diets, high or low in sugars (26% or 6% total energy) for 12 weeks, in a randomised, cross-over design. Fasting plasma lipid and lipoprotein kinetics were measured after each diet by stable isotope trace-labelling. There were significant differences in the production and catabolic rates of VLDL subclasses between men with NAFLD and controls, in response to the high and low sugar diets. Men with NAFLD had higher plasma concentrations of VLDL1-triacylglycerol (TAG) after the high (P<0.02) and low sugar (P<0.0002) diets, a lower VLDL1-TAG fractional catabolic rate after the high sugar diet (P<0.01), and a higher VLDL1-TAG production rate after the low sugar diet (P<0.01), relative to controls. An effect of the high sugar diet, was to channel hepatic TAG into a higher production of VLDL1-TAG (P<0.02) in the controls, but in contrast, a higher production of VLDL2-TAG (P<0.05) in NAFLD. These dietary effects on VLDL subclass kinetics could be explained, in part, by differences in the contribution of fatty acids from intra-hepatic stores, and de novo lipogenesis. The present study provides new evidence that liver fat accumulation leads to a differential partitioning of hepatic TAG into large and small VLDL subclasses, in response to high and low intakes of sugars.
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Cure E, Icli A, Ugur Uslu A, Aydoğan Baykara R, Sakiz D, Ozucan M, Yavuz F, Arslan S, Cumhur Cure M, Kucuk A. Atherogenic index of plasma may be strong predictor of subclinical atherosclerosis in patients with Behçet disease. Z Rheumatol 2017; 76:259-266. [PMID: 27431747 DOI: 10.1007/s00393-016-0141-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Behcet's disease (BD) is a systemic vasculitis characterized by cardiovascular complications. Early diagnosis of these complications can reduce morbidity and mortality. Carotid artery intima-media thickness (cIMT) and the logarithmic value of triglyceride to high density lipoprotein ratio (atherogenic index of plasma, AIP) are good markers of atherosclerosis. The purpose of this study was to investigate whether AIP is a predictive marker of subclinical atherosclerosis in BD patients. PATIENTS AND METHODS A total of 84 BD patients (60 male, 24 female) and 84 healthy control individuals (58 male, 26 female) were included in this study. cIMT measurements were made, and AIP values were calculated. RESULTS cIMT (p < 0.001) and AIP (p < 0.001) values of the BD patients were higher than those of the control group. A strong independent relationship was found between the AIP value and cIMT (β = 0.232, p = 0.018). In the subgroup analysis, the cIMT and AIP values of male BD patients were higher than those of female BD patients. CONCLUSION Increased AIP and cIMT values can be a good marker for subclinical atherosclerosis in BD patients, especially in male BD patients.
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Affiliation(s)
- E Cure
- Recep Tayyip Erdogan University, Rize, Turkey.
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - A Ugur Uslu
- Eskisehir Military Hospital, Eskisehir, Turkey
| | | | - D Sakiz
- Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - M Ozucan
- Necmettin Erbakan University, Konya, Turkey
| | - F Yavuz
- Dogubeyazit Docent Dr Yasar Eryilmaz State Hospital, Agri, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | | | - A Kucuk
- Malatya State Hospital, Malatya, Turkey
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Cure E, Icli A, Ugur Uslu A, Aydoğan Baykara R, Sakiz D, Ozucan M, Yavuz F, Arslan S, Cumhur Cure M, Kucuk A. Atherogenic index of plasma may be strong predictor of subclinical atherosclerosis in patients with Behçet disease. Z Rheumatol 2016. [PMID: 27431747 DOI: 10.1007/s00393-016-0141-z.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
OBJECTIVES Behcet's disease (BD) is a systemic vasculitis characterized by cardiovascular complications. Early diagnosis of these complications can reduce morbidity and mortality. Carotid artery intima-media thickness (cIMT) and the logarithmic value of triglyceride to high density lipoprotein ratio (atherogenic index of plasma, AIP) are good markers of atherosclerosis. The purpose of this study was to investigate whether AIP is a predictive marker of subclinical atherosclerosis in BD patients. PATIENTS AND METHODS A total of 84 BD patients (60 male, 24 female) and 84 healthy control individuals (58 male, 26 female) were included in this study. cIMT measurements were made, and AIP values were calculated. RESULTS cIMT (p < 0.001) and AIP (p < 0.001) values of the BD patients were higher than those of the control group. A strong independent relationship was found between the AIP value and cIMT (β = 0.232, p = 0.018). In the subgroup analysis, the cIMT and AIP values of male BD patients were higher than those of female BD patients. CONCLUSION Increased AIP and cIMT values can be a good marker for subclinical atherosclerosis in BD patients, especially in male BD patients.
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Affiliation(s)
- E Cure
- Recep Tayyip Erdogan University, Rize, Turkey.
| | - A Icli
- Necmettin Erbakan University, Konya, Turkey
| | - A Ugur Uslu
- Eskisehir Military Hospital, Eskisehir, Turkey
| | | | - D Sakiz
- Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - M Ozucan
- Necmettin Erbakan University, Konya, Turkey
| | - F Yavuz
- Dogubeyazit Docent Dr Yasar Eryilmaz State Hospital, Agri, Turkey
| | - S Arslan
- Necmettin Erbakan University, Konya, Turkey
| | | | - A Kucuk
- Malatya State Hospital, Malatya, Turkey
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Pramfalk C, Pavlides M, Banerjee R, McNeil CA, Neubauer S, Karpe F, Hodson L. Sex-Specific Differences in Hepatic Fat Oxidation and Synthesis May Explain the Higher Propensity for NAFLD in Men. J Clin Endocrinol Metab 2015; 100:4425-33. [PMID: 26414963 PMCID: PMC4667166 DOI: 10.1210/jc.2015-2649] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT AND OBJECTIVE In most populations a greater proportion of men have hepatic steatosis than women. Sex-specific differences in hepatic dietary fatty acid (FA) metabolism have not been well characterized. We compared fasting and postprandial hepatic FA synthesis (de novo lipogenesis [DNL]) and oxidation in men and women. PARTICIPANTS AND METHODS Fasting and postprandial hepatic FA metabolism was studied in 22 healthy men (n = 11) and women with similar age, body mass index, and liver fat content using metabolic substrates labeled with stable-isotope tracers ((2)H2O and [U(13)C]palmitate). Dietary FA oxidation was assessed by appearance of (13)C into plasma 3-hydroxybutyrate and breath CO2 as markers of liver and whole-body FA oxidation, respectively. RESULTS Despite similar liver fat content, fasting and postprandial plasma triacylglycerol (TG) concentrations were significantly (P < .05) higher in men compared with women. The appearance of (13)C from dietary FA into plasma 3-hydroxybutyrate and breath CO2 was greater (P < .05) in women compared with men. Although the contribution of DNL into very low-density lipoprotein (VLDL)-TG was similar (∼ 10%) in the fasting state, there was a divergence in pattern over the course of the study, with men maintaining a higher contribution of DNL to VLDL-TG than women (P = .006 time x sex interaction). CONCLUSIONS The combination of lower dietary FA oxidation and a prolonged increase in DNL observed in men may represent partitioning of FA into esterification and storage pathways within the liver, leading to greater VLDL-TG production, and predispose to the sex difference in hepatic steatosis.
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Affiliation(s)
- Camilla Pramfalk
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Michael Pavlides
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Rajarshi Banerjee
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Catriona A McNeil
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Stefan Neubauer
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology, and Metabolism (C.P., C.A.M., F.K., L.H.), Oxford Centre for Clinical Magnetic Resonance Research (M.P., R.B., S.N.), University of Oxford, Churchill Hospital, Oxford OX3 7LE, United Kingdom; and Translational Gastroenterology Unit (M.P.), John Radcliffe Hospital and National Institute for Health Research Oxford Biomedical Research Centre (F.K.), Oxford University Hospital Trusts, Oxford OX3 9DU, United Kingdom
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Hodson L, Banerjee R, Rial B, Arlt W, Adiels M, Boren J, Marinou K, Fisher C, Mostad IL, Stratton IM, Barrett PHR, Chan DC, Watts GF, Harnden K, Karpe F, Fielding BA. Menopausal Status and Abdominal Obesity Are Significant Determinants of Hepatic Lipid Metabolism in Women. J Am Heart Assoc 2015; 4:e002258. [PMID: 26432801 PMCID: PMC4845132 DOI: 10.1161/jaha.115.002258] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Android fat distribution (abdominal obesity) is associated with insulin resistance, hepatic steatosis, and greater secretion of large very low‐density lipoprotein (VLDL) particles in men. Since abdominal obesity is becoming increasingly prevalent in women, we aimed to investigate the relationship between android fat and hepatic lipid metabolism in pre‐ and postmenopausal women. Methods and Results We used a combination of stable isotope tracer techniques to investigate intrahepatic fatty acid synthesis and partitioning in 29 lean and 29 abdominally obese women (android fat/total fat 0.065 [0.02 to 0.08] and 0.095 [0.08 to 0.11], respectively). Thirty women were premenopausal aged 35 to 45 and they were matched for abdominal obesity with 28 postmenopausal women aged 55 to 65. As anticipated, abdominal obese women were more insulin resistant with enhanced hepatic secretion of large (404±30 versus 268±26 mg/kg lean mass, P<0.001) but not small VLDL (160±11 versus 142±13). However, postmenopausal status had a pronounced effect on the characteristics of small VLDL particles, which were considerably triglyceride‐enriched (production ratio of VLDL2‐ triglyceride:apolipoprotein B 30±5.3 versus 19±1.6, P<0.05). In contrast to postmenopausal women, there was a tight control of hepatic fatty acid metabolism and triglyceride production in premenopausal women, whereby oxidation (rs=−0.49, P=0.006), de novo lipogenesis (rs=0.55, P=0.003), and desaturation (rs=0.48, P=0.012) were closely correlated with abdominal obesity‐driven large VLDL‐triglyceride secretion rate. Conclusions In women, abdominal obesity is a major driver of hepatic large VLDL particle secretion, whereas postmenopausal status was characterized by increased small VLDL particle size. These data provide a mechanistic basis for the hyperlipidemia observed in postmenopausal obesity.
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Affiliation(s)
- Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK (L.H., K.M., K.H., F.K., B.A.F.)
| | - Rajarshi Banerjee
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK (R.B., B.R.)
| | - Belén Rial
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, UK (R.B., B.R.)
| | - Wiebke Arlt
- Centre for Endocrinology, Diabetes and Metabolism, School of Clinical & Experimental Medicine, University of Birmingham, UK (W.A.)
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden (M.A.) Department of Mathematical Sciences, University of Gothenburg, Sweden (M.A., J.B.)
| | - Jan Boren
- Department of Mathematical Sciences, University of Gothenburg, Sweden (M.A., J.B.)
| | - Kyriakoula Marinou
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK (L.H., K.M., K.H., F.K., B.A.F.) Department of Experimental Physiology, Athens University School of Medicine, Athens, Greece (K.M.)
| | - Ciaran Fisher
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK (C.F., B.A.F.)
| | - Ingrid L Mostad
- Department of Clinical Nutrition, Clinic of Clinical Service, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (I.L.M.) Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Trondheim, Norway (I.L.M.)
| | - Irene M Stratton
- Gloucestershire Diabetic Retinopathy Research Group, Cheltenham General Hospital, Gloucestershire, UK (I.M.S.)
| | - P Hugh R Barrett
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia (H.R.B., D.C.C., G.F.W.) Faculty of Engineering, Computing and Mathematics, University of Western Australia, Perth, WA, Australia (H.R.B.)
| | - Dick C Chan
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia (H.R.B., D.C.C., G.F.W.)
| | - Gerald F Watts
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia (H.R.B., D.C.C., G.F.W.)
| | - Karin Harnden
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK (L.H., K.M., K.H., F.K., B.A.F.)
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK (L.H., K.M., K.H., F.K., B.A.F.) National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital Trusts, Oxford, UK (F.K.)
| | - Barbara A Fielding
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK (L.H., K.M., K.H., F.K., B.A.F.) Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK (C.F., B.A.F.)
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Abstract
Labelling molecules with stable isotopes to create tracers has become a gold-standard method to study the metabolism of lipids and lipoproteins in humans. There are a range of techniques which use stable isotopes to measure fatty acid flux and oxidation, hepatic fatty synthesis, cholesterol absorption and synthesis and lipoprotein metabolism in humans. Stable isotope tracers are safe to use, enabling repeated studies to be undertaken and allowing studies to be undertaken in children and pregnant women. This review provides details of the most appropriate tracers to use, the techniques which have been developed and validated for measuring different aspects of lipid metabolism and some of the limitations of the methodology.
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Affiliation(s)
- A Margot Umpleby
- Diabetes and Metabolic MedicineFaculty of Health and Metabolic Sciences, University of Surrey, Leggett Building, Daphne Jackson Road, Manor Park, Guildford GU2 7WG, UK
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Usman H, Rashid R, Ameer F, Iqbal A, Zaid M, Hasnain S, Kalbacher H, Zaidi N. Revisiting the dyslipidemia associated with acute leukemia. Clin Chim Acta 2015; 444:43-9. [PMID: 25680744 DOI: 10.1016/j.cca.2015.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 01/06/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Previous studies appreciate the leukemia-associated alterations in plasma lipid profiles but fail to provide a consistent pattern of lipid anomalies in leukemia patients. These inconsistencies could be due to overlooking the effects of related confounding risk-factors and comorbidities. METHODS The plasma lipid profiles of acute-leukemia and control groups were compared. RESULTS We observed that acute lymphocytic leukemia (ALL) patients display significantly higher triglycerides and very low-density lipoproteins, whereas, acute myeloid leukemia (AML) patients display significantly lower high-density lipoproteins. To assess the confounding effects of related risk factors gender-, age- and BMI-based analyses were performed. We observed that the aforementioned significant differences in the lipid profiles of leukemia patients were restricted to female participants of the respective groups. Moreover, a significant decrease in total cholesterol and low-density lipoprotein levels was observed only in male participants of the AML population. Various age-specific trends in plasma lipid profile of the leukemia patients were also observed. BMI-based analysis did not display many significant differences from the overall analyses. In addition to comparing the absolute values of plasma lipids in leukemia and control groups we also compared and observed significant differences in prevalence of various isolated- and mixed-dyslipidemias in these groups. CONCLUSIONS These findings may help in outlining the prevalence and types of dyslipidemia in leukemia patients that may emerge as diagnostic/prognostic factors for the management of acute leukemia.
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Affiliation(s)
- Hina Usman
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Rida Rashid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Fatima Ameer
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Areeb Iqbal
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Muhammad Zaid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Shahida Hasnain
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan
| | - Hubert Kalbacher
- Medical and Natural Sciences Research Centre, University of Tubingen, Germany
| | - Nousheen Zaidi
- Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan.
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13
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Abstract
This study aimed to 1) develop a method that completely separated hepatic (VLDL1, VLDL2) and intestinal [chylomicron (CM)] lipoproteins and 2) use the method to measure triacylglycerol (TAG) kinetics in these lipoproteins in the fed and fasting state in healthy subjects, using intravenous [²H₅]glycerol as the tracer. An immunoaffinity method that completely separated hepatic and intestinal particles using sequential binding to three antibodies to apolipoprotein B-100 (apoB-100) was established and validated. Six healthy volunteers were studied in a fasted and continuous feeding study (study 1). Five additional healthy volunteers were studied in a continuous feeding study that included an oral [¹³C₃]glycerol tripalmitin tracer (study 2). In both studies, an intravenous bolus of [²H₅]glycerol was administered to label TAG in hepatic and intestinal lipoproteins. In both feeding studies there was sufficient incorporation of the [²H₅]glycerol tracer into the exogenous lipoproteins to enable isotopic enrichment to be measured. In study 2, the oral tracer enrichment in VLDL1 was <5% of CM enrichment 150 min after tracer administration, demonstrating negligible contamination of VLDL1 with apoB-48. Western blotting showed no detectable apoB-100 in CMs. VLDL1 and VLDL2 TAG fractional catabolic rate (FCR) did not differ between feeding and fasting (study 1). There was no difference between CM and VLDL1 TAG FCR in both fed studies. In fed study 2, 47% of the total TAG production rate (CM + VLDL1) was from CM. This methodology may be a useful tool for understanding the abnormalities in postprandial TAG kinetics in metabolic syndrome and type 2 diabetes.
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Affiliation(s)
- Feifei Sun
- Diabetes and Metabolic Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom; and
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