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Taskinen MR, Matikainen N, Björnson E, Söderlund S, Inkeri J, Hakkarainen A, Parviainen H, Sihlbom C, Thorsell A, Andersson L, Adiels M, Packard CJ, Borén J. Contribution of intestinal triglyceride-rich lipoproteins to residual atherosclerotic cardiovascular disease risk in individuals with type 2 diabetes on statin therapy. Diabetologia 2023; 66:2307-2319. [PMID: 37775612 PMCID: PMC10627993 DOI: 10.1007/s00125-023-06008-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/30/2023] [Indexed: 10/01/2023]
Abstract
AIMS/HYPOTHESIS This study explored the hypothesis that significant abnormalities in the metabolism of intestinally derived lipoproteins are present in individuals with type 2 diabetes on statin therapy. These abnormalities may contribute to residual CVD risk. METHODS To investigate the kinetics of ApoB-48- and ApoB-100-containing lipoproteins, we performed a secondary analysis of 11 overweight/obese individuals with type 2 diabetes who were treated with lifestyle counselling and on a stable dose of metformin who were from an earlier clinical study, and compared these with 11 control participants frequency-matched for age, BMI and sex. Participants in both groups were on a similar statin regimen during the study. Stable isotope tracers were used to determine the kinetics of the following in response to a standard fat-rich meal: (1) apolipoprotein (Apo)B-48 in chylomicrons and VLDL; (2) ApoB-100 in VLDL, intermediate-density lipoprotein (IDL) and LDL; and (3) triglyceride (TG) in VLDL. RESULTS The fasting lipid profile did not differ significantly between the two groups. Compared with control participants, in individuals with type 2 diabetes, chylomicron TG and ApoB-48 levels exhibited an approximately twofold higher response to the fat-rich meal, and a twofold higher increment was observed in ApoB-48 particles in the VLDL1 and VLDL2 density ranges (all p < 0.05). Again comparing control participants with individuals with type 2 diabetes, in the latter, total ApoB-48 production was 25% higher (556 ± 57 vs 446 ± 57 mg/day; p < 0.001), conversion (fractional transfer rate) of chylomicrons to VLDL was around 40% lower (35 ± 25 vs 82 ± 58 pools/day; p=0.034) and direct clearance of chylomicrons was 5.6-fold higher (5.6 ± 2.2 vs 1.0 ± 1.8 pools/day; p < 0.001). During the postprandial period, ApoB-48 particles accounted for a higher proportion of total VLDL in individuals with type 2 diabetes (44%) compared with control participants (25%), and these ApoB-48 VLDL particles exhibited a fivefold longer residence time in the circulation (p < 0.01). No between-group differences were seen in the kinetics of ApoB-100 and TG in VLDL, or in LDL ApoB-100 production, pool size and clearance rate. As compared with control participants, the IDL ApoB-100 pool in individuals with type 2 diabetes was higher due to increased conversion from VLDL2. CONCLUSIONS/INTERPRETATION Abnormalities in the metabolism of intestinally derived ApoB-48-containing lipoproteins in individuals with type 2 diabetes on statins may help to explain the residual risk of CVD and may be suitable targets for interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02948777.
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Affiliation(s)
- Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Niina Matikainen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sanni Söderlund
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Jussi Inkeri
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Helka Parviainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Carina Sihlbom
- Proteomic Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomic Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Wallenberg Laboratory, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Oura P, Hakkarainen A, Sajantila A. Forensic neuropathology in the past decade: a scoping literature review. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00672-9. [PMID: 37439948 DOI: 10.1007/s12024-023-00672-9] [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] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
While there has been notable research activity in the field of clinical neuropathology over the recent years, forensic approaches have been less frequent. This scoping literature review explored original research on forensic neuropathology over the past decade (January 1, 2010, until February 12, 2022) using the MEDLINE database. The aims were to (1) analyze the volume of research on the topic, (2) describe meta-level attributes and sample characteristics, and (3) summarize key research themes and methods. Of 5053 initial hits, 2864 fell within the target timeframe, and 122 were included in the review. Only 3-17 articles were published per year globally. Most articles originated from the Europe (39.3%) and Asia (36.1%) and were published in forensic journals (57.4%). A median sample included 57 subjects aged between 16 and 80 years. The most common research theme was traumatic intracranial injury (24.6%), followed by anatomy (12.3%) and substance abuse (11.5%). Key methods included immunotechniques (31.1%) and macroscopic observation (21.3%). Although a number of novel findings were reported, most were of preliminary nature and will require further validation. In order to reach breakthroughs and validate novel tools for routine use, more research input is urged from researchers across the world. It would be necessary to ensure appropriate sample sizes and make use of control groups.
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Affiliation(s)
- Petteri Oura
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland.
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland.
| | - Antti Hakkarainen
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland
| | - Antti Sajantila
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, FI-00271, Finland
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Lapatto HA, Kuusela M, Heikkinen A, Muniandy M, van der Kolk BW, Gopalakrishnan S, Pöllänen N, Sandvik M, Schmidt MS, Heinonen S, Saari S, Kuula J, Hakkarainen A, Tampio J, Saarinen T, Taskinen MR, Lundbom N, Groop PH, Tiirola M, Katajisto P, Lehtonen M, Brenner C, Kaprio J, Pekkala S, Ollikainen M, Pietiläinen KH, Pirinen E. Nicotinamide riboside improves muscle mitochondrial biogenesis, satellite cell differentiation, and gut microbiota in a twin study. Sci Adv 2023; 9:eadd5163. [PMID: 36638183 PMCID: PMC9839336 DOI: 10.1126/sciadv.add5163] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Nicotinamide adenine dinucleotide (NAD+) precursor nicotinamide riboside (NR) has emerged as a promising compound to improve obesity-associated mitochondrial dysfunction and metabolic syndrome in mice. However, most short-term clinical trials conducted so far have not reported positive outcomes. Therefore, we aimed to determine whether long-term NR supplementation boosts mitochondrial biogenesis and metabolic health in humans. Twenty body mass index (BMI)-discordant monozygotic twin pairs were supplemented with an escalating dose of NR (250 to 1000 mg/day) for 5 months. NR improved systemic NAD+ metabolism, muscle mitochondrial number, myoblast differentiation, and gut microbiota composition in both cotwins. NR also showed a capacity to modulate epigenetic control of gene expression in muscle and adipose tissue in both cotwins. However, NR did not ameliorate adiposity or metabolic health. Overall, our results suggest that NR acts as a potent modifier of NAD+ metabolism, muscle mitochondrial biogenesis and stem cell function, gut microbiota, and DNA methylation in humans irrespective of BMI.
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Affiliation(s)
- Helena A. K. Lapatto
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Minna Kuusela
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Aino Heikkinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Maheswary Muniandy
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Birgitta W. van der Kolk
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | | | - Noora Pöllänen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Martin Sandvik
- Institute of Biotechnology, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Mark S. Schmidt
- Department of Biochemistry, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sini Heinonen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Sina Saari
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Juho Kuula
- Department of Radiology, Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Antti Hakkarainen
- Department of Radiology, Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Janne Tampio
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Tuure Saarinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
- Abdominal Center, Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Per-Henrik Groop
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Nephrology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - Marja Tiirola
- Department of Environmental and Biological Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Pekka Katajisto
- Institute of Biotechnology, HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | - Marko Lehtonen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Charles Brenner
- Department of Diabetes and Cancer Metabolism, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Jaakko Kaprio
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
| | - Satu Pekkala
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Miina Ollikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
- Abdominal Center, Healthy Weight Hub, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eija Pirinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, FIN-00014 Helsinki, Finland
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, University of Oulu, FIN-90220 Oulu, Finland
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Taskinen MR, Björnson E, Matikainen N, Söderlund S, Rämo J, Ainola MM, Hakkarainen A, Sihlbom C, Thorsell A, Andersson L, Bergh PO, Henricsson M, Romeo S, Adiels M, Ripatti S, Laakso M, Packard CJ, Borén J. Postprandial metabolism of apolipoproteins B48, B100, C-III and E in humans with APOC3 loss-of-function mutations. JCI Insight 2022; 7:160607. [PMID: 36040803 DOI: 10.1172/jci.insight.160607] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Apolipoprotein CIII is a regulator of triglyceride (TG) metabolism, and due to its association with risk of cardiovascular disease, is an emergent target for pharmacological intervention. The impact of substantially lowering apoC-III on lipoprotein metabolism is not clear. METHODS We investigated the kinetics of apolipoproteins B48 and B100 in chylomicrons, VLDL1, VLDL2, IDL and LDL in subjects heterozygous for a loss-of-function (LOF) mutation in the APOC3 gene. Studies were conducted in the post-prandial state to provide a more comprehensive view of the influence of this protein on TG transport. RESULTS Compared to non-LOF subjects, a genetically-determined decrease in apoC-III resulted in marked acceleration of lipolysis of triglyceride-rich lipoproteins (TRL), increased removal of VLDL remnants from the bloodstream, and a substantial decrease in circulating levels of VLDL1, VLDL2 and IDL particles. Production rates for apolipoprotein B48-containing chylomicrons and apoB100-containing VLDL1 and VLDL2 were not different between LOF carriers and non-carriers. Likewise, the rate of production of LDL was not affected by the lower apoC-III level, nor was the concentration of LDL-apoB100 or its clearance rate. CONCLUSION These findings indicate that apoC-III lowering will have a marked effect on TRL and remnant metabolism, with possibly significant consequences for cardiovascular disease prevention. TRIAL REGISTRATIONS Clinical Trials NCT04209816 and NCT01445730FUNDING. This project was funded by grants from Swedish Heart-Lung Foundation, Swedish Research Council, ALF grant from the Sahlgrenska University Hospital, Novo Nordisk Foundation, Sigrid Juselius Foundation, Helsinki University Hospital Government Research funds, Finnish Heart Foundation, and Finnish Diabetes Research Foundation.
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Affiliation(s)
- Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Niina Matikainen
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Sanni Söderlund
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Joel Rämo
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Scienc, University of Helsinki, Helsinki, Finland
| | - Mari-Mia Ainola
- Research Programs Unit, Clinical and Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, University of Helsinki, Helsinki, Finland
| | - Carina Sihlbom
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Per-Olof Bergh
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Marcus Henricsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Scienc, University of Helsinki, Helsinki, Finland
| | - Markku Laakso
- Department of Medicine, University of Kuopio, Kuopio, Finland
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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5
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Kuula J, Martola J, Hakkarainen A, Räikkönen K, Savolainen S, Salli E, Hovi P, Björkqvist J, Kajantie E, Lundbom N. Brain Volumes and Abnormalities in Adults Born Preterm at Very Low Birth Weight. J Pediatr 2022; 246:48-55.e7. [PMID: 35301016 DOI: 10.1016/j.jpeds.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/03/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess radiographic brain abnormalities and investigate volumetric differences in adults born preterm at very low birth weight (<1500 g), using siblings as controls. STUDY DESIGN We recruited 79 adult same-sex sibling pairs with one born preterm at very low birth weight and the sibling at term. We acquired 3-T brain magnetic resonance imaging from 78 preterm participants and 72 siblings. A neuroradiologist, masked to participants' prematurity status, reviewed the images for parenchymal and structural abnormalities, and FreeSurfer software 6.0 was used to conduct volumetric analyses. Data were analyzed by linear mixed models. RESULTS We found more structural abnormalities in very low birth weight participants than in siblings (37% vs 13%). The most common finding was periventricular leukomalacia, present in 15% of very low birth weight participants and in 3% of siblings. The very low birth weight group had smaller absolute brain volumes (-0.4 SD) and, after adjusting for estimated intracranial volume, less gray matter (-0.2 SD), larger ventricles (1.5 SD), smaller thalami (-0.6 SD), caudate nuclei (-0.4 SD), right hippocampus (-0.4 SD), and left pallidum (-0.3 SD). We saw no volume differences in total white matter (-0.04 SD; 95% CI, -0.13 to 0.09). CONCLUSIONS Preterm very low birth weight adults had a higher prevalence of brain abnormalities than their term-born siblings. They also had smaller absolute brain volumes, less gray but not white matter, and smaller volumes in several gray matter structures.
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Affiliation(s)
- Juho Kuula
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.
| | - Juha Martola
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sauli Savolainen
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Physics, University of Helsinki, Helsinki, Finland
| | - Eero Salli
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Petteri Hovi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Johan Björkqvist
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Kuula J, Lundbom J, Hakkarainen A, Hovi P, Hauta-Alus H, Kaseva N, Sandboge S, Björkqvist J, Eriksson J, Pietiläinen KH, Lundbom N, Kajantie E. Abdominal adipose tissue and liver fat imaging in very low birth weight adults born preterm: birth cohort with sibling-controls. Sci Rep 2022; 12:9905. [PMID: 35701494 PMCID: PMC9198082 DOI: 10.1038/s41598-022-13936-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/30/2022] [Indexed: 12/03/2022] Open
Abstract
Preterm birth at very low birth weight (VLBW, < 1500 g) is associated with an accumulation of cardiovascular and metabolic risk factors from childhood at least to middle age. Small-scale studies suggest that this could partly be explained by increased visceral or ectopic fat. We performed magnetic resonance imaging on 78 adults born preterm at VLBW in Finland between 1978 and 1990 and 72 term same-sex siblings as controls, with a mean age of 29 years. We collected T1-weighted images from the abdomen, and magnetic resonance spectra from the liver, subcutaneous abdominal adipose tissue, and tibia. The adipose tissue volumes of VLBW adults did not differ from their term siblings when adjusting for age, sex, and maternal and perinatal factors. The mean differences were as follows: subcutaneous − 0.48% (95% CI − 14.8%, 16.3%), visceral 7.96% (95% CI − 10.4%, 30.1%), and total abdominal fat quantity 1.05% (95% CI − 13.7%, 18.4%). Hepatic triglyceride content was also similar. VLBW individuals displayed less unsaturation in subcutaneous adipose tissue (− 4.74%, 95% CI − 9.2%, − 0.1%) but not in tibial bone marrow (1.68%, 95% CI − 1.86%, 5.35%). VLBW adults displayed similar adipose tissue volumes and hepatic triglyceride content as their term siblings. Previously reported differences could thus partly be due to genetic or environmental characteristics shared between siblings. The VLBW group displayed less unsaturation in subcutaneous abdominal adipose tissue, suggesting differences in its metabolic activity and energy storage.
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Affiliation(s)
- Juho Kuula
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. .,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.
| | - Jesper Lundbom
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Petteri Hovi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Helena Hauta-Alus
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism (CAMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nina Kaseva
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Samuel Sandboge
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Johan Björkqvist
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Johan Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.,Human Potential Translational Research Programme and Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Obesity Center, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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7
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Taskinen MR, Matikainen N, Björnson E, Söderlund S, Ainola M, Hakkarainen A, Lundbom N, Sihlbom C, Thorsell A, Andersson L, Adiels M, Hartmann B, Deacon CF, Holst JJ, Packard CJ, Borén J. Role of endogenous incretins in the regulation of postprandial lipoprotein metabolism. Eur J Endocrinol 2022; 187:75-84. [PMID: 35521766 DOI: 10.1530/eje-21-1187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/22/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Incretins are known to influence lipid metabolism in the intestine when administered as pharmacologic agents. The aggregate influence of endogenous incretins on chylomicron production and clearance is less clear, particularly in light of opposing effects of co-secreted hormones. Here, we tested the hypothesis that physiological levels of incretins may impact on production or clearances rates of chylomicrons and VLDL. DESIGN AND METHODS A group of 22 overweight/obese men was studied to determine associations between plasma levels of glucagon-like peptides 1 and 2 (GLP-1 and GLP-2) and glucose-dependent insulinotropic polypeptide (GIP) after a fat-rich meal and the production and clearance rates of apoB48- and apoB100-containing triglyceride-rich lipoproteins. Subjects were stratified by above- and below-median incretin response (area under the curve). RESULTS Stratification yielded subgroups that differed about two-fold in incretin response. There were neither differences in apoB48 production rates in chylomicrons or VLDL fractions nor in apoB100 or triglyceride kinetics in VLDL between men with above- vs below-median incretin responses. The men with above-median GLP-1 and GLP-2 responses exhibited higher postprandial plasma and chylomicron triglyceride levels, but this could not be related to altered kinetic parameters. No differences were found between incretin response subgroups and particle clearance rates. CONCLUSION We found no evidence for a regulatory effect of endogenous incretins on contemporaneous chylomicron or VLDL metabolism following a standardised fat-rich meal. The actions of incretins at pharmacological doses may not be reflected at physiological levels of these hormones.
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Affiliation(s)
- Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Niina Matikainen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sanni Söderlund
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Mari Ainola
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Carina Sihlbom
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Carolyn F Deacon
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
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8
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Luukkonen PK, Qadri S, Ahlholm N, Porthan K, Männistö V, Sammalkorpi H, Penttilä AK, Hakkarainen A, Lehtimäki TE, Gaggini M, Gastaldelli A, Ala-Korpela M, Orho-Melander M, Arola J, Juuti A, Pihlajamäki J, Hodson L, Yki-Järvinen H. Distinct contributions of metabolic dysfunction and genetic risk factors in the pathogenesis of non-alcoholic fatty liver disease. J Hepatol 2022; 76:526-535. [PMID: 34710482 PMCID: PMC8852745 DOI: 10.1016/j.jhep.2021.10.013] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS There is substantial inter-individual variability in the risk of non-alcoholic fatty liver disease (NAFLD). Part of which is explained by insulin resistance (IR) ('MetComp') and part by common modifiers of genetic risk ('GenComp'). We examined how IR on the one hand and genetic risk on the other contribute to the pathogenesis of NAFLD. METHODS We studied 846 individuals: 492 were obese patients with liver histology and 354 were individuals who underwent intrahepatic triglyceride measurement by proton magnetic resonance spectroscopy. A genetic risk score was calculated using the number of risk alleles in PNPLA3, TM6SF2, MBOAT7, HSD17B13 and MARC1. Substrate concentrations were assessed by serum NMR metabolomics. In subsets of participants, non-esterified fatty acids (NEFAs) and their flux were assessed by D5-glycerol and hyperinsulinemic-euglycemic clamp (n = 41), and hepatic de novo lipogenesis (DNL) was measured by D2O (n = 61). RESULTS We found that substrate surplus (increased concentrations of 28 serum metabolites including glucose, glycolytic intermediates, and amino acids; increased NEFAs and their flux; increased DNL) characterized the 'MetComp'. In contrast, the 'GenComp' was not accompanied by any substrate excess but was characterized by an increased hepatic mitochondrial redox state, as determined by serum β-hydroxybutyrate/acetoacetate ratio, and inhibition of hepatic pathways dependent on tricarboxylic acid cycle activity, such as DNL. Serum β-hydroxybutyrate/acetoacetate ratio correlated strongly with all histological features of NAFLD. IR and hepatic mitochondrial redox state conferred additive increases in histological features of NAFLD. CONCLUSIONS These data show that the mechanisms underlying 'Metabolic' and 'Genetic' components of NAFLD are fundamentally different. These findings may have implications with respect to the diagnosis and treatment of NAFLD. LAY SUMMARY The pathogenesis of non-alcoholic fatty liver disease can be explained in part by a metabolic component, including obesity, and in part by a genetic component. Herein, we demonstrate that the mechanisms underlying these components are fundamentally different: the metabolic component is characterized by hepatic oversupply of substrates, such as sugars, lipids and amino acids. In contrast, the genetic component is characterized by impaired hepatic mitochondrial function, making the liver less able to metabolize these substrates.
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Affiliation(s)
- Panu K Luukkonen
- Department of Internal Medicine, Yale University, New Haven, CT, USA; Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland.
| | - Sami Qadri
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Noora Ahlholm
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Kimmo Porthan
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Ville Männistö
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Henna Sammalkorpi
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Anne K Penttilä
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Tiina E Lehtimäki
- Department of Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland
| | | | | | - Mika Ala-Korpela
- Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; University of Eastern Finland, Kuopio, Finland; NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Marju Orho-Melander
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Johanna Arola
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Finland
| | - Anne Juuti
- Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford & NIHR Oxford Biomedical Research Centre, Oxford University Hospitals Foundation Trust, UK
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland.
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9
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Borén J, Adiels M, Björnson E, Matikainen N, Söderlund S, Rämö J, Henricsson M, Ripatti P, Ripatti S, Palotie A, Mancina RM, Ainola M, Hakkarainen A, Romeo S, Packard CJ, Taskinen MR. Effects of PNPLA3 I148M on hepatic lipid and very-low-density lipoprotein metabolism in humans. J Intern Med 2022; 291:218-223. [PMID: 34411351 DOI: 10.1111/joim.13375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The phospholipase domain-containing 3 gene (PNPLA3)-148M variant is associated with liver steatosis but its influence on the metabolism of triglyceride-rich lipoproteins remains unclear. Here, we investigated the kinetics of large, triglyceride-rich very-low-density lipoprotein (VLDL), (VLDL1 ), and smaller VLDL2 in homozygotes for the PNPLA3-148M variant. METHODS AND RESULTS The kinetics of apolipoprotein (apo) B100 (apoB100) and triglyceride in VLDL subfractions were analysed in nine subjects homozygous for PNPLA3-148M and nine subjects homozygous for PNPLA3-148I (controls). Liver fat was >3-fold higher in the 148M subjects. Production rates for apoB100 and triglyceride in VLDL1 did not differ significantly between the two groups. Likewise, production rates for VLDL2 -apoB100 and -triglyceride, and fractional clearance rates for both apoB100 and triglyceride in VLDL1 and VLDL2 , were not significantly different. CONCLUSIONS Despite the higher liver fat content in PNPLA3 148M homozygotes, there was no increase in VLDL production. Equally, VLDL production was maintained at normal levels despite the putative impairment in cytosolic lipid hydrolysis in these subjects.
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Affiliation(s)
- Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Laboratory/Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Niina Matikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sanni Söderlund
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Joel Rämö
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Marcus Henricsson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Pietari Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.,Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA.,Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.,Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA
| | - Rosellina M Mancina
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mari Ainola
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Finland
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Laboratory/Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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10
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Hanttu A, Vuoti S, Kivelä P, Arkkila P, Lundbom N, Hakkarainen A, Lundbom J, Lehtimäki T, Viskari H, Lehtinen V, Pietiläinen KH, Sutinen J. Liver Fat, Adipose Tissue, and Body Composition Changes After Switching from a Protease Inhibitor or Efavirenz to Raltegravir. AIDS Patient Care STDS 2021; 35:335-341. [PMID: 34524919 DOI: 10.1089/apc.2021.0106] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Integrase inhibitors appear to increase body weight, but paradoxically some data indicate that raltegravir (RAL) may decrease liver fat. Our objective was to study the effects of switching from a protease inhibitor (PI) or efavirenz (EFV) to RAL on liver fat, body composition, and metabolic parameters among people living with HIV (PLWH) with high risk for nonalcoholic fatty liver disease (NAFLD). We randomized overweight PLWH with signs of metabolic syndrome to switch a PI or EFV to RAL (n = 19) or to continue unchanged antiretroviral therapy (control, n = 24) for 24 weeks. Liver fat was measured by magnetic resonance spectroscopy (MRS), body composition by magnetic resonance imaging, and bioimpedance analysis; subcutaneous fat biopsies were obtained. Median (interquartile range) liver fat content was normal in RAL 2.3% (1.1-6.0) and control 3.1% (1.6-7.3) group at baseline. Liver fat and visceral adipose tissue remained unchanged during the study. Body weight [from 85.9 kg (76.1-97.7) to 89.3 (78.7-98.7), p = 0.019], body fat mass [from 20.3 kg (14.6-29.7) to 22.7 (17.0-29.7), p = 0.015], and subcutaneous adipose tissue (SAT) volume [from 3979 mL (2068-6468) to 4043 (2206-6433), p = 0.048] increased, yet, adipocyte size [from 564 pL (437-733) to 478 (423-587), p = 0.019] decreased in RAL but remained unchanged in control group. Circulating lipids and inflammatory markers improved in RAL compared to control group. The median liver fat measured by MRS was unexpectedly within normal range in this relatively small study population with presumably high risk for NAFLD contradicting high prevalence of NAFLD reported with other methods. Despite weight gain, increase in SAT together with decreased adipocyte size and reduced inflammation may reflect improved adipose tissue function. Clinical Trial Registration number: NCT03374358.
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Affiliation(s)
- Anna Hanttu
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sauli Vuoti
- Department of Clinical Chemistry, University of Jyväskylä, Jyväskylä, Finland
| | - Pia Kivelä
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Perttu Arkkila
- Department of Gastroenterology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, Helsinki Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, Helsinki Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- Department of Radiology, Helsinki Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tiina Lehtimäki
- Department of Radiology, Helsinki Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hanna Viskari
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ville Lehtinen
- Department of Internal Medicine, Central Hospital of Päijät-Häme, Lahti, Finland
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Obesity Center, Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Sutinen
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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11
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Uutela A, Ovissi A, Hakkarainen A, Ristimäki A, Lundbom N, Kallio R, Soveri LM, Salminen T, Ålgars A, Halonen P, Ristamäki R, Nordin A, Blanco Sequeiros R, Rinta-Kiikka I, Lantto E, Virtanen J, Pääkkö E, Liukkonen E, Saunavaara J, Ryymin P, Lammentausta E, Osterlund P, Isoniemi H. Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy: a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and 1H-MR spectroscopy compared with histology (subgroup in the RAXO trial). ESMO Open 2021; 6:100208. [PMID: 34325107 PMCID: PMC8332656 DOI: 10.1016/j.esmoop.2021.100208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/02/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023] Open
Abstract
Background Colorectal cancer liver metastases respond to chemotherapy and targeted agents not only by shrinking, but also by morphologic and metabolic changes. The aim of this study was to evaluate the value of advanced magnetic resonance imaging (MRI) methods in predicting treatment response and survival. Patients and methods We investigated contrast-enhanced MRI, apparent diffusion coefficient (ADC) in diffusion-weighted imaging and 1H-magnetic resonance spectroscopy (1H-MRS) in detecting early morphologic and metabolic changes in borderline or resectable liver metastases, as a response to first-line neoadjuvant or conversion therapy in a prospective substudy of the RAXO trial (NCT01531621, EudraCT2011-003158-24). MRI findings were compared with histology of resected liver metastases and Kaplan–Meier estimates of overall survival (OS). Results In 2012-2018, 52 patients at four Finnish university hospitals were recruited. Forty-seven patients received neoadjuvant or conversion chemotherapy and 40 liver resections were carried out. Low ADC values (below median) of the representative liver metastases, at baseline and after systemic therapy, were associated with partial response according to RECIST criteria, but not with morphologic MRI changes or histology. Decreasing ADC values following systemic therapy were associated with improved OS compared to unchanged or increasing ADC, both in the liver resected subgroup (5-year OS rate 100% and 34%, respectively, P = 0.022) and systemic therapy subgroup (5-year OS rate 62% and 23%, P = 0.049). 1H-MRS revealed steatohepatosis induced by systemic therapy. Conclusions Low ADC values at baseline or during systemic therapy were associated with treatment response by RECIST but not with histology, morphologic or detectable metabolic changes. A decreasing ADC during systemic therapy is associated with improved OS both in all patients receiving systemic therapy and in the resected subgroup. Colorectal liver metastases respond to systemic therapy by shrinking but also by morphological and metabolic changes. Advanced MRI technologies (DWI and 1H-MRS) might provide more detailed insight into cancer treatment-induced changes. We compare changes seen in MRI with histology. Reduction of ADC during chemotherapy was associated with improved survival after liver resection.
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Affiliation(s)
- A Uutela
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Ovissi
- Department of Radiology, HUS Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Hakkarainen
- Department of Radiology, HUS Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Helsinki, Finland
| | - A Ristimäki
- Department of Pathology, HUS Diagnostic Centre and Applied Tumour Genomics, Research Programs Unit, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - N Lundbom
- Department of Radiology, HUS Medical Imaging Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - R Kallio
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - L M Soveri
- Joint Municipal Authority for Health Care and Social Services in Keski-Uusimaa, Home Care Geriatric Clinic and Palliative Care, Hyvinkää, Finland
| | - T Salminen
- Department of Oncology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - A Ålgars
- Department of Oncology, Turku University Hospital and University of Turku, Turku, Finland
| | - P Halonen
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
| | - R Ristamäki
- Department of Oncology, Turku University Hospital and University of Turku, Turku, Finland
| | - A Nordin
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - R Blanco Sequeiros
- Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - I Rinta-Kiikka
- Department of Radiology, Medical Imaging Centre Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Medical Physics, Medical Imaging Centre Tampere University Hospital and University of Tampere, Tampere, Finland
| | - E Lantto
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - J Virtanen
- Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | - E Pääkkö
- Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - E Liukkonen
- Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - J Saunavaara
- Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | - P Ryymin
- Department of Radiology, Medical Imaging Centre Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Medical Physics, Medical Imaging Centre Tampere University Hospital and University of Tampere, Tampere, Finland
| | - E Lammentausta
- Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - P Osterlund
- Department of Oncology, Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland; Department of Pathology/Oncology, Karolinska Institutet and Karolinska sjukhuset - Tema Cancer, Stockholm, Sweden.
| | - H Isoniemi
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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12
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Taskinen MR, Björnson E, Matikainen N, Söderlund S, Pietiläinen KH, Ainola M, Hakkarainen A, Lundbom N, Fuchs J, Thorsell A, Andersson L, Adiels M, Packard CJ, Borén J. Effects of liraglutide on the metabolism of triglyceride-rich lipoproteins in type 2 diabetes. Diabetes Obes Metab 2021; 23:1191-1201. [PMID: 33502078 DOI: 10.1111/dom.14328] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/08/2021] [Accepted: 01/23/2021] [Indexed: 01/07/2023]
Abstract
AIM To elucidate the impact of liraglutide on the kinetics of apolipoprotein (apo)B48- and apoB100-containing triglyceride-rich lipoproteins in subjects with type 2 diabetes (T2D) after a single fat-rich meal. MATERIALS AND METHODS Subjects with T2D were included in a study to investigate postprandial apoB48 and apoB100 metabolism before and after 16 weeks on l.8 mg/day liraglutide (n = 14) or placebo (n = 4). Stable isotope tracer and compartmental modelling techniques were used to determine the impact of liraglutide on chylomicron and very low-density lipoprotein (VLDL) production and clearance after a single fat-rich meal. RESULTS Liraglutide reduced apoB48 synthesis in chylomicrons by 60% (p < .0001) and increased the triglyceride/apoB48 ratio (i.e. the size) of chylomicrons (p < .001). Direct clearance of chylomicrons, a quantitatively significant pathway pretreatment, decreased by 90% on liraglutide (p < .001). Liraglutide also reduced VLDL1 -triglyceride secretion (p = .017) in parallel with reduced liver fat. Chylomicron-apoB48 production and particle size were related to insulin sensitivity (p = .015 and p < .001, respectively), but these associations were perturbed by liraglutide. CONCLUSIONS In a physiologically relevant setting that mirrored regular feeding in subjects with T2D, liraglutide promoted potentially beneficial changes on postprandial apoB48 metabolism. Using our data in an integrated metabolic model, we describe how the action of liraglutide in T2D on chylomicron and VLDL kinetics could lead to decreased generation of remnant lipoproteins.
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Affiliation(s)
- Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Niina Matikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sanni Söderlund
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Mari Ainola
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Finland
| | - Johannes Fuchs
- Proteomics Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomics Core Facility at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Laboratory/Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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13
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Lallukka-Brück S, Isokuortti E, Luukkonen PK, Hakkarainen A, Lundbom N, Sutinen J, Yki-Järvinen H. Natural Course of Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Patients With Human Immunodeficiency Virus With and Without Combination Antiretroviral Therapy-associated Lipodystrophy: A 16-Year Follow-up Study. Clin Infect Dis 2021; 70:1708-1716. [PMID: 31131845 DOI: 10.1093/cid/ciz435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/14/2018] [Accepted: 05/24/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Abnormal glucose metabolism and nonalcoholic fatty liver disease (NAFLD) are common in patients with human immunodeficiency virus (HIV+ patients), but longitudinal data are lacking. We determined the natural course of NAFLD (liver fat [LFAT]) and type 2 diabetes mellitus (T2DM) in HIV+ patients with and without lipodystrophy (LD+ and LD-, respectively) during a 16-year longitudinal study. METHODS LFAT (by proton magnetic resonance spectroscopy) and clinical characteristics were measured in 41 HIV+ patients at baseline and after 16 years. Liver fibrosis was estimated by measuring liver stiffness using transient elastography (TE) and magnetic resonance elastography (MRE) at 16 years. We also longitudinally studied 28 healthy subjects. RESULTS During follow-up, the HIV+ patients gained more body fat (8.6% ± 0.7%) than the control patients (4.5% ± 0.6%, P < .001). Features of insulin resistance increased significantly in the HIV+ patients but not the control patients. A significant proportion (20%, P < .01 vs 0% at baseline) of the HIV+ but none of the control patients developed T2DM. LFAT was significantly higher at baseline in the LD+ (4.3 [1.9-11.8]) than the LD- (1.0 [0.5-1.5]; P < .001) HIV+ patients. LFAT remained stable during follow-up in all groups. At follow-up, liver stiffness measured with TE was similar among all HIV, LD+, LD-, and control patients and between the LD+ and LD- patients measured with MRE. Advanced fibrosis by MRE was observed in 3 of LD+ and none of LD- patients. CONCLUSIONS During 16 years of follow-up, progression of NAFLD is rare compared to development of T2DM in HIV+ patients.
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Affiliation(s)
- Susanna Lallukka-Brück
- Minerva Foundation Institute for Medical Research.,Department of Medicine, University of Helsinki, and Helsinki University Hospital
| | - Elina Isokuortti
- Minerva Foundation Institute for Medical Research.,Department of Medicine, University of Helsinki, and Helsinki University Hospital
| | - Panu K Luukkonen
- Minerva Foundation Institute for Medical Research.,Department of Medicine, University of Helsinki, and Helsinki University Hospital
| | - Antti Hakkarainen
- Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital
| | - Nina Lundbom
- Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital
| | - Jussi Sutinen
- Department of Infectious Diseases, University of Helsinki, and Helsinki University Hospital, Finland
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research.,Department of Medicine, University of Helsinki, and Helsinki University Hospital
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14
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Luukkonen PK, Qadri S, Lehtimäki TE, Juuti A, Sammalkorpi H, Penttilä AK, Hakkarainen A, Orho-Melander M, Arola J, Yki-Järvinen H. The PNPLA3-I148M Variant Confers an Antiatherogenic Lipid Profile in Insulin-resistant Patients. J Clin Endocrinol Metab 2021; 106:e300-e315. [PMID: 33064150 DOI: 10.1210/clinem/dgaa729] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/14/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT The I148M (rs738409-G) variant in PNPLA3 increases liver fat content but may be protective against cardiovascular disease. Insulin resistance (IR) amplifies the effect of PNPLA3-I148M on liver fat. OBJECTIVE To study whether PNPLA3-I148M confers an antihyperlipidemic effect in insulin-resistant patients. DESIGN Cross-sectional study comparing the impact of PNPLA3-I148M on plasma lipids and lipoproteins in 2 cohorts, both divided into groups based on rs738409-G allele carrier status and median HOMA-IR. SETTING Tertiary referral center. PATIENTS A total of 298 obese patients who underwent a liver biopsy during bariatric surgery (bariatric cohort: age 49 ± 9 years, body mass index [BMI] 43.2 ± 6.8 kg/m2), and 345 less obese volunteers in whom liver fat was measured by proton magnetic resonance spectroscopy (nonbariatric cohort: age 45 ± 14 years, BMI 29.7 ± 5.7 kg/m2). MAIN OUTCOME MEASURES Nuclear magnetic resonance profiling of plasma lipids, lipoprotein particle subclasses and their composition. RESULTS In both cohorts, individuals carrying the PNPLA3-I148M variant had significantly higher liver fat content than noncarriers. In insulin-resistant and homozygous carriers, PNPLA3-I148M exerted a distinct antihyperlipidemic effect with decreased very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) particles and their constituents, and increased high-density lipoprotein particles and their constituents, compared with noncarriers. VLDL particles were smaller and LDL particles larger in PNPLA3-I148M carriers. These changes were geometrically opposite to those due to IR. PNPLA3-I148M did not have a measurable effect in patients with lower IR, and its effect was smaller albeit still significant in the less obese than in the obese cohort. CONCLUSIONS PNPLA3-I148M confers an antiatherogenic plasma lipid profile particularly in insulin-resistant individuals.
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Affiliation(s)
- Panu K Luukkonen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Sami Qadri
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Tiina E Lehtimäki
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Anne Juuti
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Henna Sammalkorpi
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Anne K Penttilä
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | | | - Johanna Arola
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
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15
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Taskinen MR, Björnson E, Kahri J, Söderlund S, Matikainen N, Porthan K, Ainola M, Hakkarainen A, Lundbom N, Fermanelli V, Fuchs J, Thorsell A, Kronenberg F, Andersson L, Adiels M, Packard CJ, Borén J. Effects of Evolocumab on the Postprandial Kinetics of Apo (Apolipoprotein) B100- and B48-Containing Lipoproteins in Subjects With Type 2 Diabetes. Arterioscler Thromb Vasc Biol 2020; 41:962-975. [PMID: 33356392 DOI: 10.1161/atvbaha.120.315446] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Increased risk of atherosclerotic cardiovascular disease in subjects with type 2 diabetes is linked to elevated levels of triglyceride-rich lipoproteins and their remnants. The metabolic effects of PCSK9 (proprotein convertase subtilisin/kexin 9) inhibitors on this dyslipidemia were investigated using stable-isotope-labeled tracers. Approach and Results: Triglyceride transport and the metabolism of apos (apolipoproteins) B48, B100, C-III, and E after a fat-rich meal were investigated before and on evolocumab treatment in 13 subjects with type 2 diabetes. Kinetic parameters were determined for the following: apoB48 in chylomicrons; triglyceride in VLDL1 (very low-density lipoprotein) and VLDL2; and apoB100 in VLDL1, VLDL2, IDL (intermediate-density lipoprotein), and LDL (low-density lipoprotein). Evolocumab did not alter the kinetics of apoB48 in chylomicrons or apoB100 or triglyceride in VLDL1. In contrast, the fractional catabolic rates of VLDL2-apoB100 and VLDL2-triglyceride were both increased by about 45%, which led to a 28% fall in the VLDL2 plasma level. LDL-apoB100 was markedly reduced by evolocumab, which was linked to metabolic heterogeneity in this fraction. Evolocumab increased clearance of the more rapidly metabolized LDL by 61% and decreased production of the more slowly cleared LDL by 75%. ApoC-III kinetics were not altered by evolocumab, but the apoE fractional catabolic rates increased by 45% and the apoE plasma level fell by 33%. The apoE fractional catabolic rates was associated with the decrease in VLDL2- and IDL-apoB100 concentrations. CONCLUSIONS Evolocumab had only minor effects on lipoproteins that are involved in triglyceride transport (chylomicrons and VLDL1) but, in contrast, had a profound impact on lipoproteins that carry cholesterol (VLDL2, IDL, LDL). Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02948777.
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Affiliation(s)
- Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine (E.B., L.A., M. Adiels, J.B.), University of Gothenburg, Sweden
| | - Juhani Kahri
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland
| | - Sanni Söderlund
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland.,Department of Endocrinology, Abdominal Center (S.S., N.M.), Helsinki University Hospital, Finland
| | - Niina Matikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland.,Department of Endocrinology, Abdominal Center (S.S., N.M.), Helsinki University Hospital, Finland
| | - Kimmo Porthan
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland
| | - Mari Ainola
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine (M.-R.T., J.K., S.S., N.M., K.P., M. Ainola), University of Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital (A.H., N.L.), University of Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland (A.H.)
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital (A.H., N.L.), University of Helsinki, Finland
| | | | - Johannes Fuchs
- Proteomics Core Facility (J.F., A.T.), University of Gothenburg, Sweden
| | - Annika Thorsell
- Proteomics Core Facility (J.F., A.T.), University of Gothenburg, Sweden
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Austria (F.K.)
| | - Linda Andersson
- Department of Molecular and Clinical Medicine (E.B., L.A., M. Adiels, J.B.), University of Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine (E.B., L.A., M. Adiels, J.B.), University of Gothenburg, Sweden.,Department of Biostatistics, School of Public Health and Community Medicine (M. Adiels), University of Gothenburg, Sweden
| | - Chris J Packard
- Isnstitute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (C.J.P.)
| | - Jan Borén
- Department of Molecular and Clinical Medicine (E.B., L.A., M. Adiels, J.B.), University of Gothenburg, Sweden.,Department of Cardiology, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden (J.B.)
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16
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Borén J, Adiels M, Björnson E, Matikainen N, Söderlund S, Rämö J, Ståhlman M, Ripatti P, Ripatti S, Palotie A, Mancina RM, Hakkarainen A, Romeo S, Packard CJ, Taskinen MR. Effects of TM6SF2 E167K on hepatic lipid and very low-density lipoprotein metabolism in humans. JCI Insight 2020; 5:144079. [PMID: 33170809 PMCID: PMC7819740 DOI: 10.1172/jci.insight.144079] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is characterized by hepatic lipid accumulation. The transmembrane 6 superfamily member 2 (TM6SF2) E167K genetic variant associates with NAFLD and with reduced plasma triglyceride levels in humans. However, the molecular mechanisms underlying these associations remain unclear. We hypothesized that TM6SF2 E167K affects hepatic very low-density lipoprotein (VLDL) secretion and studied the kinetics of apolipoprotein B100 (apoB100) and triglyceride metabolism in VLDL in homozygous subjects. In 10 homozygote TM6SF2 E167K carriers and 10 matched controls, we employed stable-isotope tracer and compartmental modeling techniques to determine apoB100 and triglyceride kinetics in the 2 major VLDL subfractions: large triglyceride-rich VLDL1 and smaller, less triglyceride-rich VLDL2. VLDL1-apoB100 production was markedly reduced in homozygote TM6SF2 E167K carriers compared with controls. Likewise, VLDL1-triglyceride production was 35% lower in the TM6SF2 E167K carriers. In contrast, the direct production rates for VLDL2-apoB100 and triglyceride were not different between carriers and controls. In conclusion, the TM6SF2 E167K genetic variant was linked to a specific reduction in hepatic secretion of large triglyceride-rich VLDL1. The impaired secretion of VLDL1 explains the reduced plasma triglyceride concentration and provides a basis for understanding the lower risk of cardiovascular disease associated with the TM6SF2 E167K genetic variant.
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Affiliation(s)
- Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Niina Matikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sanni Söderlund
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Joel Rämö
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Pietari Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.,Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA.,Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.,Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA
| | - Rosellina M Mancina
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Antti Hakkarainen
- Helsinki and Uusimaa Hospital District Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Finland
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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17
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Björnson E, Packard CJ, Adiels M, Andersson L, Matikainen N, Söderlund S, Kahri J, Hakkarainen A, Lundbom N, Lundbom J, Sihlbom C, Thorsell A, Zhou H, Taskinen MR, Borén J. Apolipoprotein B48 metabolism in chylomicrons and very low-density lipoproteins and its role in triglyceride transport in normo- and hypertriglyceridemic human subjects. J Intern Med 2020; 288:422-438. [PMID: 31846520 DOI: 10.1111/joim.13017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Renewed interest in triglyceride-rich lipoproteins as causative agents in cardiovascular disease mandates further exploration of the integrated metabolism of chylomicrons and very low-density lipoproteins (VLDL). METHODS Novel tracer techniques and an integrated multi-compartmental model were used to determine the kinetics of apoB48- and apoB100-containing particles in the chylomicron and VLDL density intervals in 15 subjects with a wide range of plasma triglyceride levels. RESULTS Following a fat-rich meal, apoB48 appeared in the chylomicron, VLDL1 and VLDL2 fractions in all subjects. Chylomicrons cleared rapidly from the circulation but apoB48-containing VLDL accumulated, and over the day were 3-fold higher in those with high versus low plasma triglyceride. ApoB48-containing particles were secreted directly into both the chylomicron and VLDL fractions at rates that were similar across the plasma triglyceride range studied. During fat absorption, whilst most triglyceride entered the circulation in chylomicrons, the majority of apoB48 particles were secreted into the VLDL density range. CONCLUSION The intestine secretes apoB48-containing particles not only as chylomicrons but also directly into the VLDL1 and VLDL2 density ranges both in the basal state and during dietary lipid absorption. Over the day, apoB48-containing particles appear to comprise about 20-25% of circulating VLDL and, especially in those with elevated triglycerides, form part of a slowly cleared 'remnant' particle population, thereby potentially increasing CHD risk. These findings provide a metabolic understanding of the potential consequences for increased CHD risk when slowed lipolysis leads to the accumulation of remnants, especially in individuals with hypertriglyceridemia.
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Affiliation(s)
- E Björnson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - C J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - M Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Andersson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - N Matikainen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - S Söderlund
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - J Kahri
- Department of Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, Finland
| | - A Hakkarainen
- Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - N Lundbom
- Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - J Lundbom
- Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - C Sihlbom
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - A Thorsell
- Proteomics Facility, University of Gothenburg, Gothenburg, Sweden
| | - H Zhou
- Merck Research Laboratories, Merck & Co. Inc., Kenilworth, NJ, USA
| | - M-R Taskinen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - J Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
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18
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Qadri S, Lallukka-Brück S, Luukkonen PK, Zhou Y, Gastaldelli A, Orho-Melander M, Sammalkorpi H, Juuti A, Penttilä AK, Perttilä J, Hakkarainen A, Lehtimäki TE, Orešič M, Hyötyläinen T, Hodson L, Olkkonen VM, Yki-Järvinen H. The PNPLA3-I148M variant increases polyunsaturated triglycerides in human adipose tissue. Liver Int 2020; 40:2128-2138. [PMID: 32386450 DOI: 10.1111/liv.14507] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/23/2020] [Accepted: 05/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS The I148M variant in PNPLA3 is the major genetic risk factor for non-alcoholic fatty liver disease (NAFLD). The liver is enriched with polyunsaturated triglycerides (PUFA-TGs) in PNPLA3-I148M carriers. Gene expression data indicate that PNPLA3 is liver-specific in humans, but whether it functions in adipose tissue (AT) is unknown. We investigated whether PNPLA3-I148M modifies AT metabolism in human NAFLD. METHODS Profiling of the AT lipidome and fasting serum non-esterified fatty acid (NEFA) composition was conducted in 125 volunteers (PNPLA3148MM/MI , n = 63; PNPLA3148II , n = 62). AT fatty acid composition was determined in 50 volunteers homozygous for the variant (PNPLA3148MM , n = 25) or lacking the variant (PNPLA3148II , n = 25). Whole-body insulin sensitivity of lipolysis was determined using [2 H5 ]glycerol, and PNPLA3 mRNA and protein levels were measured in subcutaneous AT and liver biopsies in a subset of the volunteers. RESULTS PUFA-TGs were significantly increased in AT in carriers versus non-carriers of PNPLA3-I148M. The variant did not alter the rate of lipolysis or the composition of fasting serum NEFAs. PNPLA3 mRNA was 33-fold higher in the liver than in AT (P < .0001). In contrast, PNPLA3 protein levels per tissue protein were three-fold higher in AT than the liver (P < .0001) and nine-fold higher when related to whole-body AT and liver tissue masses (P < .0001). CONCLUSIONS Contrary to previous assumptions, PNPLA3 is highly abundant in AT. PNPLA3-I148M locally remodels AT TGs to become polyunsaturated as it does in the liver, without affecting lipolysis or composition of serum NEFAs. Changes in AT metabolism do not contribute to NAFLD in PNPLA3-I148M carriers.
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Affiliation(s)
- Sami Qadri
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Susanna Lallukka-Brück
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Panu K Luukkonen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - You Zhou
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Systems Immunity University Research Institute and Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Henna Sammalkorpi
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Anne Juuti
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Anne K Penttilä
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Julia Perttilä
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Tiina E Lehtimäki
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Matej Orešič
- Department of Chemistry, Örebro University, Örebro, Sweden
| | | | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - Vesa M Olkkonen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
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19
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Pirinen E, Auranen M, Khan NA, Brilhante V, Urho N, Pessia A, Hakkarainen A, Ulla Heinonen JK, Schmidt MS, Haimilahti K, Piirilä P, Lundbom N, Taskinen MR, Brenner C, Velagapudi V, Pietiläinen KH, Suomalainen A. Niacin Cures Systemic NAD + Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy. Cell Metab 2020; 32:144. [PMID: 32640244 DOI: 10.1016/j.cmet.2020.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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20
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Pirinen E, Auranen M, Khan NA, Brilhante V, Urho N, Pessia A, Hakkarainen A, Kuula J, Heinonen U, Schmidt MS, Haimilahti K, Piirilä P, Lundbom N, Taskinen MR, Brenner C, Velagapudi V, Pietiläinen KH, Suomalainen A. Niacin Cures Systemic NAD + Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy. Cell Metab 2020; 31:1078-1090.e5. [PMID: 32386566 DOI: 10.1016/j.cmet.2020.04.008] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/24/2020] [Accepted: 04/03/2020] [Indexed: 12/21/2022]
Abstract
NAD+ is a redox-active metabolite, the depletion of which has been proposed to promote aging and degenerative diseases in rodents. However, whether NAD+ depletion occurs in patients with degenerative disorders and whether NAD+ repletion improves their symptoms has remained open. Here, we report systemic NAD+ deficiency in adult-onset mitochondrial myopathy patients. We administered an increasing dose of NAD+-booster niacin, a vitamin B3 form (to 750-1,000 mg/day; clinicaltrials.govNCT03973203) for patients and their matched controls for 10 or 4 months, respectively. Blood NAD+ increased in all subjects, up to 8-fold, and muscle NAD+ of patients reached the level of their controls. Some patients showed anemia tendency, while muscle strength and mitochondrial biogenesis increased in all subjects. In patients, muscle metabolome shifted toward controls and liver fat decreased even 50%. Our evidence indicates that blood analysis is useful in identifying NAD+ deficiency and points niacin to be an efficient NAD+ booster for treating mitochondrial myopathy.
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Affiliation(s)
- Eija Pirinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland.
| | - Mari Auranen
- Research Program of Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland; Department of Neurosciences, Helsinki University Hospital, Helsinki, Finland
| | - Nahid A Khan
- Research Program of Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland
| | - Virginia Brilhante
- Research Program of Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland
| | - Niina Urho
- Department of Neurosciences, Helsinki University Hospital, Helsinki, Finland
| | - Alberto Pessia
- Metabolomics Unit, Institute for Molecular Medicine Finland (FIMM), Helsinki 00290, Finland
| | - Antti Hakkarainen
- Department of Radiology, Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo 12200, Finland
| | - Juho Kuula
- Department of Radiology, Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulla Heinonen
- Department of Neurosciences, Helsinki University Hospital, Helsinki, Finland
| | - Mark S Schmidt
- Department of Biochemistry, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Kimmo Haimilahti
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland
| | - Päivi Piirilä
- Unit of Clinical Physiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland
| | - Charles Brenner
- Department of Biochemistry, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Vidya Velagapudi
- Metabolomics Unit, Institute for Molecular Medicine Finland (FIMM), Helsinki 00290, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland; Obesity Centre, Abdominal Centre, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anu Suomalainen
- Research Program of Stem Cells and Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00290, Finland; HUSlab, Helsinki University Hospital, Helsinki 00290, Finland; Neuroscience Center, HiLife, University of Helsinki, Helsinki 00290, Finland.
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21
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Luukkonen PK, Tukiainen T, Juuti A, Sammalkorpi H, Haridas PAN, Niemelä O, Arola J, Orho-Melander M, Hakkarainen A, Kovanen PT, Dwivedi O, Groop L, Hodson L, Gastaldelli A, Hyötyläinen T, Orešič M, Yki-Järvinen H. Hydroxysteroid 17-β dehydrogenase 13 variant increases phospholipids and protects against fibrosis in nonalcoholic fatty liver disease. JCI Insight 2020; 5:132158. [PMID: 32161197 DOI: 10.1172/jci.insight.132158] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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: 07/29/2019] [Accepted: 02/05/2020] [Indexed: 12/22/2022] Open
Abstract
Carriers of the hydroxysteroid 17-β dehydrogenase 13 (HSD17B13) gene variant (rs72613567:TA) have a reduced risk of NASH and cirrhosis but not steatosis. We determined its effect on liver histology, lipidome, and transcriptome using ultra performance liquid chromatography-mass spectrometry and RNA-seq. In carriers and noncarriers of the gene variant, we also measured pathways of hepatic fatty acids (de novo lipogenesis [DNL] and adipose tissue lipolysis [ATL] using 2H2O and 2H-glycerol) and insulin sensitivity using 3H-glucose and euglycemic-hyperinsulinemic clamp) and plasma cytokines. Carriers and noncarriers had similar age, sex and BMI. Fibrosis was significantly less frequent while phospholipids, but not other lipids, were enriched in the liver in carriers compared with noncarriers. Expression of 274 genes was altered in carriers compared with noncarriers, consisting predominantly of downregulated inflammation-related gene sets. Plasma IL-6 concentrations were lower, but DNL, ATL and hepatic insulin sensitivity were similar between the groups. In conclusion, carriers of the HSD17B13 variant have decreased fibrosis and expression of inflammation-related genes but increased phospholipids in the liver. These changes are not secondary to steatosis, DNL, ATL, or hepatic insulin sensitivity. The increase in phospholipids and decrease in fibrosis are opposite to features of choline-deficient models of liver disease and suggest HSD17B13 as an attractive therapeutic target.
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Affiliation(s)
- Panu K Luukkonen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Taru Tukiainen
- Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Anne Juuti
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henna Sammalkorpi
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Tampere, Finland
| | - Johanna Arola
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | | | - Om Dwivedi
- Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Leif Groop
- Institute for Molecular Medicine Finland, Helsinki, Finland.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | | | - Matej Orešič
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
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22
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Ämmälä AJ, Urrila AS, Lahtinen A, Santangeli O, Hakkarainen A, Kantojärvi K, Castaneda AE, Lundbom N, Marttunen M, Paunio T. Epigenetic dysregulation of genes related to synaptic long-term depression among adolescents with depressive disorder and sleep symptoms. Sleep Med 2019; 61:95-103. [DOI: 10.1016/j.sleep.2019.01.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/18/2019] [Accepted: 01/23/2019] [Indexed: 12/14/2022]
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23
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Luukkonen PK, Nick A, Hölttä-Vuori M, Thiele C, Isokuortti E, Lallukka-Brück S, Zhou Y, Hakkarainen A, Lundbom N, Peltonen M, Orho-Melander M, Orešič M, Hyötyläinen T, Hodson L, Ikonen E, Yki-Järvinen H. Human PNPLA3-I148M variant increases hepatic retention of polyunsaturated fatty acids. JCI Insight 2019; 4:127902. [PMID: 31434800 DOI: 10.1172/jci.insight.127902] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [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: 02/01/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022] Open
Abstract
The common patatin-like phospholipase domain-containing protein 3 (PNPLA3) variant I148M predisposes to nonalcoholic liver disease but not its metabolic sequelae. We compared the handling of labeled polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFA) in vivo in humans and in cells harboring different PNPLA3 genotypes. In 148M homozygous individuals, triglycerides (TGs) in very low-density lipoproteins (VLDL) were depleted of PUFAs both under fasting and postprandial conditions compared with 148I homozygotes, and the PUFA/SFA ratio in VLDL-TGs was lower relative to the chylomicron precursor pool. In human PNPLA3-148M and PNPLA3-KO cells, PUFA but not SFA incorporation into TGs was increased at the expense of phosphatidylcholines, and under lipolytic conditions, PUFA-containing diacylglycerols (DAGs) accumulated compared with PNPLA3-148I cells. Polyunsaturated TGs were increased, while phosphatidylcholines (PCs) were decreased in the human liver in 148M homozygous individuals as compared with 148I homozygotes. We conclude that human PNPLA3-I148M is a loss-of-function allele that remodels liver TGs in a polyunsaturated direction by impairing hydrolysis/transacylation of PUFAs from DAGs to feed phosphatidylcholine synthesis.
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Affiliation(s)
- Panu K Luukkonen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Auli Nick
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Faculty of Medicine, Department of Anatomy, University of Helsinki, Helsinki, Finland
| | - Maarit Hölttä-Vuori
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Faculty of Medicine, Department of Anatomy, University of Helsinki, Helsinki, Finland
| | | | - Elina Isokuortti
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Susanna Lallukka-Brück
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - You Zhou
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Systems Immunity Research Institute, Cardiff University, Cardiff, United Kingdom.,Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Markku Peltonen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Matej Orešič
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,School of Medical Sciences and
| | | | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Elina Ikonen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Faculty of Medicine, Department of Anatomy, University of Helsinki, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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24
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Adiels M, Taskinen MR, Björnson E, Andersson L, Matikainen N, Söderlund S, Kahri J, Hakkarainen A, Lundbom N, Sihlbom C, Thorsell A, Zhou H, Pietiläinen KH, Packard C, Borén J. Role of apolipoprotein C-III overproduction in diabetic dyslipidaemia. Diabetes Obes Metab 2019; 21:1861-1870. [PMID: 30972934 DOI: 10.1111/dom.13744] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/07/2019] [Accepted: 04/09/2019] [Indexed: 12/14/2022]
Abstract
AIMS To investigate how apolipoprotein C-III (apoC-III) metabolism is altered in subjects with type 2 diabetes, whether the perturbed plasma triglyceride concentrations in this condition are determined primarily by the secretion rate or the removal rate of apoC-III, and whether improvement of glycaemic control using the glucagon-like peptide-1 analogue liraglutide for 16 weeks modifies apoC-III dynamics. MATERIALS AND METHODS Postprandial apoC-III kinetics were assessed after a bolus injection of [5,5,5-2 H3 ]leucine using ultrasensitive mass spectrometry techniques. We compared apoC-III kinetics in two situations: in subjects with type 2 diabetes before and after liraglutide therapy, and in type 2 diabetic subjects with matched body mass index (BMI) non-diabetic subjects. Liver fat content, subcutaneous abdominal and intra-abdominal fat were determined using proton magnetic resonance spectroscopy. RESULTS Improved glycaemic control by liraglutide therapy for 16 weeks significantly reduced apoC-III secretion rate (561 ± 198 vs. 652 ± 196 mg/d, P = 0.03) and apoC-III levels (10.0 ± 3.8 vs. 11.7 ± 4.3 mg/dL, P = 0.035) in subjects with type 2 diabetes. Change in apoC-III secretion rate was significantly associated with the improvement in indices of glucose control (r = 0.67; P = 0.009) and change in triglyceride area under the curve (r = 0.59; P = 0.025). In line with this, the apoC-III secretion rate was higher in subjects with type 2 diabetes compared with BMI-matched non-diabetic subjects (676 ± 208 vs. 505 ± 174 mg/d, P = 0.042). CONCLUSIONS The results reveal that the secretion rate of apoC-III is associated with elevation of triglyceride-rich lipoproteins in subjects with type 2 diabetes, potentially through the influence of glucose homeostasis on the production of apoC-III.
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Affiliation(s)
- Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marja-Riitta Taskinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elias Björnson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Andersson
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Niina Matikainen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sanni Söderlund
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Juhani Kahri
- Department of Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Carina Sihlbom
- Proteomics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Thorsell
- Proteomics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Haihong Zhou
- Merck Research Laboratories, Merck & Co. Inc., Kenilworth, New Jersey
| | - Kirsi H Pietiläinen
- Endocrinology, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Chris Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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25
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Koskimies J, Heinonen S, Jukarainen S, Ek V, Hakkarainen A, Lundbom N, Borén J, Pietiläinen K, Taskinen M, Matikainen N, Söderlund S. Adipocyte Size In Obesity With And Without Metabolic Syndrome. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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26
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Matikainen N, Söderlund S, Björnson E, Pietiläinen K, Hakkarainen A, Lundbom N, Taskinen M, Borén J. Liraglutide treatment improves postprandial lipid metabolism and cardiometabolic risk factors in humans with adequately controlled type 2 diabetes: A single-centre randomized controlled study. Diabetes Obes Metab 2019; 21:84-94. [PMID: 30073766 PMCID: PMC6585708 DOI: 10.1111/dom.13487] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [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: 06/04/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022]
Abstract
AIMS Patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) exhibit considerable residual risk for cardiovascular disease (CVD). There is, therefore, increasing interest in targeting postprandial lipid metabolism and remnant cholesterol. Treatment with the glucagon-like peptide 1 (GLP-1) analogue liraglutide reduces CVD risk by mechanisms that remain unexplained in part. Here we investigated the effects of liraglutide intervention on ectopic fat depots, hepatic lipogenesis and fat oxidation, postprandial lipid metabolism and glycaemia in humans with type 2 diabetes. METHODS The effect of liraglutide was investigated in 22 patients with adequately controlled type 2 diabetes. Patients were randomly allocated, in a single-blind fashion, to either liraglutide 1.8 mg or placebo once daily for 16 weeks. Because liraglutide is known to promote weight loss, the study included dietary counselling to achieve similar weight loss in the liraglutide and placebo groups. Cardiometabolic responses to a high-fat mixed meal were measured before and at the end of the liraglutide intervention. RESULTS Weight loss at Week 16 was similar between the groups: -2.4 kg (-2.5%) in the liraglutide group and -2.1 kg (-2.2%) in the placebo group. HBA1c improved by 6.4 mmol/mol (0.6%) in the liraglutide group (P = 0.005). Liver fat decreased in both groups, by 31% in the liraglutide group and by 18% in the placebo group, but there were no significant changes in the rate of hepatic de novo lipogenesis or β-hydroxybutyrate levels, a marker of fat oxidation. We observed significant postprandial decreases in triglycerides only in plasma, chylomicrons and VLDL, and remnant particle cholesterol after treatment in the liraglutide group. Fasting and postprandial apoCIII concentrations decreased after liraglutide intervention and these changes were closely related to reduced glycaemia. In relative importance analysis, approximately half of the changes in postprandial lipids were explained by reductions in apoCIII concentrations, whereas less than 10% of the variation in postprandial lipids was explained by reductions in weight, glycaemic control, liver fat or postprandial insulin responses. CONCLUSIONS Intervention with liraglutide for 16 weeks produces multiple improvements in cardiometabolic risk factors that were not seen in the placebo group, despite similar weight loss. Of particular importance was a marked reduction in postprandial atherogenic remnant particles. The underlying mechanism may be improved glycaemic control, which leads to reduced expression of apoCIII, a key regulator of hypertriglyceridaemia in hyperglycaemic patients.
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Affiliation(s)
- Niina Matikainen
- Research Programs Unit, Diabetes and Obesity, Department of Internal MedicineHelsinki University Hospital, University of HelsinkiHelsinkiFinland
- Endocrinology, Abdominal CenterHelsinki University HospitalHelsinkiFinland
| | - Sanni Söderlund
- Research Programs Unit, Diabetes and Obesity, Department of Internal MedicineHelsinki University Hospital, University of HelsinkiHelsinkiFinland
| | - Elias Björnson
- Department of Molecular and Clinical MedicineUniversity of Gothenburg and Sahlgrenska University HospitalGothenburgSweden
| | - Kirsi Pietiläinen
- Research Programs Unit, Diabetes and Obesity, Department of Internal MedicineHelsinki University Hospital, University of HelsinkiHelsinkiFinland
- Endocrinology, Abdominal CenterHelsinki University HospitalHelsinkiFinland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, RadiologyHelsinki University Hospital, University of HelsinkiHelsinkiFinland
| | - Nina Lundbom
- HUS Medical Imaging Center, RadiologyHelsinki University Hospital, University of HelsinkiHelsinkiFinland
| | - Marja‐Riitta Taskinen
- Research Programs Unit, Diabetes and Obesity, Department of Internal MedicineHelsinki University Hospital, University of HelsinkiHelsinkiFinland
| | - Jan Borén
- Department of Molecular and Clinical MedicineUniversity of Gothenburg and Sahlgrenska University HospitalGothenburgSweden
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27
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Vihma V, Heinonen S, Naukkarinen J, Kaprio J, Rissanen A, Turpeinen U, Hämäläinen E, Hakkarainen A, Lundbom J, Lundbom N, Mikkola TS, Tikkanen MJ, Pietiläinen KH. Increased body fat mass and androgen metabolism - A twin study in healthy young women. Steroids 2018; 140:24-31. [PMID: 30149073 DOI: 10.1016/j.steroids.2018.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/15/2018] [Accepted: 08/21/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Obesity may alter serum steroid concentrations and metabolism. We investigated this in healthy young women with increased body fat and their leaner co-twin sisters. DESIGN Age and genetic background both strongly influence serum steroid levels and body composition. This is a cross-sectional study of 13 female monozygotic twin pairs (age, 23-36 years), ten of which were discordant for body mass index (median difference in body weight between the co-twins, 19 kg). METHODS We determined body composition by dual energy X-ray absorptiometry and magnetic resonance imaging, serum androgens by liquid chromatography-tandem mass spectrometry, and mRNA expression of genes in subcutaneous adipose tissue and adipocytes. RESULTS The heavier women had lower serum dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), and sex hormone-binding globulin (SHBG) (P < 0.05 for all) compared to their leaner co-twins with no differences in serum testosterone or androstenedione levels. Serum DHEA correlated inversely with %body fat (r = -0.905, P = 0.002), and DHT positively with SHBG (r = 0.842, P = 0.002). In adipose tissue or adipocytes, expressions of STS (steroid sulfatase) and androgen-related genes were significantly higher in the heavier compared to the leaner co-twin, and within pairs, correlated positively with adiposity but were not related to serum androgen levels. None of the serum androgen or SHBG levels correlated with indices of insulin resistance. CONCLUSIONS Serum DHEA levels were best predicted by %body fat, and serum DHT by SHBG. These or other serum androgen concentrations did not reflect differences in androgen-related genes in adipose tissue. General or intra-abdominal adiposity were not associated with increased androgenicity in young women.
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Affiliation(s)
- Veera Vihma
- University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Biomedicum C315a, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, P.O. Box 63, 00014 University of Helsinki, Finland.
| | - Sini Heinonen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Jussi Naukkarinen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Jaakko Kaprio
- University of Helsinki, FIMM, Institute for Molecular Medicine Finland, and Department of Public Health, P.O. Box 20, 00014 University of Helsinki, Finland
| | - Aila Rissanen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Ursula Turpeinen
- Helsinki University Hospital, HUSLAB, P.O. Box 720, 00029 HUS, Helsinki, Finland
| | - Esa Hämäläinen
- Helsinki University Hospital, HUSLAB, P.O. Box 720, 00029 HUS, Helsinki, Finland
| | - Antti Hakkarainen
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Jesper Lundbom
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Nina Lundbom
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Tomi S Mikkola
- Folkhälsan Research Center, P.O. Box 63, 00014 University of Helsinki, Finland; Helsinki University Hospital, Obstetrics and Gynecology, P.O. Box 140, 00029 HUS, Helsinki, Finland
| | - Matti J Tikkanen
- University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Biomedicum C315a, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Kirsi H Pietiläinen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014 University of Helsinki, Finland; Helsinki University Hospital, Endocrinology, Abdominal Center, P.O. Box 340, 00029 HUS, Helsinki, Finland
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28
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Lovric A, Granér M, Bjornson E, Arif M, Benfeitas R, Nyman K, Ståhlman M, Pentikäinen MO, Lundbom J, Hakkarainen A, Sirén R, Nieminen MS, Lundbom N, Lauerma K, Taskinen MR, Mardinoglu A, Boren J. Characterization of different fat depots in NAFLD using inflammation-associated proteome, lipidome and metabolome. Sci Rep 2018; 8:14200. [PMID: 30242179 PMCID: PMC6155005 DOI: 10.1038/s41598-018-31865-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/21/2018] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is recognized as a liver manifestation of metabolic syndrome, accompanied with excessive fat accumulation in the liver and other vital organs. Ectopic fat accumulation was previously associated with negative effects at the systemic and local level in the human body. Thus, we aimed to identify and assess the predictive capability of novel potential metabolic biomarkers for ectopic fat depots in non-diabetic men with NAFLD, using the inflammation-associated proteome, lipidome and metabolome. Myocardial and hepatic triglycerides were measured with magnetic spectroscopy while function of left ventricle, pericardial and epicardial fat, subcutaneous and visceral adipose tissue were measured with magnetic resonance imaging. Measured ectopic fat depots were profiled and predicted using a Random Forest algorithm, and by estimating the Area Under the Receiver Operating Characteristic curves. We have identified distinct metabolic signatures of fat depots in the liver (TAG50:1, glutamate, diSM18:0 and CE20:3), pericardium (N-palmitoyl-sphinganine, HGF, diSM18:0, glutamate, and TNFSF14), epicardium (sphingomyelin, CE20:3, PC38:3 and TNFSF14), and myocardium (CE20:3, LAPTGF-β1, glutamate and glucose). Our analyses highlighted non-invasive biomarkers that accurately predict ectopic fat depots, and reflect their distinct metabolic signatures in subjects with NAFLD.
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Affiliation(s)
- Alen Lovric
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Marit Granér
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Elias Bjornson
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Muhammad Arif
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Rui Benfeitas
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Kristofer Nyman
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Markku O Pentikäinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Reijo Sirén
- Department of General Practice and Primary Health Care, Health Care Centre of City of Helsinki and University of Helsinki, Helsinki, Finland
| | - Markku S Nieminen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi Lauerma
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marja-Riitta Taskinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
| | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden. .,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.
| | - Jan Boren
- Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
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29
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Luukkonen PK, Sädevirta S, Zhou Y, Kayser B, Ali A, Ahonen L, Lallukka S, Pelloux V, Gaggini M, Jian C, Hakkarainen A, Lundbom N, Gylling H, Salonen A, Orešič M, Hyötyläinen T, Orho-Melander M, Rissanen A, Gastaldelli A, Clément K, Hodson L, Yki-Järvinen H. Saturated Fat Is More Metabolically Harmful for the Human Liver Than Unsaturated Fat or Simple Sugars. Diabetes Care 2018; 41:1732-1739. [PMID: 29844096 PMCID: PMC7082640 DOI: 10.2337/dc18-0071] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/01/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease (i.e., increased intrahepatic triglyceride [IHTG] content), predisposes to type 2 diabetes and cardiovascular disease. Adipose tissue lipolysis and hepatic de novo lipogenesis (DNL) are the main pathways contributing to IHTG. We hypothesized that dietary macronutrient composition influences the pathways, mediators, and magnitude of weight gain-induced changes in IHTG. RESEARCH DESIGN AND METHODS We overfed 38 overweight subjects (age 48 ± 2 years, BMI 31 ± 1 kg/m2, liver fat 4.7 ± 0.9%) 1,000 extra kcal/day of saturated (SAT) or unsaturated (UNSAT) fat or simple sugars (CARB) for 3 weeks. We measured IHTG (1H-MRS), pathways contributing to IHTG (lipolysis ([2H5]glycerol) and DNL (2H2O) basally and during euglycemic hyperinsulinemia), insulin resistance, endotoxemia, plasma ceramides, and adipose tissue gene expression at 0 and 3 weeks. RESULTS Overfeeding SAT increased IHTG more (+55%) than UNSAT (+15%, P < 0.05). CARB increased IHTG (+33%) by stimulating DNL (+98%). SAT significantly increased while UNSAT decreased lipolysis. SAT induced insulin resistance and endotoxemia and significantly increased multiple plasma ceramides. The diets had distinct effects on adipose tissue gene expression. CONCLUSIONS Macronutrient composition of excess energy influences pathways of IHTG: CARB increases DNL, while SAT increases and UNSAT decreases lipolysis. SAT induced the greatest increase in IHTG, insulin resistance, and harmful ceramides. Decreased intakes of SAT could be beneficial in reducing IHTG and the associated risk of diabetes.
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Affiliation(s)
- Panu K Luukkonen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Sanja Sädevirta
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - You Zhou
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Systems Immunity University Research Institute and Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, U.K
| | - Brandon Kayser
- Sorbonne Universités, INSERM, UMRS 1166, Nutriomics Team, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Ashfaq Ali
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Linda Ahonen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Susanna Lallukka
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Véronique Pelloux
- Sorbonne Universités, INSERM, UMRS 1166, Nutriomics Team, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Melania Gaggini
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Ching Jian
- Immunobiology Research Program, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- Helsinki Medical Imaging Centre, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Helsinki Medical Imaging Centre, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Helena Gylling
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Anne Salonen
- Immunobiology Research Program, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| | - Matej Orešič
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,School of Medical Sciences, Örebro University, Örebro, Sweden.,Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| | - Tuulia Hyötyläinen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Chemistry, Örebro University, Örebro, Sweden
| | | | - Aila Rissanen
- Obesity Research Unit, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Karine Clément
- Sorbonne Universités, INSERM, UMRS 1166, Nutriomics Team, Institute of Cardiometabolism and Nutrition, Paris, France.,Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, U.K
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland .,Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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30
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Nyman K, Granér M, Pentikäinen MO, Lundbom J, Hakkarainen A, Sirén R, Nieminen MS, Taskinen MR, Lundbom N, Lauerma K. Metabolic syndrome associates with left atrial dysfunction. Nutr Metab Cardiovasc Dis 2018; 28:727-734. [PMID: 29764718 DOI: 10.1016/j.numecd.2018.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/05/2018] [Accepted: 02/13/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Obesity and metabolic syndrome (MetS) are risk factors of atrial fibrillation (AF), but limited data exist on their effect on left atrial (LA) function. The aim of the study was to evaluate the effects of cardiac, hepatic and intra-abdominal ectopic fat depots and cardiometabolic risk factors on LA function in non-diabetic male subjects. METHODS AND RESULTS Myocardial and hepatic triglyceride contents were measured with 1.5T 1H-magnetic resonance spectroscopy and LA and left ventricular function, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epicardial and pericardial fat by magnetic resonance imaging (MRI) in 33 men with MetS and 40 men without MetS. LA volumes were assessed using a novel three-chamber orientation based MRI approach. LA ejection fraction (EF) was lower in MetS patients than in the control group (44 ± 7.7% in MetS vs. 49 ± 8.6% in controls, p = 0.013) without LA enlargement, indicating LA dysfunction. LA EF correlated negatively with waist circumference, body mass index, SAT, VAT, fasting serum insulin, and homeostasis model assessment of insulin resistance index, and positively with fasting serum high-density lipoprotein cholesterol. VAT was the best predictor of reduced LA EF. CONCLUSIONS MetS associates with subclinical LA dysfunction. Multiple components of MetS are related to LA dysfunction, notably visceral obesity and insulin resistance. Further studies are needed to elucidate the role of mechanical atrial remodeling in the development of AF.
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Affiliation(s)
- K Nyman
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - M Granér
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, Research Programs' Unit, University of Helsinki and Clinical Research Institute, HUCH Ltd, Helsinki, Finland
| | - M O Pentikäinen
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - J Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Hakkarainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - R Sirén
- Department of General Practice and Primary Health Care, Health Care Centre of City of Helsinki and University of Helsinki, Helsinki, Finland
| | - M S Nieminen
- Heart and Lung Center, Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - M-R Taskinen
- Diabetes and Obesity Research Program, Research Programs' Unit, University of Helsinki and Clinical Research Institute, HUCH Ltd, Helsinki, Finland
| | - N Lundbom
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Lauerma
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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31
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Urrila AS, Hakkarainen A, Castaneda A, Paunio T, Marttunen M, Lundbom N. Frontal Cortex Myo-Inositol Is Associated with Sleep and Depression in Adolescents: A Proton Magnetic Resonance Spectroscopy Study. Neuropsychobiology 2018; 75:21-31. [PMID: 28793304 DOI: 10.1159/000478861] [Citation(s) in RCA: 25] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 06/19/2017] [Indexed: 01/07/2023]
Abstract
AIM This study used proton magnetic resonance spectroscopy (1H MRS) to evaluate the neurochemistry of the frontal cortex in adolescents with symptoms of sleep and depression. METHODS Nineteen non-medicated adolescent boys (mean age 16.0 years; 9 clinical cases with depression/sleep symptoms and 10 healthy controls) underwent 1H MRS at 3 T. MR spectra were acquired from the anterior cingulate cortex (ACC), the dorsolateral prefrontal cortex, and frontal white matter. Concentrations of N-acetyl aspartate, total creatine, choline-containing compounds, total glutamine plus glutamate, and myo-inositol (mI) were compared in the 2 subgroups, and correlated with sleep and clinical measures in the total sample. Sleep was assessed with self-report questionnaires and ambulatory polysomnography recordings. RESULTS Concentrations of mI were lower in both frontal cortical regions among the depressed adolescents than in controls. No statistically significant differences in other metabolite concentrations were observed between the subgroups. Frontal cortex mI concentrations correlated negatively with depression severity, subjective daytime sleepiness, insomnia symptoms, and the level of anxiety, and correlated positively with total sleep time and overall psychosocial functioning. The correlations between mI in the ACC and total sleep time as well as daytime sleepiness remained statistically significant when depression severity was controlled in the analyses. CONCLUSION Lower frontal cortex mI may indicate a disturbed second messenger system. Frontal cortical mI may thus be linked to the pathophysiology of depression and concomitant sleep symptoms among maturing adolescents. Short sleep and daytime sleepiness may be associated with frontal cortex mI independently from depression.
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Affiliation(s)
- Anna S Urrila
- Unit of Mental Health, Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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32
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Roine U, Roine TJ, Hakkarainen A, Tokola A, Balk MH, Mannerkoski M, Åberg LE, Lönnqvist T, Autti T. Global and Widespread Local White Matter Abnormalities in Juvenile Neuronal Ceroid Lipofuscinosis. AJNR Am J Neuroradiol 2018; 39:1349-1354. [PMID: 29853519 DOI: 10.3174/ajnr.a5687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/11/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND PURPOSE Juvenile neuronal ceroid lipofuscinosis is a progressive neurodegenerative lysosomal storage disease of childhood. It manifests with loss of vision, seizures, and loss of cognitive and motor functions leading to premature death. Previous MR imaging studies have reported cerebral and cerebellar atrophy, progressive hippocampal atrophy, thalamic signal intensity alterations, and decreased white matter volume in the corona radiata. However, conventional MR imaging findings are usually normal at younger than 10 years of age. The purpose of our study was to investigate whether diffusion MR imaging could reveal changes in white matter microstructure already present at a younger age. MATERIALS AND METHODS We investigated global and local white matter abnormalities in 14 children with juvenile neuronal ceroid lipofuscinosis (mean age, 9.6 ± 3.4 years; 10 boys) and 14 control subjects (mean age, 11.2 ± 2.3 years; 7 boys). Twelve patients underwent follow-up MR imaging after 2 years (mean age, 11.4 ± 3.2 years; 8 boys). We performed a global analysis using 2 approaches: white matter tract skeleton and constrained spherical deconvolution-based whole-brain tractography. Then, we investigated local microstructural abnormalities using Tract-Based Spatial Statistics. RESULTS We found globally decreased anisotropy (P = .000001) and increased diffusivity (P = .001) in patients with juvenile neuronal ceroid lipofuscinosis. In addition, we found widespread increased diffusivity and decreased anisotropy in, for example, the corona radiata (P < .001) and posterior thalamic radiation (P < .001). However, we found no differences between the first and second acquisitions. CONCLUSIONS The patients with juvenile neuronal ceroid lipofuscinosis exhibited global and local abnormalities in white matter microstructure. Future studies could apply more specific microstructural models and study whether these abnormalities are already present at a younger age.
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Affiliation(s)
- U Roine
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center
| | - T J Roine
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center.,imec-Vision Lab (T.J.R.), Department of Physics, University of Antwerp, Wilrijk (Antwerp), Belgium
| | - A Hakkarainen
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center
| | - A Tokola
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center
| | - M H Balk
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center
| | | | - L E Åberg
- Psychiatry (L.E.Å), University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Lönnqvist
- Department of Child Neurology (T.L.), Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Autti
- From the Department of Radiology (U.R., T.J.R., A.H., A.T., M.H.B., T.A.), HUS Medical Imaging Center
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33
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Mardinoglu A, Wu H, Bjornson E, Zhang C, Hakkarainen A, Räsänen SM, Lee S, Mancina RM, Bergentall M, Pietiläinen KH, Söderlund S, Matikainen N, Ståhlman M, Bergh PO, Adiels M, Piening BD, Granér M, Lundbom N, Williams KJ, Romeo S, Nielsen J, Snyder M, Uhlén M, Bergström G, Perkins R, Marschall HU, Bäckhed F, Taskinen MR, Borén J. An Integrated Understanding of the Rapid Metabolic Benefits of a Carbohydrate-Restricted Diet on Hepatic Steatosis in Humans. Cell Metab 2018; 27:559-571.e5. [PMID: 29456073 PMCID: PMC6706084 DOI: 10.1016/j.cmet.2018.01.005] [Citation(s) in RCA: 270] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/06/2017] [Accepted: 01/10/2018] [Indexed: 02/07/2023]
Abstract
A carbohydrate-restricted diet is a widely recommended intervention for non-alcoholic fatty liver disease (NAFLD), but a systematic perspective on the multiple benefits of this diet is lacking. Here, we performed a short-term intervention with an isocaloric low-carbohydrate diet with increased protein content in obese subjects with NAFLD and characterized the resulting alterations in metabolism and the gut microbiota using a multi-omics approach. We observed rapid and dramatic reductions of liver fat and other cardiometabolic risk factors paralleled by (1) marked decreases in hepatic de novo lipogenesis; (2) large increases in serum β-hydroxybutyrate concentrations, reflecting increased mitochondrial β-oxidation; and (3) rapid increases in folate-producing Streptococcus and serum folate concentrations. Liver transcriptomic analysis on biopsy samples from a second cohort revealed downregulation of the fatty acid synthesis pathway and upregulation of folate-mediated one-carbon metabolism and fatty acid oxidation pathways. Our results highlight the potential of exploring diet-microbiota interactions for treating NAFLD.
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Affiliation(s)
- Adil Mardinoglu
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hao Wu
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elias Bjornson
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cheng Zhang
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sari M Räsänen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Sunjae Lee
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Rosellina M Mancina
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mattias Bergentall
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kirsi H Pietiläinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sanni Söderlund
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Niina Matikainen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per-Olof Bergh
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Brian D Piening
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Marit Granér
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kevin J Williams
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Michael Snyder
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Mathias Uhlén
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rosie Perkins
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fredrik Bäckhed
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Marja-Riitta Taskinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
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Hua B, Hakkarainen A, Zhou Y, Lundbom N, Yki-Järvinen H. Fat accumulates preferentially in the right rather than the left liver lobe in non-diabetic subjects. Dig Liver Dis 2018; 50:168-174. [PMID: 28964678 DOI: 10.1016/j.dld.2017.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/19/2017] [Accepted: 08/14/2017] [Indexed: 12/11/2022]
Abstract
AIMS To examine the distribution of liver fat (LFAT) in non-diabetic subjects and test whether the fat in the right as compared to the left lobe correlates better with components of the metabolic syndrome or not. METHODS In this cross sectional study, we determined LFAT by 1H-MRS in the right lobe (LFAT%MRS), and by MRI (LFAT%MRI) in four regions of interest (ROIs 1-4, two in the right and two in the left lobe) in 97 non-diabetic subjects (age range 22-74 years, BMI 18-41kg/m2) and compared the accuracy of LFATMRI in the different ROIs in diagnosing non-alcoholic fatty liver disease (NAFLD) using areas under the receiver operator characteristic (AUROC) curves. RESULTS 38% of the subjects had NAFLD (LFAT%MRS). LFAT%MRI was significantly higher in the right (5.7±0.5%) than the left (5.1±0.4%) lobe (p<0.02). The AUROC for LFAT%MRI in the right lobe for diagnosing NAFLD was significantly better than that in the left lobe. The relationships between several metabolic parameters and LFAT%MRI in the left lobe were significantly worse than those for LFAT%MRS while there was no difference between LFAT%MRS and right lobe ROIs. CONCLUSIONS Liver right lobe contains more fat and correlates better with components of the metabolic syndrome than the left in non-diabetic subjects.
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Affiliation(s)
- Bian Hua
- Minerva Foundation Institute for Medical Research, Helsinki, Finland; Department of Endocrinology, Zhongshan Hosipital, Fudan University, Shanghai, China.
| | - Antti Hakkarainen
- Department of Radiology, Helsinki Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - You Zhou
- Minerva Foundation Institute for Medical Research, Helsinki, Finland; Systems Immunity University Research Institute and Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Nina Lundbom
- Department of Radiology, Helsinki Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland; Department of Medicine, University of Helsinki, Helsinki, Finland
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Lallukka S, Luukkonen PK, Zhou Y, Isokuortti E, Leivonen M, Juuti A, Hakkarainen A, Orho-Melander M, Lundbom N, Olkkonen VM, Lassila R, Yki-Järvinen H. Obesity/insulin resistance rather than liver fat increases coagulation factor activities and expression in humans. Thromb Haemost 2017; 117:286-294. [DOI: 10.1160/th16-09-0716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/11/2016] [Indexed: 12/11/2022]
Abstract
SummaryIncreased liver fat may be caused by insulin resistance and adipose tissue inflammation or by the common I148M variant in PNPLA3 at rs738409, which lacks both of these features. We hypothesised that obesity/insulin resistance rather than liver fat increases circulating coagulation factor activities. We measured plasma prothrombin time (PT, Owren method), activated partial thromboplastin time (APTT), activities of several coagulation factors, VWF:RCo and fibrinogen, and D-dimer concentration in 92 subjects divided into groups based on insulin sensitivity [insulin-resistant (‘IR’) versus insulin-sensitive (‘IS’)] and PNPLA3 genotype (PNPLA3148MM/MI vs PNPLA3148II). Liver fat content (1H-MRS) was similarly increased in ‘IR’ (13 ± 1 %) and PNPLA3148MM/MI (12 ± 2 %) as compared to ‘IS’ (6 ± 1 %, p < 0.05) and PNPLA3148II (8 ± 1 %, p < 0.05), respectively. FVIII, FIX, FXIII, fibrinogen and VWF:RCo activities were increased, and PT and APTT shortened in ‘IR’ versus ‘IS’, in contrast to these factors being similar between PNPLA3148MM/MI and PNPLA3148II groups. In subjects undergoing a liver biopsy and entirely lacking the I148M variant, insulin-resistant subjects had higher hepatic expression of F8, F9 and FGG than equally obese insulin-sensitive subjects. Expression of pro-inflammatory genes in adipose tissue correlated positively with PT (% of normal), circulating FVIII, FIX, FXI, VWR:RCo and fibrinogen, and expression of anti-inflammatory genes negatively with PT (%), FIX and fibrinogen. We conclude that obesity/insulin resistance rather than an increase in liver fat is associated with a procoagulant plasma profile. This reflects adipose tissue inflammation and increased hepatic production of coagulation factors and their susceptibility for activation.Supplementary Material to this article is available online at www.thrombosis-online.com.
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36
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Lallukka S, Sädevirta S, Kallio MT, Luukkonen PK, Zhou Y, Hakkarainen A, Lundbom N, Orho-Melander M, Yki-Järvinen H. Predictors of Liver Fat and Stiffness in Non-Alcoholic Fatty Liver Disease (NAFLD) - an 11-Year Prospective Study. Sci Rep 2017; 7:14561. [PMID: 29109528 PMCID: PMC5674024 DOI: 10.1038/s41598-017-14706-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/10/2017] [Indexed: 12/16/2022] Open
Abstract
Liver fat can be non-invasively measured by proton magnetic resonance spectroscopy (1H-MRS) and fibrosis estimated as stiffness using transient elastography (FibroScan). There are no longitudinal data on changes in liver fat in Europids or on predictors of liver stiffness using these methods. We determined liver fat (1H-MRS) and clinical characteristics including features of insulin resistance at baseline and after a median follow-up period of 11.3 (range 7.3-13.4) years in 97 Finnish subjects. Liver stiffness was measured at 11.3 years. Liver fat content decreased by 5% (p < 0.05) over time. Values at baseline and 11.3 years were closely interrelated (r = 0.81, p < 0.001). Baseline liver fat (OR 1.32; 95%CI: 1.15-1.50) and change in BMI (OR 1.67; 95%CI: 1.24-2.25) were independent predictors of liver fat at 11.3 years (AUROC 0.90; 95%CI: 0.83-0.96). Baseline liver fat (AUROC 0.84; 95%CI: 0.76-0.92) predicted liver fat at 11.3 years more accurately than routinely available parameters (AUROC 0.76; 95%CI: 0.65-0.86, p = 0.02). At 11.3 years, 29% of the subjects had increased liver stiffness. Baseline liver fat (OR 2.17; 95%CI: 1.05-4.46) was an independent predictor of increased liver stiffness. These data show that liver fat is more important than the associated metabolic abnormalities as the predictor of future liver fat and fibrosis.
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Affiliation(s)
- Susanna Lallukka
- Minerva Foundation Institute for Medical Research, Helsinki, Finland. .,Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland.
| | - Sanja Sädevirta
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Markus T Kallio
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Panu K Luukkonen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - You Zhou
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Systems Immunity University Research Institute and Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Marju Orho-Melander
- Department of Clinical Sciences, Diabetes and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Medicine, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
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37
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Jakkula P, Reinikainen M, Hästbacka J, Pettilä V, Loisa P, Karlsson S, Laru-Sompa R, Bendel S, Oksanen T, Birkelund T, Tiainen M, Toppila J, Hakkarainen A, Skrifvars MB. Targeting low- or high-normal Carbon dioxide, Oxygen, and Mean arterial pressure After Cardiac Arrest and REsuscitation: study protocol for a randomized pilot trial. Trials 2017; 18:507. [PMID: 29084585 PMCID: PMC5663085 DOI: 10.1186/s13063-017-2257-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 10/16/2017] [Indexed: 12/02/2022] Open
Abstract
Background Arterial carbon dioxide tension (PaCO2), oxygen tension (PaO2), and mean arterial pressure (MAP) are modifiable factors that affect cerebral blood flow (CBF), cerebral oxygen delivery, and potentially the course of brain injury after cardiac arrest. No evidence regarding optimal treatment targets exists. Methods The Carbon dioxide, Oxygen, and Mean arterial pressure After Cardiac Arrest and REsuscitation (COMACARE) trial is a pilot multi-center randomized controlled trial (RCT) assessing the feasibility of targeting low- or high-normal PaCO2, PaO2, and MAP in comatose, mechanically ventilated patients after out-of-hospital cardiac arrest (OHCA), as well as its effect on brain injury markers. Using a 23 factorial design, participants are randomized upon admission to an intensive care unit into one of eight groups with various combinations of PaCO2, PaO2, and MAP target levels for 36 h after admission. The primary outcome is neuron-specific enolase (NSE) serum concentration at 48 h after cardiac arrest. The main feasibility outcome is the between-group differences in PaCO2, PaO2, and MAP during the 36 h after ICU admission. Secondary outcomes include serum concentrations of NSE, S100 protein, and cardiac troponin at 24, 48, and 72 h after cardiac arrest; cerebral oxygenation, measured with near-infrared spectroscopy (NIRS); potential differences in epileptic activity, monitored via continuous electroencephalogram (EEG); and neurological outcomes at six months after cardiac arrest. Discussion The trial began in March 2016 and participant recruitment has begun in all seven study sites as of March 2017. Currently, 115 of the total of 120 patients have been included. When completed, the results of this trial will provide preliminary clinical evidence regarding the feasibility of targeting low- or high-normal PaCO2, PaO2, and MAP values and its effect on developing brain injury, brain oxygenation, and epileptic seizures after cardiac arrest. The results of this trial will be used to evaluate whether a larger RCT on this subject is justified. Trial registration ClinicalTrials.gov, NCT02698917. Registered on 26 January 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2257-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pekka Jakkula
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Johanna Hästbacka
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ville Pettilä
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pekka Loisa
- Päijät-Häme Central Hospital, Lahti, Finland
| | | | | | | | | | | | - Marjaana Tiainen
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Toppila
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Hakkarainen
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markus B Skrifvars
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Australia and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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38
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Isokuortti E, Zhou Y, Peltonen M, Bugianesi E, Clement K, Bonnefont-Rousselot D, Lacorte JM, Gastaldelli A, Schuppan D, Schattenberg JM, Hakkarainen A, Lundbom N, Jousilahti P, Männistö S, Keinänen-Kiukaanniemi S, Saltevo J, Anstee QM, Yki-Järvinen H. Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study. Diabetologia 2017; 60:1873-1882. [PMID: 28660493 DOI: 10.1007/s00125-017-4340-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/15/2017] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Recent European guidelines for non-alcoholic fatty liver disease (NAFLD) call for reference values for HOMA-IR. In this study, we aimed to determine: (1) the upper limit of normal HOMA-IR in two population-based cohorts; (2) the HOMA-IR corresponding to NAFLD; (3) the effect of sex and PNPLA3 genotype at rs738409 on HOMA-IR; and (4) inter-laboratory variations in HOMA-IR. METHODS We identified healthy individuals in two population-based cohorts (FINRISK 2007 [n = 5024] and the Programme for Prevention of Type 2 Diabetes in Finland [FIN-D2D; n = 2849]) to define the upper 95th percentile of HOMA-IR. Non-obese individuals with normal fasting glucose levels, no excessive alcohol use, no known diseases and no use of any drugs were considered healthy. The optimal HOMA-IR cut-off for NAFLD (liver fat ≥5.56%, based on the Dallas Heart Study) was determined in 368 non-diabetic individuals (35% with NAFLD), whose liver fat was measured using proton magnetic resonance spectroscopy (1H-MRS). Samples from ten individuals were simultaneously analysed for HOMA-IR in seven European laboratories. RESULTS The upper 95th percentiles of HOMA-IR were 1.9 and 2.0 in healthy individuals in the FINRISK (n = 1167) and FIN-D2D (n = 459) cohorts. Sex or PNPLA3 genotype did not influence these values. The optimal HOMA-IR cut-off for NAFLD was 1.9 (sensitivity 87%, specificity 79%). A HOMA-IR of 2.0 corresponded to normal liver fat (<5.56% on 1H-MRS) in linear regression analysis. The 2.0 HOMA-IR measured in Helsinki corresponded to 1.3, 1.6, 1.8, 1.8, 2.0 and 2.1 in six other laboratories. The inter-laboratory CV% of HOMA-IR was 25% due to inter-assay variation in insulin (25%) rather than glucose (5%) measurements. CONCLUSIONS/INTERPRETATION The upper limit of HOMA-IR in population-based cohorts closely corresponds to that of normal liver fat. Standardisation of insulin assays would be the first step towards definition of normal values for HOMA-IR.
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Affiliation(s)
- Elina Isokuortti
- Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2 U, Tukholmankatu 8, FIN - 00290, Helsinki, Finland.
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - You Zhou
- Systems Immunity University Research Institute, Cardiff University, Cardiff, UK
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Markku Peltonen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Elisabetta Bugianesi
- Division of Gastroenterology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Karine Clement
- Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France
- Sorbonne Université, UPMC University Paris 06, UMR_S 1166, Inserm, Paris, France
| | - Dominique Bonnefont-Rousselot
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
- Department of Biochemistry, Faculty of Pharmacy, Paris Descartes University, Paris, France
- CNRS UMR8258 - Inserm U1022, Faculty of Pharmacy, Paris Descartes University, Paris, France
| | - Jean-Marc Lacorte
- Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France
- Sorbonne Université, UPMC University Paris 06, UMR_S 1166, Inserm, Paris, France
- Department of Endocrine and Oncological Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Amalia Gastaldelli
- Cardiometabolic Risk Laboratory, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Detlef Schuppan
- Institute of Translational Immunology, Research Center of Immune Therapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörn M Schattenberg
- Department of Medicine I, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Antti Hakkarainen
- Helsinki Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- Helsinki Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Satu Männistö
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Juha Saltevo
- Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
| | - Quentin M Anstee
- Institute of Cellular Medicine, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Biomedicum Helsinki 2 U, Tukholmankatu 8, FIN - 00290, Helsinki, Finland
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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39
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Berntzen B, Jukarainen S, Kataja M, Hakkarainen A, Lundbom J, Lundbom N, Tammelin T, Simonen R, Piirilä P, Rissanen A, Kaprio J, Paavonen EJ, Pietiläinen KH. Physical activity, cardiorespiratory fitness, and metabolic outcomes in monozygotic twin pairs discordant for body mass index. Scand J Med Sci Sports 2017; 28:1048-1055. [DOI: 10.1111/sms.12975] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2017] [Indexed: 12/19/2022]
Affiliation(s)
- B. Berntzen
- Obesity Research Unit; Research Programs Unit; Diabetes and Obesity, Biomedicum Helsinki; University of Helsinki; Helsinki Finland
| | - S. Jukarainen
- Obesity Research Unit; Research Programs Unit; Diabetes and Obesity, Biomedicum Helsinki; University of Helsinki; Helsinki Finland
| | - M. Kataja
- Obesity Research Unit; Research Programs Unit; Diabetes and Obesity, Biomedicum Helsinki; University of Helsinki; Helsinki Finland
| | - A. Hakkarainen
- Helsinki Medical Imaging Center; University of Helsinki; Helsinki Finland
| | - J. Lundbom
- Helsinki Medical Imaging Center; University of Helsinki; Helsinki Finland
- German Diabetes Center; Leibniz Center for Diabetes Research; Institute for Clinical Diabetology; Heinrich Heine University; Düsseldorf Germany
| | - N. Lundbom
- Helsinki Medical Imaging Center; University of Helsinki; Helsinki Finland
| | - T. Tammelin
- LIKES Research Centre for Physical Activity and Health Sciences; Jyväskylä Finland
| | - R. Simonen
- Finnish Institute of Occupational Health; Helsinki Finland
| | - P. Piirilä
- Unit of Clinical Physiology; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - A. Rissanen
- Obesity Research Unit; Research Programs Unit; Diabetes and Obesity, Biomedicum Helsinki; University of Helsinki; Helsinki Finland
| | - J. Kaprio
- Department of Public Health; Finnish Twin Cohort Study; University of Helsinki; Helsinki Finland
- FIMM; Institute for Molecular Medicine Finland; University of Helsinki; Helsinki Finland
| | - E. J. Paavonen
- Child Psychiatry; Helsinki University Hospital and University of Helsinki; Helsinki Finland
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - K. H. Pietiläinen
- Obesity Research Unit; Research Programs Unit; Diabetes and Obesity, Biomedicum Helsinki; University of Helsinki; Helsinki Finland
- Endocrinology; Abdominal Center; Obesity Center; Helsinki University Hospital and University of Helsinki; Helsinki Finland
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40
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Vihma V, Naukkarinen J, Turpeinen U, Hämäläinen E, Kaprio J, Rissanen A, Heinonen S, Hakkarainen A, Lundbom J, Lundbom N, Mikkola TS, Tikkanen MJ, Pietiläinen KH. Metabolism of sex steroids is influenced by acquired adiposity-A study of young adult male monozygotic twin pairs. J Steroid Biochem Mol Biol 2017; 172:98-105. [PMID: 28619249 DOI: 10.1016/j.jsbmb.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 10/19/2022]
Abstract
Obesity and ageing are associated with lower serum testosterone levels in men. How fat distribution or adipose tissue metabolism, independent of genetic factors and age, are related to sex steroid metabolism is less clear. We studied the associations between adiposity and serum sex hormone concentrations, and mRNA expression of genes regulating sex hormone metabolism in adipose tissue in young adult male monozygotic (MZ) twin pairs. The subjects [n=18 pairs; mean age, 32 years; individual body mass indexes (BMIs) 22-36kg/m2] included 9 male MZ twin pairs discordant for BMI [intra-pair difference (Δ) in BMI ≥3kg/m2]. Sex steroid concentrations were determined by liquid chromatography-tandem mass spectrometry, body composition by dual-energy X-ray absorptiometry and magnetic resonance imaging, and mRNA expressions from subcutaneous adipose tissue by Affymetrix. In BMI-discordant pairs (mean ΔBMI=5.9kg/m2), serum dihydrotestosterone (DHT) was lower [mean 1.9 (SD 0.7) vs. 2.4 (1.0) nmol/l, P=0.040] and mRNA expressions of DHT-inactivating AKR1C2 (P=0.021) and cortisol-producing HSD11B1 (P=0.008) higher in the heavier compared to the leaner co-twins. Serum free 17β-estradiol (E2) was higher [2.3 (0.5) vs. 1.9 (0.5) pmol/l, P=0.028], and in all twin pairs, serum E2 and estrone concentrations were higher in the heavier than in the leaner co-twins [107 (28) vs. 90 (22) pmol/l, P=0.006; and 123 (43) vs. 105 (27) pmol/l, P=0.025]. Within all twin pairs, i.e. independent of genetic effects and age, 1) the amount of subcutaneous fat inversely correlated with serum total and free testosterone, DHT, and sex hormone-binding globulin (SHBG) concentrations (P<0.01 for all), 2) intra-abdominal fat with total testosterone and SHBG (P<0.05), and 3) liver fat with SHBG (P=0.006). Also, 4) general and intra-abdominal adiposity correlated positively with mRNA expressions of AKR1C2, HSD11B1, and aromatase in adipose tissue (P<0.05). In conclusion, acquired adiposity was associated with decreased serum DHT and increased estrogen concentrations, independent of genetic factors and age. The reduction of DHT could be linked to its increased degradation (by AKR1C2 and HSD11B1) and increased estrogen levels to increased adiposity-related expression of aromatase in adipose tissue.
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Affiliation(s)
- Veera Vihma
- University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Biomedicum C415, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, P.O. Box 63, 00014, University of Helsinki, Finland.
| | - Jussi Naukkarinen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014, University of Helsinki, Finland; University of Helsinki, FIMM, Institute for Molecular Medicine Finland, P.O. Box 20, 00014, University of Helsinki, Finland
| | - Ursula Turpeinen
- Helsinki University Hospital, HUSLAB, P.O. Box 720, 00029 HUS, Helsinki, Finland
| | - Esa Hämäläinen
- Helsinki University Hospital, HUSLAB, P.O. Box 720, 00029 HUS, Helsinki, Finland
| | - Jaakko Kaprio
- University of Helsinki, FIMM, Institute for Molecular Medicine Finland, P.O. Box 20, 00014, University of Helsinki, Finland
| | - Aila Rissanen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014, University of Helsinki, Finland
| | - Sini Heinonen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014, University of Helsinki, Finland
| | - Antti Hakkarainen
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Jesper Lundbom
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Nina Lundbom
- University of Helsinki and HUS Medical Imaging Center, Helsinki University Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Tomi S Mikkola
- Folkhälsan Research Center, P.O. Box 63, 00014, University of Helsinki, Finland; Helsinki University Hospital, Obstetrics and Gynecology, P.O. Box 140, 00029 HUS, Helsinki, Finland
| | - Matti J Tikkanen
- University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Biomedicum C415, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, P.O. Box 63, 00014, University of Helsinki, Finland
| | - Kirsi H Pietiläinen
- University of Helsinki, Research Programs Unit, Diabetes and Obesity, Obesity Research Unit, P.O. Box 63, 00014, University of Helsinki, Finland; Helsinki University Hospital, Endocrinology, Abdominal Center, P.O. Box 340, 00029 HUS, Helsinki, Finland
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41
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Taskinen MR, Söderlund S, Bogl LH, Hakkarainen A, Matikainen N, Pietiläinen KH, Räsänen S, Lundbom N, Björnson E, Eliasson B, Mancina RM, Romeo S, Alméras N, Pepa GD, Vetrani C, Prinster A, Annuzzi G, Rivellese A, Després JP, Borén J. Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity. J Intern Med 2017; 282:187-201. [PMID: 28548281 DOI: 10.1111/joim.12632] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Overconsumption of dietary sugars, fructose in particular, is linked to cardiovascular risk factors such as type 2 diabetes, obesity, dyslipidemia and nonalcoholic fatty liver disease. However, clinical studies have to date not clarified whether these adverse cardiometabolic effects are induced directly by dietary sugars, or whether they are secondary to weight gain. OBJECTIVES To assess the effects of fructose (75 g day-1 ), served with their habitual diet over 12 weeks, on liver fat content and other cardiometabolic risk factors in a large cohort (n = 71) of abdominally obese men. METHODS We analysed changes in body composition, dietary intake, an extensive panel of cardiometabolic risk markers, hepatic de novo lipogenesis (DNL), liver fat content and postprandial lipid responses after a standardized oral fat tolerance test (OFTT). RESULTS Fructose consumption had modest adverse effects on cardiometabolic risk factors. However, fructose consumption significantly increased liver fat content and hepatic DNL and decreased β-hydroxybutyrate (a measure of β-oxidation). The individual changes in liver fat were highly variable in subjects matched for the same level of weight change. The increase in liver fat content was significantly more pronounced than the weight gain. The increase in DNL correlated positively with triglyceride area under the curve responses after an OFTT. CONCLUSION Our data demonstrated adverse effects of moderate fructose consumption for 12 weeks on multiple cardiometabolic risk factors in particular on liver fat content despite only relative low increases in weight and waist circumference. Our study also indicates that there are remarkable individual differences in susceptibility to visceral adiposity/liver fat after real-world daily consumption of fructose-sweetened beverages over 12 weeks.
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Affiliation(s)
- M-R Taskinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - S Söderlund
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - L H Bogl
- Institute for Molecular Medicine FIMM, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - N Matikainen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - K H Pietiläinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.,Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - S Räsänen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - N Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - E Björnson
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - B Eliasson
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - R M Mancina
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Romeo
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - N Alméras
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada
| | - G D Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - C Vetrani
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Prinster
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - G Annuzzi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - J-P Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada
| | - J Borén
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
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42
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Puustinen L, Hakkarainen A, Kivisaari R, Boyd S, Nieminen U, Färkkilä M, Lundbom N, Arkkila P. 31Phosphorus magnetic resonance spectroscopy of the liver for evaluating inflammation and fibrosis in autoimmune hepatitis. Scand J Gastroenterol 2017; 52:886-892. [PMID: 28415898 DOI: 10.1080/00365521.2017.1315738] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Liver biopsy is the gold standard in evaluating inflammation and fibrosis in autoimmune hepatitis. AIMS In search of non-invasive follow-up tools in autoimmune hepatitis, we evaluated 31phosphorus magnetic resonance spectroscopy (31P MRS). METHODS Twelve consecutive AIH patients (mean age 42.8 years, 10 women) underwent liver biopsy, routine laboratory liver function tests, which were compared to findings in 31P MRS and transient elastography (TE). RESULTS Phosphoenolpuryvate (PEP) correlated with the grade of inflammation (r = 0.746, p = .005) and thromboplastin time (r = 0.592, p = .043). It also differentiated patients with active inflammation from patients without (t = 3.781, p = .009). There was no correlation between PEP and aminotransferase or immunoglobulin G levels. The phosphoethanolamine (PE)/phosphocholine (PC) ratio, PE/glyserophosphoethanolamine (GPE) ratio and PC/[total phosphomonoester (PME) + phosphodiester (PDE)] ratios correlated with immunoglobulin G (r = 0.764, p = .006; r = 0.618, p = .043; and r= -0.636, p = .035, respectively). PME/PDE and PE/GPE correlated with fibrosis (r = 0.668, p = .018 and r = 0.604, p = .037). PE/GPE also differentiated F3 from F0-2 patients (t = 3.810, p = .003). Phosphorus metabolites did not correlate with TE results and TE did not correlate with liver histology or laboratory parameters. CONCLUSIONS 31P MRS seems to detect active inflammation and advanced fibrosis in AIH patients. TE was ineffective in fibrosis quantification.
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Affiliation(s)
- Lauri Puustinen
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Antti Hakkarainen
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Reetta Kivisaari
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Sonja Boyd
- c Department of Pathology , Haartmann Institute, Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Urpo Nieminen
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Martti Färkkilä
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Nina Lundbom
- b HUS Helsinki Medical Imaging Center, Radiology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
| | - Perttu Arkkila
- a Department of Gastroenterology , Helsinki University Hospital and University of Helsinki , Helsinki , Finland
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43
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Matikainen N, Söderlund S, Björnson E, Bogl LH, Pietiläinen KH, Hakkarainen A, Lundbom N, Eliasson B, Räsänen SM, Rivellese A, Patti L, Prinster A, Riccardi G, Després JP, Alméras N, Holst JJ, Deacon CF, Borén J, Taskinen MR. Fructose intervention for 12 weeks does not impair glycemic control or incretin hormone responses during oral glucose or mixed meal tests in obese men. Nutr Metab Cardiovasc Dis 2017; 27:534-542. [PMID: 28428027 DOI: 10.1016/j.numecd.2017.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/28/2017] [Accepted: 03/09/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Incretin hormones glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide (GIP) are affected early on in the pathogenesis of metabolic syndrome and type 2 diabetes. Epidemiologic studies consistently link high fructose consumption to insulin resistance but whether fructose consumption impairs the incretin response remains unknown. METHODS AND RESULTS As many as 66 obese (BMI 26-40 kg/m2) male subjects consumed fructose-sweetened beverages containing 75 g fructose/day for 12 weeks while continuing their usual lifestyle. Glucose, insulin, GLP-1 and GIP were measured during oral glucose tolerance test (OGTT) and triglycerides (TG), GLP-1, GIP and PYY during a mixed meal test before and after fructose intervention. Fructose intervention did not worsen glucose and insulin responses during OGTT, and GLP-1 and GIP responses during OGTT and fat-rich meal were unchanged. Postprandial TG response increased significantly, p = 0.004, and we observed small but significant increases in weight and liver fat content, but not in visceral or subcutaneous fat depots. However, even the subgroups who gained weight or liver fat during fructose intervention did not worsen their glucose, insulin, GLP-1 or PYY responses. A minor increase in GIP response during OGTT occurred in subjects who gained liver fat (p = 0.049). CONCLUSION In obese males with features of metabolic syndrome, 12 weeks fructose intervention 75 g/day did not change glucose, insulin, GLP-1 or GIP responses during OGTT or GLP-1, GIP or PYY responses during a mixed meal. Therefore, fructose intake, even accompanied with mild weight gain, increases in liver fat and worsening of postprandial TG profile, does not impair glucose tolerance or gut incretin response to oral glucose or mixed meal challenge.
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Affiliation(s)
- N Matikainen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
| | - S Söderlund
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - E Björnson
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - L H Bogl
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine FIMM, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - K H Pietiläinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - A Hakkarainen
- Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Finland
| | - N Lundbom
- Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Finland
| | - B Eliasson
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S M Räsänen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - L Patti
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Prinster
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - J-P Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Québec, Canada
| | - N Alméras
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Québec, Canada
| | - J J Holst
- NNF Centre for Basic Metabolic Research, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C F Deacon
- NNF Centre for Basic Metabolic Research, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Borén
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M-R Taskinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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Kaye S, Lokki AI, Hanttu A, Nissilä E, Heinonen S, Hakkarainen A, Lundbom J, Lundbom N, Saarinen L, Tynninen O, Muniandy M, Rissanen A, Kaprio J, Meri S, Pietiläinen KH. Upregulation of Early and Downregulation of Terminal Pathway Complement Genes in Subcutaneous Adipose Tissue and Adipocytes in Acquired Obesity. Front Immunol 2017; 8:545. [PMID: 28559893 PMCID: PMC5432622 DOI: 10.3389/fimmu.2017.00545] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/24/2017] [Indexed: 12/11/2022] Open
Abstract
Inflammation is an important mediator of obesity-related complications such as the metabolic syndrome but its causes and mechanisms are unknown. As the complement system is a key mediator of inflammation, we studied whether it is activated in acquired obesity in subcutaneous adipose tissue (AT) and isolated adipocytes. We used a special study design of genetically matched controls of lean and heavy groups, rare monozygotic twin pairs discordant for body mass index (BMI) [n = 26, within-pair difference (Δ) in body mass index, BMI >3 kg/m2] with as much as 18 kg mean Δweight. Additionally, 14 BMI-concordant (BMI <3 kg/m2) served as a reference group. The detailed measurements included body composition (DEXA), fat distribution (MRI), glucose, insulin, adipokines, C3a and SC5b-9 levels, and the expression of complement and insulin signaling pathway-related genes in AT and adipocytes. In both AT and isolated adipocytes, the classical and alternative pathway genes were upregulated, and the terminal pathway genes downregulated in the heavier co-twins of the BMI-discordant pairs. The upregulated genes included C1q, C1s, C2, ficolin-1, factor H, receptors for C3a and C5a (C5aR1), and the iC3b receptor (CR3). While the terminal pathway components C5 and C6 were downregulated, its inhibitor clusterin was upregulated. Complement gene upregulation in AT and adipocytes correlated positively with adiposity and hyperinsulinemia and negatively with the expression of insulin signaling-related genes. Plasma C3a, but not SC5b-9, levels were elevated in the heavier co-twins. There were no differences between the co-twins in BMI-concordant pairs. Obesity is associated with increased expression of the early, but not late, complement pathway components and of key receptors. The twins with acquired obesity have therefore an inflated inflammatory activity in the AT. The results suggest that complement is likely involved in orchestrating clearance of apoptotic debris and inflammation in the AT.
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Affiliation(s)
- Sanna Kaye
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Helsinki Haartman City Hospital, Department of Emergency Care, Helsinki, Finland
| | - A Inkeri Lokki
- Department of Bacteriology and Immunology, University of Helsinki and Helsinki Central Hospital, Helsinki, Finland.,Immunobiology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Anna Hanttu
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Eija Nissilä
- Department of Bacteriology and Immunology, University of Helsinki and Helsinki Central Hospital, Helsinki, Finland.,Immunobiology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Sini Heinonen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Lilli Saarinen
- Genome-Scale Biology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Olli Tynninen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Maheswary Muniandy
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Seppo Meri
- Department of Bacteriology and Immunology, University of Helsinki and Helsinki Central Hospital, Helsinki, Finland.,Immunobiology Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.,Obesity Center, Endocrinology, Abdominal Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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45
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Jukarainen S, Holst R, Dalgård C, Piirilä P, Lundbom J, Hakkarainen A, Lundbom N, Rissanen A, Kaprio J, Kyvik KO, Sørensen TIA, Pietiläinen KH. Cardiorespiratory Fitness and Adiposity as Determinants of Metabolic Health-Pooled Analysis of Two Twin Cohorts. J Clin Endocrinol Metab 2017; 102:1520-1528. [PMID: 28324016 DOI: 10.1210/jc.2016-3435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/18/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT The joint effects of cardiorespiratory fitness (CRF) and body composition on metabolic health are not well known. OBJECTIVE To examine the associations of CRF, fat-free mass index (FFMI), and fat mass index (FMI) with metabolic health in individual twins and controlling for genetic and shared environmental effects by studying monozygotic intrapair differences. DESIGN, SETTING, AND PARTICIPANTS Two cross-sectional samples of healthy adult monozygotic and dizygotic twins were drawn from population-based Danish and Finnish national twin registries (n = 996 and n = 309). MAIN MEASURES CRF was defined as VO2max divided by fat-free mass. Insulin sensitivity and acute insulin response indices were derived from an oral glucose tolerance test. A continuous metabolic syndrome score was calculated. Visceral and liver fat were measured in the Finnish sample. Associations were analyzed separately in both cohorts with multivariate linear regression and aggregated with meta-analytic methods. RESULTS Insulin sensitivity, acute insulin response, metabolic syndrome score, visceral, and liver fat amount had strong and statistically significant associations with FMI (|β| 0.53 to 0.79), whereas their associations with CRF and FFMI were at most weak (|β| 0.02 to 0.15). The results of the monozygotic intrapair differences analysis showed the same pattern. CONCLUSIONS Although FMI is strongly associated with worsening of metabolic health traits, even after controlling for genetic and shared environmental factors, there was little evidence for the effects of CRF or FFMI on metabolic health. This suggests that changing FMI rather than CRF or FFMI may affect metabolic health irrespective of genetic or early environmental determinants.
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Affiliation(s)
- Sakari Jukarainen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, 00290 Helsinki, Finland
| | - René Holst
- Institute of Regional Health Service Research, University of Southern Denmark, 5230 Odense, Denmark
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, 0313 Oslo, Norway
| | - Christine Dalgård
- Department of Public Health - Environmental Medicine, University of Southern Denmark, 5230 Odense, Denmark
- Danish Twin Registry, University of Southern Denmark, 5230 Odense, Denmark
| | - Päivi Piirilä
- Unit of Clinical Physiology, Helsinki University Hospital and University of Helsinki, Meilahti Hospital, 00290 Helsinki, Finland
| | - Jesper Lundbom
- Helsinki Medical Imaging Center, Radiology, University of Helsinki, 00290 Helsinki, Finland
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - Antti Hakkarainen
- Helsinki Medical Imaging Center, Radiology, University of Helsinki, 00290 Helsinki, Finland
| | - Nina Lundbom
- Helsinki Medical Imaging Center, Radiology, University of Helsinki, 00290 Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, 00290 Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, 00300 Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, 00290 Helsinki, Finland
| | - Kirsten Ohm Kyvik
- Odense Patient Data Explorative Network, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5200 Odense, Denmark
- Danish Twin Registry, University of Southern Denmark, 5230 Odense, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospitals, The Capital Region, 2400 Copenhagen, Denmark
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, 00290 Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Central Hospital and University of Helsinki, 00290 Helsinki, Finland
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46
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Mardinoglu A, Bjornson E, Zhang C, Klevstig M, Söderlund S, Ståhlman M, Adiels M, Hakkarainen A, Lundbom N, Kilicarslan M, Hallström BM, Lundbom J, Vergès B, Barrett PHR, Watts GF, Serlie MJ, Nielsen J, Uhlén M, Smith U, Marschall HU, Taskinen MR, Boren J. Personal model-assisted identification of NAD + and glutathione metabolism as intervention target in NAFLD. Mol Syst Biol 2017; 13:916. [PMID: 28254760 PMCID: PMC5371732 DOI: 10.15252/msb.20167422] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To elucidate the molecular mechanisms underlying non‐alcoholic fatty liver disease (NAFLD), we recruited 86 subjects with varying degrees of hepatic steatosis (HS). We obtained experimental data on lipoprotein fluxes and used these individual measurements as personalized constraints of a hepatocyte genome‐scale metabolic model to investigate metabolic differences in liver, taking into account its interactions with other tissues. Our systems level analysis predicted an altered demand for NAD+ and glutathione (GSH) in subjects with high HS. Our analysis and metabolomic measurements showed that plasma levels of glycine, serine, and associated metabolites are negatively correlated with HS, suggesting that these GSH metabolism precursors might be limiting. Quantification of the hepatic expression levels of the associated enzymes further pointed to altered de novo GSH synthesis. To assess the effect of GSH and NAD+ repletion on the development of NAFLD, we added precursors for GSH and NAD+ biosynthesis to the Western diet and demonstrated that supplementation prevents HS in mice. In a proof‐of‐concept human study, we found improved liver function and decreased HS after supplementation with serine (a precursor to glycine) and hereby propose a strategy for NAFLD treatment.
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Affiliation(s)
- Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden .,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Elias Bjornson
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cheng Zhang
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Martina Klevstig
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sanni Söderlund
- Research programs Unit, Diabetes and Obesity, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Murat Kilicarslan
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Björn M Hallström
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Jesper Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Bruno Vergès
- Department of Endocrinology-Diabetology, University Hospital and INSERM CRI 866, Dijon, France
| | - Peter Hugh R Barrett
- Faculty of Engineering, Computing and Mathematics, University of Western Australia, Perth, WA, Australia
| | - Gerald F Watts
- Metabolic Research Centre, Cardiovascular Medicine, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Mireille J Serlie
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jens Nielsen
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden.,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Mathias Uhlén
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Ulf Smith
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marja-Riitta Taskinen
- Research programs Unit, Diabetes and Obesity, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jan Boren
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
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47
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Heinonen S, Muniandy M, Buzkova J, Mardinoglu A, Rodríguez A, Frühbeck G, Hakkarainen A, Lundbom J, Lundbom N, Kaprio J, Rissanen A, Pietiläinen KH. Mitochondria-related transcriptional signature is downregulated in adipocytes in obesity: a study of young healthy MZ twins. Diabetologia 2017; 60:169-181. [PMID: 27734103 DOI: 10.1007/s00125-016-4121-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/09/2016] [Indexed: 01/04/2023]
Abstract
AIMS/HYPOTHESIS Low mitochondrial activity in adipose tissue is suggested to be an underlying factor in obesity and its metabolic complications. We aimed to find out whether mitochondrial measures are downregulated in obesity also in isolated adipocytes. METHODS We studied young adult monozygotic (MZ) twin pairs discordant (n = 14, intrapair difference ΔBMI ≥ 3 kg/m2) and concordant (n = 5, ΔBMI < 3 kg/m2) for BMI, identified from ten birth cohorts of 22- to 36-year-old Finnish twins. Abdominal body fat distribution (MRI), liver fat content (magnetic resonance spectroscopy), insulin sensitivity (OGTT), high-sensitivity C-reactive protein, serum lipids and adipokines were measured. Subcutaneous abdominal adipose tissue biopsies were obtained to analyse the transcriptomics patterns of the isolated adipocytes as well as of the whole adipose tissue. Mitochondrial DNA transcript levels in adipocytes were measured by quantitative real-time PCR. Western blots of oxidative phosphorylation (OXPHOS) protein levels in adipocytes were performed in obese and lean unrelated individuals. RESULTS The heavier (BMI 29.9 ± 1.0 kg/m2) co-twins of the discordant twin pairs had more subcutaneous, intra-abdominal and liver fat and were more insulin resistant (p < 0.01 for all measures) than the lighter (24.1 ± 0.9 kg/m2) co-twins. Altogether, 2538 genes in adipocytes and 2135 in adipose tissue were significantly differentially expressed (nominal p < 0.05) between the co-twins. Pathway analysis of these transcripts in both isolated adipocytes and adipose tissue revealed that the heavier co-twins displayed reduced expression of genes relating to mitochondrial pathways, a result that was replicated when analysing the pathways behind the most consistently downregulated genes in the heavier co-twins (in at least 12 out of 14 pairs). Consistently upregulated genes in adipocytes were related to inflammation. We confirmed that mitochondrial DNA transcript levels (12S RNA, 16S RNA, COX1, ND5, CYTB), expression of mitochondrial ribosomal protein transcripts and a major mitochondrial regulator PGC-1α (also known as PPARGC1A) were reduced in the heavier co-twins' adipocytes (p < 0.05). OXPHOS protein levels of complexes I and III in adipocytes were lower in obese than in lean individuals. CONCLUSIONS/INTERPRETATION Subcutaneous abdominal adipocytes in obesity show global expressional downregulation of oxidative pathways, mitochondrial transcripts and OXPHOS protein levels and upregulation of inflammatory pathways. DATA AVAILABILITY The datasets analysed and generated during the current study are available in the figshare repository, https://dx.doi.org/10.6084/m9.figshare.3806286.v1.
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Affiliation(s)
- Sini Heinonen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Biomedicum Helsinki, C424b, P.O. Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland
| | - Maheswary Muniandy
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Biomedicum Helsinki, C424b, P.O. Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland
| | - Jana Buzkova
- Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland
| | - Adil Mardinoglu
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBEROBN, Instituto de Salud Carlos III, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBEROBN, Instituto de Salud Carlos III, Pamplona, Spain
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- FIMM, Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
- Finnish Twin Cohort Study, Department of Public Health, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Biomedicum Helsinki, C424b, P.O. Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland
- Department of Psychiatry, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Biomedicum Helsinki, C424b, P.O. Box 63, Haartmaninkatu 8, 00014, Helsinki, Finland.
- FIMM, Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland.
- Endocrinology, Abdominal Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
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48
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Rämö JT, Kaye SM, Jukarainen S, Bogl LH, Hakkarainen A, Lundbom J, Lundbom N, Rissanen A, Kaprio J, Matikainen N, Pietiläinen KH. Liver Fat and Insulin Sensitivity Define Metabolite Profiles During a Glucose Tolerance Test in Young Adult Twins. J Clin Endocrinol Metab 2017; 102:220-231. [PMID: 27809652 PMCID: PMC6287394 DOI: 10.1210/jc.2015-3512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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] [Received: 09/23/2015] [Accepted: 10/31/2016] [Indexed: 12/29/2022]
Abstract
CONTEXT The associations of body mass index (BMI) and liver fat (LF) with circulating prandial metabolomic markers are incompletely understood. OBJECTIVE We aimed to characterize circulating metabolite excursions during an oral glucose tolerance test (OGTT) and evaluate whether the metabolomic signatures of BMI discordance coassociate with LF content. DESIGN, SETTING, AND PARTICIPANTS We measured 80 metabolite parameters by nuclear magnetic resonance, together with glucose and insulin, during a 2-hour OGTT in 64 monozygotic (MZ) and 73 dizygotic (DZ) twin pairs (aged 22.8 to 36.2 years). Metabolite excursions during the OGTT were compared within BMI-discordant (intrapair difference, BMI ≥ 3 kg/m2) cotwins separately within MZ and DZ pairs. Insulin-based indices were calculated from the OGTT. LF was measured by magnetic resonance spectroscopy in 25 BMI-discordant MZ pairs. Metabolite profiles were compared with respect to LF discordance (ΔLF% ≥ 2%). RESULTS We replicated many previously reported OGTT-induced metabolite excursions in all 274 individuals and report novel lipoprotein excursions. The associations between some metabolite excursions and BMI differed in MZ and DZ twins. In BMI-discordant MZ pairs (mean ΔBMI = 4.9 kg/m2) who were concordant for LF (Δ0.2%), few metabolites differed between the cotwins: very-low-density lipoprotein (VLDL) cholesterol and apolipoprotein B were elevated, and high-density lipoprotein size and concentration were decreased in the cotwins with higher BMI. In contrast, in BMI-discordant MZ pairs (ΔBMI = 6.1 kg/m2) who were discordant for LF (Δ6.8%), cotwins with higher BMI exhibited lower insulin sensitivity and widespread metabolomic differences: elevations in small VLDL and low-density lipoprotein particles, fatty acids (FAs), and isoleucine. Within all 64 MZ twin pairs, lower insulin sensitivity associated with higher levels of VLDLs, triglycerides, FAs, and isoleucine. CONCLUSIONS BMI-discordant MZ twin pairs who also are discordant for LF have more pronounced within-pair differences in metabolomics profiles during an OGTT than BMI-discordant pairs without LF discordance.
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Affiliation(s)
- Joel T Rämö
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
- Institute for Molecular Medicine Finland, FI-00014, Helsinki, Finland
| | - Sanna M Kaye
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
| | - Sakari Jukarainen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
| | - Leonie H Bogl
- Department of Public Health, University of Helsinki, FI-00014, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, FI-00029, Helsinki, Finland
| | - Jesper Lundbom
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, 40225, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, 40225, Düsseldorf, Germany
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, FI-00029, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
- Department of Psychiatry, Helsinki University Hospital, and University of Helsinki, 00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, FI-00014, Helsinki, Finland
- Department of Public Health, University of Helsinki, FI-00014, Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, FI-00014, Helsinki, Finland; and
| | - Niina Matikainen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, and University of Helsinki, FI-00029, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, FI-00029, Helsinki, Finland
- Institute for Molecular Medicine Finland, FI-00014, Helsinki, Finland
- Endocrinology, Abdominal Center, Helsinki University Hospital, and University of Helsinki, FI-00029, Helsinki, Finland
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49
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Ahola S, Auranen M, Isohanni P, Niemisalo S, Urho N, Buzkova J, Velagapudi V, Lundbom N, Hakkarainen A, Muurinen T, Piirilä P, Pietiläinen KH, Suomalainen A. Modified Atkins diet induces subacute selective ragged-red-fiber lysis in mitochondrial myopathy patients. EMBO Mol Med 2016; 8:1234-1247. [PMID: 27647878 PMCID: PMC5090657 DOI: 10.15252/emmm.201606592] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Mitochondrial myopathy (MM) with progressive external ophthalmoplegia (PEO) is a common manifestation of mitochondrial disease in adulthood, for which there is no curative therapy. In mice with MM, ketogenic diet significantly delayed progression of the disease. We asked in this pilot study what effects high-fat, low-carbohydrate "modified Atkins" diet (mAD) had for PEO/MM patients and control subjects and followed up the effects by clinical, morphological, transcriptomic, and metabolomic analyses. All of our five patients, irrespective of genotype, showed a subacute response after 1.5-2 weeks of diet, with progressive muscle pain and leakage of muscle enzymes, leading to premature discontinuation of the diet. Analysis of muscle ultrastructure revealed selective fiber damage, especially in the ragged-red-fibers (RRFs), a MM hallmark. Two years of follow-up showed improvement of muscle strength, suggesting activation of muscle regeneration. Our results indicate that (i) nutrition can modify mitochondrial disease progression, (ii) dietary counseling should be part of MM care, (iii) short mAD is a tool to induce targeted RRF lysis, and (iv) mAD, a common weight-loss method, may induce muscle damage in a population subgroup.
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Affiliation(s)
- Sofia Ahola
- Research Program of Molecular Neurology, Biomedicum Helsinki University of Helsinki, Helsinki, Finland
| | - Mari Auranen
- Research Program of Molecular Neurology, Biomedicum Helsinki University of Helsinki, Helsinki, Finland.,Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Isohanni
- Research Program of Molecular Neurology, Biomedicum Helsinki University of Helsinki, Helsinki, Finland
| | - Satu Niemisalo
- Obesity Research Unit, Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Niina Urho
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jana Buzkova
- Research Program of Molecular Neurology, Biomedicum Helsinki University of Helsinki, Helsinki, Finland
| | - Vidya Velagapudi
- Metabolomics Unit, Institute for Molecular Medicine Finland FIMM University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, University of Helsinki and HUS Radiology Helsinki Medical Imaging Center, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, University of Helsinki and HUS Radiology Helsinki Medical Imaging Center, Helsinki, Finland
| | - Tiina Muurinen
- Department of Clinical Physiology and Nuclear Medicine, Laboratory of Clinical Physiology, Helsinki University Hospitals, Helsinki, Finland
| | - Päivi Piirilä
- Department of Clinical Physiology and Nuclear Medicine, Laboratory of Clinical Physiology, Helsinki University Hospitals, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Medicine, Division of Endocrinology, Helsinki University Central Hospital, Helsinki, Finland
| | - Anu Suomalainen
- Research Program of Molecular Neurology, Biomedicum Helsinki University of Helsinki, Helsinki, Finland .,Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Neuroscience Center, University of Helsinki, Helsinki, Finland
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Kaye S, Hanttu A, Lokki AI, Nissilä E, Heinonen S, Hakkarainen A, Lundbom J, Lundbom N, Saarinen L, Muniandy M, Rissanen A, Kaprio J, Meri S, Pietiläinen KH. Altered complement gene expression profile of adipose tissue and adipocytes in obesity: A monozygotic twin study. Immunobiology 2016. [DOI: 10.1016/j.imbio.2016.06.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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