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Hashem AM, Cifuentes L, Calderon G, Ricardo-Silgado ML, Gonzalez-Izundegui D, Campos A, McRae A, Franks S, Hurtado MD, Burton D, Petterson XM, Lanza IR, Camilleri M, Acosta A. Effect of caloric intake and macronutrient composition on intestinal cholesterol absorption and bile acids in patients with obesity. Am J Physiol Gastrointest Liver Physiol 2022; 323:G157-G164. [PMID: 35727128 PMCID: PMC9377780 DOI: 10.1152/ajpgi.00108.2022] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 01/31/2023]
Abstract
Obesity is associated with alterations in cholesterol and bile acid (BA) metabolism. However, the interaction among dietary intake, cholesterol absorption, and BA metabolism in patients with obesity remains unclear. We conducted a 4-wk nutritional intervention nonrandomized clinical trial with three different sequential diets for a week in the following order: regular diet (RD); high calorie, high-fat diet (HCHF), washout period on RD; and low-calorie, low-fat diet (LCLF). We provided participants with meal replacements during HCHF and LCLF diets. A total of 16 participants completed the study [n = 8 normal weight (NW); n = 8 with obesity (OB)]. Overall, there was a significant increase in intestinal cholesterol uptake when changing from RD to HCHF and a reduction in intestinal cholesterol uptake from HCHF to LCLF. When analyzing by BMI groups, these findings were similar in patients with NW (RD to HCHF: P < 0.007; HCHF to LCLF: P = 0.02); however, in patients with obesity, the change in intestinal cholesterol uptake was only observed when changing from RD to HCHF (P = 0.006). There was no correlation between cholesterol absorption and fecal bile acids or other markers of BA metabolism in all patients or the subgroups. Dietary caloric content had a significant effect on cholesterol absorption, however, this effect is blunted in patients with obesity. These data are consistent with the impaired effect of a low-fat diet on cholesterol absorption in obesity.NEW & NOTEWORTHY We show how switching from a regular diet to an HCHF increases cholesterol absorption in patients with normal weight and obesity. The decrease in cholesterol absorption from an HCHF to an LCLF, on the other hand, was only seen in normal-weight controls, underlining the importance of body weight in this regulation. In addition, changes in caloric and fat content had an immediate and direct effect on hepatic bile acid production.
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Affiliation(s)
- Anas Mohamad Hashem
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Lizeth Cifuentes
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Gerardo Calderon
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Maria Laura Ricardo-Silgado
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Daniel Gonzalez-Izundegui
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alejandro Campos
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alison McRae
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Shawna Franks
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Maria Daniela Hurtado
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic Health System, La Crosse, Wisconsin
| | - Duane Burton
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Ian R Lanza
- Metabolomics Core Laboratory, Mayo Clinic, Rochester, Minnesota
- Endocrinology Research Unit, Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Michael Camilleri
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Andres Acosta
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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McRae A, Ricardo-Silgado ML, Liu Y, Calderon G, Gonzalez-Izundegui D, Rohakhtar FR, Simon V, Li Y, Acosta A. A Protocol for the Cryopreservation of Human Intestinal Mucosal Biopsies Compatible With Single-Cell Transcriptomics and Ex Vivo Studies. Front Physiol 2022; 13:878389. [PMID: 35600311 PMCID: PMC9119022 DOI: 10.3389/fphys.2022.878389] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022] Open
Abstract
The heterogeneity of the human intestinal epithelium has hindered the understanding of the pathophysiology of distinct specialized cell types on a single-cell basis in disease states. Described here is a workflow for the cryopreservation of endoscopically obtained human intestinal mucosal biopsies, subsequent preparation of this tissue to yield highly viable fluorescence-activated cell sorting (FACS)isolated human intestinal epithelial cell (IEC) single-cell suspensions compatible with successful library preparation and deep single-cell RNA sequencing (scRNAseq). We validated this protocol in deep scRNAseq of 59,653 intestinal cells in 10 human participants. Furthermore, primary intestinal cultures were successfully generated from cryopreserved tissue, capable of surviving in short-term culture and suitable for physiological assays studying gut peptide secretion from rare hormone-producing enteroendocrine cells in humans. This study offers an accessible avenue for single-cell transcriptomics and ex vivo studies from cryopreserved intestinal mucosal biopsies. These techniques may be used in the future to dissect and define novel aberrations to the intestinal ecosystem that lead to the development and progression of disease states in humans, even in rare IEC populations.
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Affiliation(s)
- Alison McRae
- Precision Medicine for Obesity Program, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Maria Laura Ricardo-Silgado
- Precision Medicine for Obesity Program, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Yuanhang Liu
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Gerardo Calderon
- Precision Medicine for Obesity Program, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Daniel Gonzalez-Izundegui
- Precision Medicine for Obesity Program, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | | | - Vernadette Simon
- Center for Individualized Medicine (CIM), Mayo Clinic, Rochester, MN, United States
| | - Ying Li
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Andres Acosta
- Precision Medicine for Obesity Program, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Andres Acosta,
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Abstract
Enteroendocrine cells (EECs) are specialized cells that are widely distributed throughout the gastrointestinal tract. EECs sense luminal content and release hormones, such as: ghrelin, cholecystokinin, glucagon like peptide 1, peptide YY, insulin like peptide 5, and oxyntomodulin. These hormones can enter the circulation to act on distant targets or act locally on neighboring cells and neuronal pathways to modulate food digestion, food intake, energy balance and body weight. Obesity, insulin resistance and diabetes are associated with alterations in the levels of enteroendocrine hormones. Evidence also suggests that modified regulation and release of gut hormones are the result of compensatory mechanisms in states of excess adipose tissue and hyperglycemia. This review collects the evidence available detailing pathophysiological alterations in enteroendocrine hormones and their association with appetite, obesity and glycemic control.
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Affiliation(s)
- Maria Laura Ricardo-Silgado
- Precision Medicine for Obesity Program, and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Alison McRae
- Precision Medicine for Obesity Program, and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Andres Acosta
- Precision Medicine for Obesity Program, and Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
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Morales-Alvarez MC, Ricardo-Silgado ML, Lemus HN, González-Devia D, Mendivil CO. Fructosuria and recurrent hypoglycemia in a patient with a novel c.1693T>A variant in the 3' untranslated region of the aldolase B gene. SAGE Open Med Case Rep 2019; 7:2050313X18823098. [PMID: 30675358 PMCID: PMC6330728 DOI: 10.1177/2050313x18823098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022] Open
Abstract
Hereditary fructose intolerance, caused by mutations in the ALDOB gene, is an unusual cause of hypoglycemia. ALDOB encodes the enzyme aldolase B, responsible for the hydrolysis of fructose 1-phosphate in the liver. Here, we report the case of a 33-year-old female patient who consulted due to repetitive episodes of weakness, dizziness and headache after food ingestion. An ambulatory 72-h continuous glucose monitoring revealed multiple short hypoglycemic episodes over the day. After biochemical exclusion of other endocrine causes of hypoglycemia, hereditary fructose intolerance seemed a plausible diagnosis. Repeated measurements of urinary fructose revealed pathologic fructosuria, but genetic testing for the three most common mutations in ALDOB resulted negative. We decided to perform complete Sanger sequencing of the ALDOB gene and encountered a variant consisting of a T>A substitution in position 1963 of the ALDOB transcript (c.1693T>A). This position is located within the 3′ untranslated region of exon 9, 515 nucleotides downstream the stop codon. After complete withdrawal of dietary fructose and sucrose, the patient presented no new hypoglycemic episodes.
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Affiliation(s)
| | | | | | - Deyanira González-Devia
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.,Section of Endocrinology, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.,Section of Endocrinology, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Pérez-Matos MC, Morales-Álvarez MC, Toloza FJK, Ricardo-Silgado ML, Mantilla-Rivas JO, Pinzón-Cortes JA, Perez-Mayorga M, Jiménez E, Guevara E, Mendivil CO. The Phospholipid Linoleoylglycerophosphocholine as a Biomarker of Directly Measured Insulin Resistance. Diabetes Metab J 2017; 41:466-473. [PMID: 29199411 PMCID: PMC5741556 DOI: 10.4093/dmj.2017.41.6.466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/28/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Plasma concentrations of some lysophospholipids correlate with metabolic alterations in humans, but their potential as biomarkers of insulin resistance (IR) is insufficiently known. We aimed to explore the association between plasma linoleoylglycerophosphocholine (LGPC) and objective measures of IR in adults with different metabolic profiles. METHODS We studied 62 men and women, ages 30 to 69 years, (29% normal weight, 59% overweight, 12% obese). Participants underwent a 5-point oral glucose tolerance test (5p-OGTT) from which we calculated multiple indices of IR and insulin secretion. Fifteen participants additionally underwent a hyperinsulinemic-euglycemic clamp for estimation of insulin-stimulated glucose disposal. Plasma LGPC was determined using high performance liquid chromatography/time-of-flight mass spectrometry. Plasma LGPC was compared across quartiles defined by the IR indices. RESULTS Mean LGPC was 15.4±7.6 ng/mL in women and 14.1±7.3 ng/mL in men. LGPC did not correlate with body mass in-dex, percent body fat, waist circumference, blood pressure, glycosylated hemoglobin, log-triglycerides, or high density lipoprotein cholesterol. Plasma LGPC concentrations was not systematically associated with any of the studied 5p-OGTT-derived IR indices. However, LGPC exhibited a significant negative correlation with glucose disposal in the clamp (Spearman r=-0.56, P=0.029). Despite not being diabetic, participants with higher plasma LGPC exhibited significantly higher post-challenge plasma glucose excursions in the 5p-OGTT (P trend=0.021 for the increase in glucose area under the curve across quartiles of plasma LGPC). CONCLUSION In our sample of Latino adults without known diabetes, LGPC showed potential as a biomarker of IR and impaired glucose metabolism.
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Affiliation(s)
| | | | | | | | | | | | - Maritza Perez-Mayorga
- Molecular Epidemiology of Endocrine Diseases Group, Universidad Militar Nueva Granada, School of Medicine, Bogotá, Colombia
| | | | - Edwin Guevara
- Department of Chemistry, Universidad de los Andes, Bogotá, Colombia
| | - Carlos O Mendivil
- Department of Medicine, Universidad de los Andes School of Medicine, Bogotá, Colombia
- Section of Endocrinology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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Toloza FJK, Pérez-Matos MC, Ricardo-Silgado ML, Morales-Álvarez MC, Mantilla-Rivas JO, Pinzón-Cortés JA, Pérez-Mayorga M, Arévalo-García ML, Tolosa-González G, Mendivil CO. Comparison of plasma pigment epithelium-derived factor (PEDF), retinol binding protein 4 (RBP-4), chitinase-3-like protein 1 (YKL-40) and brain-derived neurotrophic factor (BDNF) for the identification of insulin resistance. J Diabetes Complications 2017. [PMID: 28648555 DOI: 10.1016/j.jdiacomp.2017.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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] [Indexed: 01/24/2023]
Abstract
AIMS To evaluate and compare the association of four potential insulin resistance (IR) biomarkers (pigment-epithelium-derived factor [PEDF], retinol-binding-protein-4 [RBP-4], chitinase-3-like protein 1 [YKL-40] and brain-derived neurotrophic factor [BDNF]) with objective measures of IR. METHODS We studied 81 subjects with different metabolic profiles. All participants underwent a 5-point OGTT with calculation of multiple IR indexes. A subgroup of 21 participants additionally underwent a hyperinsulinemic-euglycemic clamp. IR was defined as belonging to the highest quartile of incremental area under the insulin curve (iAUCins), or to the lowest quartile of the insulin sensitivity index (ISI). RESULTS PEDF was associated with adiposity variables. PEDF and RBP4 increased linearly across quartiles of iAUCins (for PEDF p-trend=0.029; for RBP-4 p-trend=0.053). YKL-40 and BDNF were not associated with any adiposity or IR variable. PEDF and RBP-4 levels identified individuals with IR by the iAUCins definition: A PEDF cutoff of 11.9ng/mL had 60% sensitivity and 68% specificity, while a RBP-4 cutoff of 71.6ng/mL had 70% sensitivity and 57% specificity. In multiple regression analyses simultaneously including clinical variables and the studied biomarkers, only BMI, PEDF and RBP-4 remained significant predictors of IR. CONCLUSIONS Plasma PEDF and RBP4 identified IR in subjects with no prior diagnosis of diabetes.
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Affiliation(s)
- F J K Toloza
- Universidad de los Andes, School of Medicine, Bogotá, Colombia
| | - M C Pérez-Matos
- Universidad de los Andes, School of Medicine, Bogotá, Colombia
| | | | | | | | | | - M Pérez-Mayorga
- Universidad Militar Nueva Granada, School of Medicine, Bogotá, Colombia
| | - M L Arévalo-García
- Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia
| | - G Tolosa-González
- Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia
| | - C O Mendivil
- Universidad de los Andes, School of Medicine, Bogotá, Colombia; Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia.
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