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Richter A, Truthmann J, Hummers E, Pereira JFM, Gágyor I, Schuster F, Witte A, Böhm S, Greser A, Kamin P, Stracke S, Dörr M, Bülow R, Engeli S, Chenot JF, Ittermann T. Prednisolone Versus Colchicine for Acute Gout in Primary Care: statistical analysis plan for the pragmatic, multicenter, randomized, and double-blinded COPAGO non-inferiority trial. Trials 2024; 25:229. [PMID: 38570873 PMCID: PMC10988876 DOI: 10.1186/s13063-024-08066-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND To date, colchicine and prednisolone are two effective therapies for the treatment of acute gout but have never been compared directly in a randomized clinical trial. In addition, in previous trials of treating acute gout patients with concomitant comorbidities were often excluded due to contraindications to naproxen. STUDY DESIGN This pragmatic, prospective, double-blind, double-dummy, parallel-group, randomized, non-inferiority trial compares prednisolone with colchicine in terms of non-inferiority in patients with acute gout. Patients presenting to their general practitioner with acute gout can be included if the gout attack has occurred within the last 2 days. A total of 60 practices in the vicinity of three university medical centers (Greifswald, Göttingen, and Würzburg) participate in the study. The intervention group receives 30 mg prednisolone for 5 days, while the group of standard care receives low-dose colchicine (day 1: 1.5 mg; days 2-5: 1 mg). The first dose of treatment is provided at day 0 when patients present to the general practitioner due to an acute gout attack. From day 0 to day 6, patients will be asked to complete a study diary on daily basis regarding pain quantification. For safety reasons, potential side effects and the course of systolic blood pressure are also assessed. STATISTICAL ANALYSIS PLAN N = 314 patients have to be recruited to compensate for 10% of dropout and to allow for showing non-inferiority of prednisolone compared to colchicine with a power of 90%. We use permuted block randomization with block sizes of 2, 4, and 6 to avoid imbalanced treatment arms in this multi-center study; patients are randomized in a 1:1 ratio. The absolute level of pain on day 3 (in the last 24 h) is the primary outcome and measured on a numerical rating scale (NRS: 0-10). Using a multiple linear regression model adjusted for age, sex, and pain at baseline, prednisolone is considered non-inferior if the effect estimate including the confidence intervals is lower than a margin of 1 unit on the NRS. Average response to treatment, joint swelling and tenderness, physical function of the joint, and patients' global assessment of treatment success are secondary outcomes. DISCUSSION The trial will provide evidence from a direct comparison of colchicine and prednisolone regarding their efficacy of pain reduction in acute gout patients of primary care and to indicate possible safety signals. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05698680 first posted on January 26, 2023 (retrospectively registered).
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Affiliation(s)
- Adrian Richter
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medical Center Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Germany.
| | - Julia Truthmann
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Julia Freyer Martins Pereira
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Ildikó Gágyor
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Franziska Schuster
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Amelie Witte
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Susanne Böhm
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Alexandra Greser
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Petra Kamin
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, Nephrology, University Medical Center Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, Cardiology, University Medical Center Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute for Radiology and Neuroradiology, University Medical Center Greifswald, Greifswald, Germany
| | - Stefan Engeli
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
- Institute of Pharmacology, University Medical Center Greifswald, Greifswald, Germany
| | - Jean François Chenot
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Till Ittermann
- Department SHIP-KEF, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
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Wohlgemuth A, Michalowsky B, Hoffmann W, Platen M, Engeli S, Wucherer D, Ittermann T. Prescriptions for Potentially Inappropriate Medication (PIM). Dtsch Arztebl Int 2024; 121:25-26. [PMID: 38386944 PMCID: PMC10916766 DOI: 10.3238/arztebl.m2023.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Anne Wohlgemuth
- University Medicine Greifswald, Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Greifswald,
| | - Bernhard Michalowsky
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald
| | - Wolfgang Hoffmann
- University Medicine Greifswald, Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Greifswald,
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald
| | - Moritz Platen
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald
| | - Stefan Engeli
- University Medicine Greifswald, Institute for Pharmacology, Greifswald
| | - Diana Wucherer
- German Centre for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald
- These authors share last authorship
| | - Till Ittermann
- University Medicine Greifswald, Institute for Community Medicine, Section Study of Health in Pomerania (SHIP), Greifswald
- These authors share last authorship
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Truthmann J, Freyer Martins Pereira J, Richter A, Schuster F, Witte A, Böhm S, Greser A, Kamin P, Stracke S, Dörr M, Bülow R, Engeli S, Gágyor I, Hummers E, Chenot JF. Prednisolone Versus Colchicine for Acute Gout in Primary Care (COPAGO): protocol for a two-arm multicentre, pragmatic, prospective, randomized, double-blind, controlled clinical trial of prednisolone and colchicine for non-inferiority with a parallel group design. Trials 2023; 24:643. [PMID: 37798801 PMCID: PMC10557330 DOI: 10.1186/s13063-023-07666-6] [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] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Gout is the most common form of rheumatic disease in which monosodium urate crystals are deposited in the joints followed by acute inflammatory reactions. There are various approved drugs that can be prescribed for pain relief during an acute gout attack. However, to date, no direct comparison of efficacy of colchicine and prednisolone for the treatment of acute gout attacks has been investigated. Furthermore, the majority of previous research studies were not only conducted in tertiary centres but also excluded patients with common comorbidities due to contraindications to naproxen. METHODS This pragmatic, prospective, double-blind, double-dummy, parallel-group, randomized, non-inferiority trial investigates whether prednisolone (intervention) is non-inferior to treatment with colchicine (active control) in patients with acute gout. Adult patients presenting with acute gout to their general practitioners in 60 practices across 3 university sites (Greifswald, Göttingen, and Würzburg) are eligible to participate in the study. Participants in the intervention group receive 30 mg prednisolone for 5 days. Those in the control group receive low-dose colchicine (day 1: 1.5 mg; days 2-5: 1 mg). The primary outcome is the absolute level of the most severe pain on day 3 (in the last 24 h) measured with an 11-item numerical rating scale. Day 0 is the day patients take their study medication for the first time. They are then asked to fill out a study diary the same time each day for pain quantification. Pain scores are used for comparison between the two medications. Secondary outcomes are average response to treatment, swelling, tenderness and physical function of the joint, patients' global assessment of treatment success, use of additional pain medication and non-pharmacological pain therapies. For safety reasons, potential side effects and course of systolic blood pressure are assessed. DISCUSSION This trial will provide evidence on the effectiveness of pain reduction and side effects of colchicine and prednisolone in acute gout in primary care. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05698680 first posted on January 26, 2023 (retrospectively registered). URL of trial registry record: https://clinicaltrials.gov/study/NCT05698680.
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Affiliation(s)
- Julia Truthmann
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany.
| | - Julia Freyer Martins Pereira
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Adrian Richter
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
| | - Franziska Schuster
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Amelie Witte
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Susanne Böhm
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
| | - Alexandra Greser
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Petra Kamin
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Sylvia Stracke
- Department of Internal Medicine, University Medical Center, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine, University Medical Center, Greifswald, Germany
| | - Robin Bülow
- Institute for Radiology and Neuroradiology, University Medical Center Greifswald, Greifswald, Germany
| | - Stefan Engeli
- Coordinating Center for Clinical Studies, University Medical Center Greifswald, Greifswald, Germany
- Institute of Pharmacology, University Medical Center Greifswald, Greifswald, Germany
| | - Ildikó Gágyor
- Department of General Practice, University Hospital Würzburg, Würzburg, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Jean-François Chenot
- Department of General Practice, Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Germany
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Senekowitsch S, Foja C, Wildgrube T, Schick P, Rosenbaum C, Krause J, Brokmann F, Kromrey ML, Engeli S, Weitschies W, Grimm M. Intragastric Carbon Dioxide Release Prolongs the Gastric Residence Time of Postprandially Administered Caffeine. Pharmaceutics 2023; 15:pharmaceutics15031012. [PMID: 36986872 PMCID: PMC10056953 DOI: 10.3390/pharmaceutics15031012] [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: 02/20/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Sparkling water is said to increase gastric motility by the release of carbon dioxide, thereby potentially affecting the pharmacokinetics of orally administered drugs. The hypothesis of the present work was that the induction of gastric motility by intragastric release of carbon dioxide from effervescent granules could promote the mixing of drugs into the chyme under postprandial conditions, resulting in a prolonged drug absorption. For this purpose, an effervescent and a non-effervescent granule formulation of caffeine as a marker for gastric emptying were developed. In a three-way crossover study with twelve healthy volunteers, the salivary caffeine pharmacokinetics, after administration of the effervescent granules with still water and the administration of the non-effervescent granules with still and sparkling water, were investigated after intake of a standard meal. While the administration of the effervescent granules with 240 mL of still water led to a significantly prolonged gastric residence of the substance compared to the administration of the non-effervescent granules with 240 mL still water, the application of the non-effervescent granules with 240 mL sparkling water did not prolong gastric residence via mixing into caloric chyme. Overall, the mixing of caffeine into the chyme following the administration of the effervescent granules did not seem to be a motility mediated process.
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Affiliation(s)
- Stefan Senekowitsch
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Constantin Foja
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Toni Wildgrube
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Philipp Schick
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Christoph Rosenbaum
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Julius Krause
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Friederike Brokmann
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Marie-Luise Kromrey
- Department of Diagnostic Radiology and Neuroradiology, University Hospital Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Stefan Engeli
- Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Werner Weitschies
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
| | - Michael Grimm
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport (C_DAT), University of Greifswald, Felix-Hausdorff-Str. 3, 17487 Greifswald, Germany
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5
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Schäfer E, Scheer C, Saljé K, Fritz A, Kohlmann T, Hübner NO, Napp M, Fiedler-Lacombe L, Stahl D, Rauch B, Nauck M, Völker U, Felix S, Lucchese G, Flöel A, Engeli S, Hoffmann W, Hahnenkamp K, Tzvetkov MV. Course of disease and risk factors for hospitalization in outpatients with a SARS-CoV-2 infection. Sci Rep 2022; 12:7249. [PMID: 35508524 PMCID: PMC9065670 DOI: 10.1038/s41598-022-11103-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 04/11/2022] [Indexed: 12/02/2022] Open
Abstract
We analyzed symptoms and comorbidities as predictors of hospitalization in 710 outpatients in North-East Germany with PCR-confirmed SARS-CoV-2 infection. During the first 3 days of infection, commonly reported symptoms were fatigue (71.8%), arthralgia/myalgia (56.8%), headache (55.1%), and dry cough (51.8%). Loss of smell (anosmia), loss of taste (ageusia), dyspnea, and productive cough were reported with an onset of 4 days. Anosmia or ageusia were reported by only 18% of the participants at day one, but up to 49% between days 7 and 9. Not all participants who reported ageusia also reported anosmia. Individuals suffering from ageusia without anosmia were at highest risk of hospitalization (OR 6.8, 95% CI 2.5–18.1). They also experienced more commonly dyspnea and nausea (OR of 3.0, 2.9, respectively) suggesting pathophysiological connections between these symptoms. Other symptoms significantly associated with increased risk of hospitalization were dyspnea, vomiting, and fever. Among basic parameters and comorbidities, age > 60 years, COPD, prior stroke, diabetes, kidney and cardiac diseases were also associated with increased risk of hospitalization. In conclusion, due to the delayed onset, ageusia and anosmia may be of limited use in differential diagnosis of SARS-CoV-2. However, differentiation between ageusia and anosmia may be useful for evaluating risk for hospitalization.
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Affiliation(s)
- Eik Schäfer
- Department of Clinical Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Greifswald, Germany.,Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Scheer
- Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Karen Saljé
- Department of Clinical Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Greifswald, Germany
| | - Anja Fritz
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, 17489, Greifswald, Germany
| | - Thomas Kohlmann
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Nils-Olaf Hübner
- Central Unit for Infection Prevention and Control, University Medicine Greifswald, Greifswald, Germany.,Institute of Hygiene and Environmental Medicine, University of Greifswald, Greifswald, Germany
| | - Matthias Napp
- Departments of Emergency and Acute Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Lizon Fiedler-Lacombe
- Independent Trusted Third Party, University Medicine Greifswald, Greifswald, Germany
| | - Dana Stahl
- Independent Trusted Third Party, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard Rauch
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, 17489, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Uwe Völker
- Department of Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Stephan Felix
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Guglielmo Lucchese
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Engeli
- Department of Clinical Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Klaus Hahnenkamp
- Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Mladen V Tzvetkov
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, 17489, Greifswald, Germany.
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6
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Jungnickel T, von Jan U, Engeli S, Albrecht UV. Exploring the weight bias of professionals working in the field of obesity with a mobile IAT: a pilot study. Ther Adv Endocrinol Metab 2022; 13:20420188221098881. [PMID: 35592657 PMCID: PMC9112301 DOI: 10.1177/20420188221098881] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Obesity is common in many industrialized nations and often accompanied by related health issues. Furthermore, individuals living with overweight or obesity are often confronted with stigmatization in their daily lives. These problems may be aggravated if the objectivity of health care professionals is compromised due to (unconscious) prejudices. If pharmaceutical companies, regulatory agencies, and health insurers are also susceptible to these biases, decisions related to the development, approval, and reimbursement of obesity-related therapies may be negatively impacted. MATERIALS AND METHODS The 'Implicit Association Test' (IAT) is a psychometric test allowing to measure these attitudes and could therefore assist to reveal unconscious preferences. A self-developed mobile version, in the form of a ResearchKit-based IAT app was employed in the presented study. The objective was to determine (potential) weight bias and its characteristics for professionals attending a national obesity-related conference in Germany (G1), compared to a control group (without stated interest in the topic, G2) - both using the mobile app - and a historical control (G3) based on data provided by Project Implicit acquired by a web app. RESULTS Explicit evaluations of G1 were neutral at a higher percentage compared with G2 and G3, while implicit preference toward lean individuals did not differ significantly between G2 and G3, and G1. CONCLUSION The greater discrepancy between the (more neutral) explicit attitude and the unconscious preference pointing in the anti-obesity direction could indicate an underestimated bias for the professional participants in G1. Implicit preference is often ingrained from childhood on, and difficult to overcome. Thus, even for professionals, it may unconsciously influence decisions made in the care they provide. Professionals in any given health care sector directed at obesity care should thus be made aware of this inconsistency to enable them to consciously counteract this potential effect.
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Affiliation(s)
- Tobias Jungnickel
- Peter L. Reichertz Institute for Medical
Informatics of the TU Braunschweig and Hannover Medical School, Hannover
Medical School, Hannover, Germany
| | - Ute von Jan
- Peter L. Reichertz Institute for Medical
Informatics of the TU Braunschweig and Hannover Medical School, Hannover
Medical School, Hannover, Germany
| | | | - Urs-Vito Albrecht
- Peter L. Reichertz Institute for Medical
Informatics of the TU Braunschweig and Hannover Medical School, Hannover
Medical School, Hannover, Germany
- Department of Digital Medicine, Medical Faculty
OWL, Bielefeld University, Bielefeld, Germany
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7
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Henke C, Haufe S, Ziehl D, Bornstein SR, Schulz-Menger J, Heni M, Engeli S, Jordan J, Birkenfeld AL. Low-fat hypocaloric diet reduces neprilysin in overweight and obese human subjects. ESC Heart Fail 2021; 8:938-942. [PMID: 33638612 PMCID: PMC8006681 DOI: 10.1002/ehf2.13220] [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: 03/30/2020] [Revised: 10/04/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS Neprilysin (NEP), a zinc metallopeptidase, degrades a variety of bioactive peptides including natriuretic peptides terminating their biological action on arterial blood pressure and natriuresis. Pharmacological inhibition of NEP reduces mortality in patients with heart failure with reduced ejection fraction. Physiological interventions reducing NEP levels are unknown in humans. Because obesity leads to increased NEP levels and increases the risk for heart failure, we hypothesized that weight loss reduces NEP concentrations in plasma and tissue. METHODS AND RESULTS We randomized overweight to obese human subjects to a low-fat or low-carbohydrate hypocaloric 6 month weight loss intervention. Soluble NEP was determined in plasma, and NEP mRNA was analysed from subcutaneous adipose tissue before and after diet. Low-fat diet-induced weight loss reduced soluble NEP levels from 0.83 ± 0.18 to 0.72 ± 0.18 μg/L (P = 0.038), while subcutaneous adipose tissue NEP mRNA expression was reduced by both dietary interventions [21% (P = 0.0057) by low-fat diet and 16% (P = 0.048) by low-carbohydrate diet]. We also analysed the polymorphisms of the gene coding for NEP, rs9827586 and rs701109, known to be associated with plasma NEP levels. For both single-nucleotide polymorphisms, minor allele carriers (A/A) had higher baseline plasma NEP levels (rs9827586: β = 0.53 ± 0.23, P < 0.0001; rs701109: β = 0.43 ± 0.22, P = 0.0016), and minor allele carriers of rs9827586 responded to weight loss with a larger NEP reduction (rs9827586: P = 0.0048). CONCLUSIONS Our study identifies weight loss via a hypocaloric low-fat diet as the first physiological intervention in humans to reduce NEP in plasma and adipose tissue. Specific single-nucleotide polymorphisms further contribute to the decrease. Our findings may help to explain the beneficial effect of weight loss on cardiac function in patients with heart failure.
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Affiliation(s)
- Christine Henke
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, Hanover, Germany
| | - Doreen Ziehl
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stefan R Bornstein
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Department of Diabetes, School of Life Course Science and Medicine, King's College London, London, UK
| | - Jeanette Schulz-Menger
- Experimental and Clinical Research Center (ECRC), a joint collaboration between Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Department of Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Martin Heni
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Section of Internal Medicine IV, Department of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Ottfriet-Müller-Str. 10, Tübingen, 72076, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Andreas L Birkenfeld
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Department of Diabetes, School of Life Course Science and Medicine, King's College London, London, UK.,Section of Internal Medicine IV, Department of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Ottfriet-Müller-Str. 10, Tübingen, 72076, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
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8
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Hein M, Chobanyan-Jürgens K, Tegtbur U, Engeli S, Jordan J, Haufe S. Effect of normobaric hypoxic exercise on blood pressure in old individuals. Eur J Appl Physiol 2020; 121:817-825. [PMID: 33355713 PMCID: PMC7892684 DOI: 10.1007/s00421-020-04572-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 03/05/2020] [Accepted: 11/25/2020] [Indexed: 12/28/2022]
Abstract
Purpose To test the hypothesis that the combination of endurance training and hypoxia leads to greater improvements in resting and exercise blood pressure in old sedentary individuals compared to endurance training only. Methods We randomly assigned 29 old overweight participants (age: 62 ± 6 years, body mass index (BMI): 28.5 ± 0.5 kg/m2, 52% men) to single blind 8-week bicycle exercise in hypoxia (fraction of inspired oxygen (FIO2) = 0.15) or normoxia (FIO2 = 0.21). Brachial blood pressure was measured at rest, during maximal incremental exercise testing, and during a 30 min constant work rate test, at baseline and after the training period. Results Work rate, heart rate and perceived exertion during training were similar in both groups, with lower oxygen saturation for participants exercising under hypoxia (88.7 ± 1.5 vs. 96.2 ± 1.2%, t(27) = − 13.04, p < 0.001, |g|= 4.85). Office blood pressure and blood pressure during incremental exercise tests did not change significantly in either group after the training program. Systolic blood pressure during the constant work rate test was reduced after training in hypoxia (160 ± 18 vs. 151 ± 14 mmHg, t(13) = 2.44 p < 0.05, |d|= 0.55) but not normoxia (154 ± 22 vs. 150 ± 16 mmHg, t(14) = 0.75, p = 0.46, |d|= 0.18) with no difference between groups over time (F = 0.08, p = 0.77, η2 = 0.01). Conclusion In old individuals hypoxia in addition to exercise does not have superior effects on office or exercise blood pressure compared to training in normoxia. Trial registration number ClinicalTrials.gov No. NCT02196623 (registered 22 July 2014).
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Affiliation(s)
- Markus Hein
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kristine Chobanyan-Jürgens
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center and University of Cologne, Cologne, Germany
| | - Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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9
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Abstract
There are many angles to consider in drug treatment of obese patients. On the one hand, some specific weight loss drugs are available, on the other, several drugs are associated with unintentional weight changes. When treating an obese patient for any given disease, several physiological changes may influence the pharmacokinetic properties of the drugs required. Thus, increased body weight may influence the efficacy and safety of some drug treatments. Even more complicated is the situation after weight reduction surgery. Due to the various changes to the gastrointestinal tract induced by the different surgical techniques used, and the dynamic changes in body composition thereafter, drug dosing has to be constantly reconsidered. Whereas all of these issues are of clinical importance, none of them have been investigated in the necessary depth and broadness to ensure safe and efficacious drug treatment of the massively obese patient. Individual considerations have to be based on comorbidities, concomitant medication, and on specific drug properties, for example, lipophilicity, volume of distribution, and metabolism. In this article we summarize the data available on different aspects of drug treatment in the obese patient with the hope of improving patient care.
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Affiliation(s)
| | - Christoph Schindler
- MHH Clinical Research Center Core Facility (OE 8660) and Center for Pharmacology and Toxicology, Hannover, Germany
| | - Stefan Engeli
- Hannover Medical School, Institute of Clinical Pharmacology, Hannover, Germany
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10
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Chobanyan-Jürgens K, Scheibe RJ, Potthast AB, Hein M, Smith A, Freund R, Tegtbur U, Das AM, Engeli S, Jordan J, Haufe S. Influences of Hypoxia Exercise on Whole-Body Insulin Sensitivity and Oxidative Metabolism in Older Individuals. J Clin Endocrinol Metab 2019; 104:5238-5248. [PMID: 30942862 DOI: 10.1210/jc.2019-00411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/18/2019] [Accepted: 03/28/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT Aging is a primary risk factor for most chronic diseases, including type 2 diabetes. Both exercise and hypoxia regulate pathways that ameliorate age-associated metabolic muscle dysfunction. OBJECTIVE We hypothesized that the combination of hypoxia and exercise would be more effective in improving glucose metabolism than normoxia exercise. DESIGN AND PARTICIPANTS We randomized 29 older sedentary individuals (62 ± 6 years; 14 women, 15 men) to bicycle exercise under normobaric hypoxia (fraction of inspired oxygen = 15%) or normoxia (fraction of inspired oxygen = 21%). INTERVENTION Participants trained thrice weekly for 30 to 40 minutes over 8 weeks at a heart rate corresponding to 60% to 70% of peak oxygen update. MAIN OUTCOME MEASURES Insulin sensitivity measured by hyperinsulinemic-euglycemic glucose clamp and muscle protein expression before and after hyperinsulinemic-euglycemic glucose clamp. RESULTS Heart rate and perceived exertion during training were similar between groups, with lower oxygen saturation when exercising under hypoxia (88.7 ± 1.5 vs 96.2 ± 1.2%, P < 0.01). Glucose infusion rate after 8 weeks increased in both the hypoxia (5.7 ± 1.1 to 6.7 ± 1.3 mg/min/kg; P < 0.01) and the normoxia group (6.2 ± 2.1 to 6.8 ± 2.1 mg/min/kg; P = 0.04), with a mean difference between groups of -0.44 mg/min/kg; 95% CI, -1.22 to 0.34; (P = 0.25). Markers of mitochondrial content and oxidative capacity in skeletal muscle were similar after training in both groups. Changes in Akt phosphorylation and glucose transporter 4 under fasting and insulin-stimulated conditions were not different between groups over time. CONCLUSIONS Eight weeks of hypoxia endurance training led to similar changes in insulin sensitivity and markers of oxidative metabolism compared with normoxia training. Normobaric hypoxia exercise did not enhance metabolic effects in sedentary older women and men beyond exercise alone.
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Affiliation(s)
- Kristine Chobanyan-Jürgens
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Renate J Scheibe
- Institute of Cell Biochemistry, Hannover Medical School, Hannover, Germany
| | - Arne B Potthast
- Department of Pediatrics, Pediatric Metabolic Medicine, Hannover Medical School, Hannover, Germany
| | - Markus Hein
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Andrea Smith
- Institute of Biometry, Hannover Medical School, Hannover, Germany
| | - Robert Freund
- Institute of Cell Biochemistry, Hannover Medical School, Hannover, Germany
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Anibh M Das
- Department of Pediatrics, Pediatric Metabolic Medicine, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Sven Haufe
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
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11
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Abstract
OBJECTIVES In addition to its use as a volume filler, fat grafting may have a potential role in wound healing based on the concentration of growth factors in the lipoaspirate. In this study, we compare the quantitative and qualitative concentration of the various growth factors and adipokines using the Shippert or the Coleman techniques to prepare the lipoaspirate. METHODS We measured leptin, adiponectin and the growth factors, i.e., acidic fibroblast growth factor (aFGF), basic FGF (bFGF), keratinocyte growth factor (KGF), bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) by ELISA in solid and liquid fractions obtained with both techniques in human fat obtained with Coleman technique and Shippert technique. RESULTS All of these peptides, except BMP-2, were detected in relevant quantities in the solid fraction. The Coleman but not the Shippert technique resulted in statistically higher adiponectin concentrations in the solid tissue fraction. The other four growth factors occurred in significantly higher concentrations in the solid fractions compared to the liquid fractions, independent of the processing technique. CONCLUSION In summary, we demonstrated that KGF, aFGF, bFGF and VEGF, as well as leptin and adiponectin, are contained in fat suspensions obtained by liposuction and in the supernatant. Only the concentration of adiponectin was in the range reported to contribute to wound healing.
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Affiliation(s)
- Christian Herold
- Department of Plastic and Aesthetic Surgery, Hand Surgery, Sana Klinikum Hameln Pyrmont, Hameln, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Bibiana Beckmann
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Peter M Vogt
- Department of Plastic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany
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12
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Eigendorf J, May M, Friedrich J, Engeli S, Maassen N, Gros G, Meissner JD. High Intensity High Volume Interval Training Improves Endurance Performance and Induces a Nearly Complete Slow-to-Fast Fiber Transformation on the mRNA Level. Front Physiol 2018; 9:601. [PMID: 29897050 PMCID: PMC5987183 DOI: 10.3389/fphys.2018.00601] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 01/29/2018] [Accepted: 05/03/2018] [Indexed: 12/29/2022] Open
Abstract
We present here a longitudinal study determining the effects of two 3 week-periods of high intensity high volume interval training (HIHVT) (90 intervals of 6 s cycling at 250% maximum power, Pmax/24 s) on a cycle ergometer. HIHVT was evaluated by comparing performance tests before and after the entire training (baseline, BSL, and endpoint, END) and between the two training sets (intermediate, INT). The mRNA expression levels of myosin heavy chain (MHC) isoforms and markers of energy metabolism were analyzed in M. vastus lateralis biopsies by quantitative real-time PCR. In incremental tests peak power (Ppeak) was increased, whereas V ˙ O2peak was unaltered. Prolonged time-to-exhaustion was found in endurance tests with 65 and 80% Pmax at INT and END. No changes in blood levels of lipid metabolites were detected. Training-induced decreases of hematocrit indicate hypervolemia. A shift from slow MHCI/β to fast MHCIIa mRNA expression occurred after the first and second training set. The mRNA expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α), a master regulator of oxidative energy metabolism, decreased after the second training set. In agreement, a significant decrease was also found for citrate synthase mRNA after the second training set, indicating reduced oxidative capacity. However, mRNA expression levels of glycolytic marker enzyme glyceraldehyde-3-phosphate dehydrogenase did not change after the first and second training set. HIHVT induced a nearly complete slow-to-fast fiber type transformation on the mRNA level, which, however, cannot account for the improvements of performance parameters. The latter might be explained by the well-known effects of hypervolemia on exercise performance.
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Affiliation(s)
- Julian Eigendorf
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Marcus May
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - Jan Friedrich
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Norbert Maassen
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
| | - Gerolf Gros
- Molecular and Cell Physiology, AG Vegetative Physiology, Hannover Medical School, Hannover, Germany
| | - Joachim D. Meissner
- Molecular and Cell Physiology, AG Vegetative Physiology, Hannover Medical School, Hannover, Germany
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13
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Jung FUCE, Luck-Sikorski C, Krüger M, Wiacek C, Braun PG, Engeli S, Riedel-Heller SG. Eat healthy? Attitudes of the German population towards industrially produced cardioprotective food. Nutr Metab Cardiovasc Dis 2018; 28:486-493. [PMID: 29519559 DOI: 10.1016/j.numecd.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 08/23/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIM Cardiovascular disease (CVD) is likely to increase in incidence. Foods with cardioprotective functions, e.g. specific functional food, could reduce CVD risk factors and hence CVD incidence. Little is known about industrially modified foods with cardioprotective functions. METHODS AND RESULTS In a large German sample (n = 1007), attitudes of consumers in Germany towards industrially produced cardioprotective food were assessed using Cluster analyses. Consumers were contacted via telephone and interviewed using questionnaires. Overall, about 25% knew about industrially produced food with cardioprotective function. Our analysis revealed a small but determined group of consumers who think very skeptical about cardioprotective products, but we also identified a favorable group. These two groups only differed in age, with the skeptical group being ten years older. CONCLUSIONS The rising number of industrially modified products with potential cardioprotective benefit is met by skepticism and a lack of knowledge by German costumers. If large scale studies show health benefits of these products, these will need to be better communicated to German customers in order to address possible doubts or concerns and to encourage healthy eating habits in consumer eating behavior.
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Affiliation(s)
- F U C E Jung
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany; Integrated Research and Treatment Center AdiposityDiseases (IFB), University of Leipzig, Leipzig, Germany.
| | - C Luck-Sikorski
- Integrated Research and Treatment Center AdiposityDiseases (IFB), University of Leipzig, Leipzig, Germany; SRH University of Applied Sciences, Neue Str. 28-30, 07548, Gera, Germany
| | - M Krüger
- SRH University of Applied Sciences, Neue Str. 28-30, 07548, Gera, Germany
| | - C Wiacek
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany; Institute of Food Hygiene, Center of Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - P G Braun
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany; Institute of Food Hygiene, Center of Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
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14
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Stinkens R, van der Kolk BW, Jordan J, Jax T, Engeli S, Heise T, Jocken JW, May M, Schindler C, Havekes B, Schaper N, Albrecht D, Kaiser S, Hartmann N, Letzkus M, Langenickel TH, Goossens GH, Blaak EE. The effects of angiotensin receptor neprilysin inhibition by sacubitril/valsartan on adipose tissue transcriptome and protein expression in obese hypertensive patients. Sci Rep 2018; 8:3933. [PMID: 29500454 PMCID: PMC5834447 DOI: 10.1038/s41598-018-22194-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 08/17/2017] [Accepted: 02/19/2018] [Indexed: 01/30/2023] Open
Abstract
Increased activation of the renin-angiotensin system is involved in the onset and progression of cardiometabolic diseases, while natriuretic peptides (NP) may exert protective effects. We have recently demonstrated that sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, which blocks the angiotensin II type-1 receptor and augments natriuretic peptide levels, improved peripheral insulin sensitivity in obese hypertensive patients. Here, we investigated the effects of sacubitril/valsartan (400 mg QD) treatment for 8 weeks on the abdominal subcutaneous adipose tissue (AT) phenotype compared to the metabolically neutral comparator amlodipine (10 mg QD) in 70 obese hypertensive patients. Abdominal subcutaneous AT biopsies were collected before and after intervention to determine the AT transcriptome and expression of proteins involved in lipolysis, NP signaling and mitochondrial oxidative metabolism. Both sacubitril/valsartan and amlodipine treatment did not significantly induce AT transcriptional changes in pathways related to lipolysis, NP signaling and oxidative metabolism. Furthermore, protein expression of adipose triglyceride lipase (ATGL) (Ptime*group = 0.195), hormone-sensitive lipase (HSL) (Ptime*group = 0.458), HSL-ser660 phosphorylation (Ptime*group = 0.340), NP receptor-A (NPRA) (Ptime*group = 0.829) and OXPHOS complexes (Ptime*group = 0.964) remained unchanged. In conclusion, sacubitril/valsartan treatment for 8 weeks did not alter the abdominal subcutaneous AT transcriptome and expression of proteins involved in lipolysis, NP signaling and oxidative metabolism in obese hypertensive patients.
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Affiliation(s)
- R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - B W van der Kolk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - J Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - T Jax
- Profil GmbH, Neuss, Germany
| | - S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | | | - J W Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M May
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - C Schindler
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - B Havekes
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - N Schaper
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - D Albrecht
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - S Kaiser
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - N Hartmann
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - M Letzkus
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - T H Langenickel
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - G H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - E E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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15
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Engeli S, Stinkens R, Heise T, May M, Goossens GH, Blaak EE, Havekes B, Jax T, Albrecht D, Pal P, Tegtbur U, Haufe S, Langenickel TH, Jordan J. Effect of Sacubitril/Valsartan on Exercise-Induced Lipid Metabolism in Patients With Obesity and Hypertension. Hypertension 2017; 71:70-77. [PMID: 29180454 PMCID: PMC5753808 DOI: 10.1161/hypertensionaha.117.10224] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/11/2017] [Accepted: 10/18/2017] [Indexed: 12/11/2022]
Abstract
Supplemental Digital Content is available in the text. Sacubitril/valsartan (LCZ696), a novel angiotensin receptor-neprilysin inhibitor, was recently approved for the treatment of heart failure with reduced ejection fraction. Neprilysin degrades several peptides that modulate lipid metabolism, including natriuretic peptides. In this study, we investigated the effects of 8 weeks’ treatment with sacubitril/valsartan on whole-body and adipose tissue lipolysis and lipid oxidation during defined physical exercise compared with the metabolically neutral comparator amlodipine. This was a multicenter, randomized, double-blind, active-controlled, parallel-group study enrolling subjects with abdominal obesity and moderate hypertension (mean sitting systolic blood pressure ≥130–180 mm Hg). Lipolysis during rest and exercise was assessed by microdialysis and [1,1,2,3,3-2H]-glycerol tracer kinetics. Energy expenditure and substrate oxidation were measured simultaneously using indirect calorimetry. Plasma nonesterified fatty acids, glycerol, insulin, glucose, adrenaline and noradrenaline concentrations, blood pressure, and heart rate were also determined. Exercise elevated plasma glycerol, free fatty acids, and interstitial glycerol concentrations and increased the rate of glycerol appearance. However, exercise-induced stimulation of lipolysis was not augmented on sacubitril/valsartan treatment compared with amlodipine treatment. Furthermore, sacubitril/valsartan did not alter energy expenditure and substrate oxidation during exercise compared with amlodipine treatment. In conclusion, sacubitril/valsartan treatment for 8 weeks did not elicit clinically relevant changes in exercise-induced lipolysis or substrate oxidation in obese patients with hypertension, implying that its beneficial cardiovascular effects cannot be explained by changes in lipid metabolism during exercise.
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Affiliation(s)
- Stefan Engeli
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Rudi Stinkens
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Tim Heise
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Marcus May
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Gijs H Goossens
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Ellen E Blaak
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Bas Havekes
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Thomas Jax
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Diego Albrecht
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Parasar Pal
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Uwe Tegtbur
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Sven Haufe
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Thomas H Langenickel
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.)
| | - Jens Jordan
- From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department of Internal Medicine (B.H.), Maastricht University Medical Center, The Netherlands; Profil, Neuss, Germany (T.H., T.J.); Translational Medicine, Novartis Pharma AG, Basel, Switzerland (D.A., T.H.L.); Biostatistical Sciences, Integrated Development Functions and Regions, Novartis Healthcare Pvt. Ltd, Hyderabad, India (P.P.); and Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, University of Cologne, Germany (J.J.).
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16
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Haddad S, Wang Y, Galy B, Korf-Klingebiel M, Hirsch V, Baru AM, Rostami F, Reboll MR, Heineke J, Flögel U, Groos S, Renner A, Toischer K, Zimmermann F, Engeli S, Jordan J, Bauersachs J, Hentze MW, Wollert KC, Kempf T. Iron-regulatory proteins secure iron availability in cardiomyocytes to prevent heart failure. Eur Heart J 2017; 38:362-372. [PMID: 27545647 DOI: 10.1093/eurheartj/ehw333] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 07/12/2016] [Indexed: 12/28/2022] Open
Abstract
Aims Iron deficiency (ID) is associated with adverse outcomes in heart failure (HF) but the underlying mechanisms are incompletely understood. Intracellular iron availability is secured by two mRNA-binding iron-regulatory proteins (IRPs), IRP1 and IRP2. We generated mice with a cardiomyocyte-targeted deletion of Irp1 and Irp2 to explore the functional implications of ID in the heart independent of systemic ID and anaemia. Methods and results Iron content in cardiomyocytes was reduced in Irp-targeted mice. The animals were not anaemic and did not show a phenotype under baseline conditions. Irp-targeted mice, however, were unable to increase left ventricular (LV) systolic function in response to an acute dobutamine challenge. After myocardial infarction, Irp-targeted mice developed more severe LV dysfunction with increased HF mortality. Mechanistically, the activity of the iron-sulphur cluster-containing complex I of the mitochondrial electron transport chain was reduced in left ventricles from Irp-targeted mice. As demonstrated by extracellular flux analysis in vitro, mitochondrial respiration was preserved at baseline but failed to increase in response to dobutamine in Irp-targeted cardiomyocytes. As shown by 31P-magnetic resonance spectroscopy in vivo, LV phosphocreatine/ATP ratio declined during dobutamine stress in Irp-targeted mice but remained stable in control mice. Intravenous injection of ferric carboxymaltose replenished cardiac iron stores, restored mitochondrial respiratory capacity and inotropic reserve, and attenuated adverse remodelling after myocardial infarction in Irp-targeted mice but not in control mice. As shown by electrophoretic mobility shift assays, IRP activity was significantly reduced in LV tissue samples from patients with advanced HF and reduced LV tissue iron content. Conclusions ID in cardiomyocytes impairs mitochondrial respiration and adaptation to acute and chronic increases in workload. Iron supplementation restores cardiac energy reserve and function in iron-deficient hearts.
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Affiliation(s)
- Saba Haddad
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Yong Wang
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Bruno Galy
- European Molecular Biology Laboratory, Meyerhofstraße 1, 69117 Heidelberg, Germany.,Division of Virus-associated Carcinogenesis, German Cancer Research Centre, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Mortimer Korf-Klingebiel
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Valentin Hirsch
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Abdul M Baru
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Fatemeh Rostami
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Marc R Reboll
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Jörg Heineke
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Ulrich Flögel
- Department of Molecular Cardiology, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Stephanie Groos
- Institute of Cell Biology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - André Renner
- Department of Thoracic and Cardiovascular Surgery, University of Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany
| | - Karl Toischer
- Department of Cardiology and Pneumology, University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Fabian Zimmermann
- Department of Analytical Chemistry, Leibniz University Hannover, Callinstraße 1, 30167 Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Matthias W Hentze
- European Molecular Biology Laboratory, Meyerhofstraße 1, 69117 Heidelberg, Germany
| | - Kai C Wollert
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Tibor Kempf
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.,Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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17
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Haufe S, Engeli S, Kaminski J, Witt H, Rein D, Kamlage B, Utz W, Fuhrmann JC, Haas V, Mähler A, Schulz-Menger J, Luft FC, Boschmann M, Jordan J. Branched-chain amino acid catabolism rather than amino acids plasma concentrations is associated with diet-induced changes in insulin resistance in overweight to obese individuals. Nutr Metab Cardiovasc Dis 2017; 27:858-864. [PMID: 28958691 DOI: 10.1016/j.numecd.2017.07.001] [Citation(s) in RCA: 23] [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: 02/27/2017] [Revised: 05/30/2017] [Accepted: 07/03/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND & AIMS 3-Hydroxyisobutyrate (3-HIB), a catabolic intermediate of the BCAA valine, which stimulates muscle fatty acid uptake, has been implicated in the pathogenesis of insulin resistance. We tested the hypothesis that circulating 3-HIB herald insulin resistance and that metabolic improvement with weight loss are related to changes in BCAAs and 3-HIB. METHODS AND RESULTS We analyzed plasma and urine in 109 overweight to obese individuals before and after six months on hypocaloric diets reduced in either carbohydrates or fat. We calculated the homeostasis model assessment index (HOMA-IR) and whole body insulin sensitivity from oral glucose tolerance tests and measured intramyocellular fat by magnetic resonance spectroscopy. BCAAs and 3-HIB plasma concentrations were inversely related to insulin sensitivity but not to intramyocellular fat content at baseline. With 7.4 ± 4.5% weight loss mean BCAA and 3-HIB plasma concentrations did not change, irrespective of dietary macronutrient content. Individual changes in 3-HIB with 6-month diet but not BCAAs were correlated to the change in whole body insulin sensitivity and HOMA-IR independently of BMI changes. CONCLUSIONS 3-HIB relates to insulin sensitivity but is not associated with intramyocellular fat content in overweight to obese individuals. Moreover, changes in 3-HIB rather than changes in BCAAs are associated with metabolic improvements with weight loss. Registration number for clinical trials: ClinicalTrials.gov Identifier: NCT00956566.
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Affiliation(s)
- S Haufe
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - S Engeli
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - J Kaminski
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - H Witt
- Metanomics GmbH, Berlin, Germany
| | - D Rein
- Metanomics Health GmbH, Berlin, Germany
| | - B Kamlage
- Metanomics Health GmbH, Berlin, Germany
| | - W Utz
- Working Group Cardiac MRI, Clinic for Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Germany; Experimental and Clinical Research Center, University Medicine Berlin, Charité Campus Buch, Germany
| | | | - V Haas
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - A Mähler
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - J Schulz-Menger
- Working Group Cardiac MRI, Clinic for Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Germany; Experimental and Clinical Research Center, University Medicine Berlin, Charité Campus Buch, Germany
| | - F C Luft
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M Boschmann
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - J Jordan
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany; Institute of Aerospace Medicine, German Aerospace Center and Chair of Aerospace Medicine, University of Cologne, Cologne, Germany.
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18
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von Loeffelholz C, Pfeiffer AFH, Lock JF, Lieske S, Döcke S, Murahovschi V, Kriebel J, de Las Heras Gala T, Grallert H, Rudovich N, Stockmann M, Spranger J, Jahreis G, Bornstein SR, Lau G, Xu A, Schulz-Menger J, Exner L, Haufe S, Jordan J, Engeli S, Birkenfeld AL. ANGPTL8 (Betatrophin) is Expressed in Visceral Adipose Tissue and Relates to Human Hepatic Steatosis in Two Independent Clinical Collectives. Horm Metab Res 2017; 49:343-349. [PMID: 28351093 DOI: 10.1055/s-0043-102950] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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] [Indexed: 10/19/2022]
Abstract
Angiopoietin-like protein 8 (ANGPTL8)/betatrophin expression in visceral adipose tissue and associations with circulating fatty acid profile have not yet been investigated.Forty subjects were included in a cross-sectional study, 57 in a dietary weight reduction intervention. Circulating Angiopoietin-like protein 8/betatrophin was measured in all subjects. Liver and adipose tissue were sampled and plasma fatty acids and tissue Angiopoietin-like protein 8/betatrophin expression were evaluated in the cross-sectional study. In the intervention study oral glucose testing and liver magnetic resonance scanning at baseline and after 6 months were performed. Angiopoietin-like protein 8/betatrophin mRNA was increased in visceral compared to subcutaneous adipose tissue (p<0.001). Circulating ANGPTL8/betatrophin correlated with liver steatosis (r=0.42, p=0.047), triacylglycerols (r=0.34, p=0.046), saturated (r=0.43, p=0.022), monounsaturated (r=0.51, p=0.007), and polyunsaturated fatty acids (r=-0.53, p=0.004). In the intervention study, baseline Angiopoietin-like protein 8/betatrophin correlated with age (r=0.32, p=0.010) and triacylglycerols (r=0.30, p=0.02) and was increased with hepatic steatosis (p=0.033). Weight loss reduced liver fat by 45% and circulating Angiopoietin-like protein 8/betatrophin by 11% (288±17 vs. 258±17 pg/ml; p=0.015). Angiopoietin-like protein 8/betatrophin is related to liver steatosis, while visceral adipose tissue represents an additional site of expression in humans.
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Affiliation(s)
- Christian von Loeffelholz
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Andreas F H Pfeiffer
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Johan F Lock
- Department of General-, Visceral-, Vascular- and Paediatric Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Steffi Lieske
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stephanie Döcke
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Veronica Murahovschi
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Jennifer Kriebel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Neuherberg, Germany
| | - Tonia de Las Heras Gala
- Research Unit of Diabetes Epidemiology, Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Neuherberg, Germany
| | - Natalia Rudovich
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Martin Stockmann
- Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin, Berlin, Germany
| | - Joachim Spranger
- Department of Endocrinology, Diabetes, and Nutrition, Charité - Universitätsmedizin, Berlin, Germany
| | - Gerhard Jahreis
- Institute of Nutrition, Friedrich Schiller University, Jena, Germany
| | - Stefan R Bornstein
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - George Lau
- Humanity and Health GI and Liver Centre, University of Hong Kong, Hong Kong SAR, China
| | - Aimin Xu
- Department of Pharmacology & Pharmacy, University of Hong Kong, Hong Kong SAR, China
| | - Jeanette Schulz-Menger
- Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Max-Delbrück-Centrum and Charité-Medical University Berlin and HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Louisa Exner
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Sven Haufe
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Andreas L Birkenfeld
- Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany
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19
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Kayacelebi AA, Schauerte C, Kling K, Herbers J, Beckmann B, Engeli S, Jordan J, Zoerner AA, Tsikas D. Cross-validated stable-isotope dilution GC-MS and LC-MS/MS assays for monoacylglycerol lipase (MAGL) activity by measuring arachidonic acid released from the endocannabinoid 2-arachidonoyl glycerol. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1047:151-159. [PMID: 27511795 DOI: 10.1016/j.jchromb.2016.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 05/06/2016] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 12/30/2022]
Abstract
2-Arachidonoyl glycerol (2AG) is an endocannabinoid that activates cannabinoid (CB) receptors CB1 and CB2. Monoacylglycerol lipase (MAGL) inactivates 2AG through hydrolysis to arachidonic acid (AA) and glycerol, thus modulating the activity at CB receptors. In the brain, AA released from 2AG by the action of MAGL serves as a substrate for cyclooxygenases which produce pro-inflammatory prostaglandins. Here we report stable-isotope GC-MS and LC-MS/MS assays for the reliable measurement of MAGL activity. The assays utilize deuterium-labeled 2AG (d8-2AG; 10μM) as the MAGL substrate and measure deuterium-labeled AA (d8-AA; range 0-1μM) as the MAGL product. Unlabelled AA (d0-AA, 1μM) serves as the internal standard. d8-AA and d0-AA are extracted from the aqueous buffered incubation mixtures by ethyl acetate. Upon solvent evaporation the residue is reconstituted in the mobile phase prior to LC-MS/MS analysis or in anhydrous acetonitrile for GC-MS analysis. LC-MS/MS analysis is performed in the negative electrospray ionization mode by selected-reaction monitoring the mass transitions [M-H]-→[M-H - CO2]-, i.e., m/z 311→m/z 267 for d8-AA and m/z 303→m/z 259 for d0-AA. Prior to GC-MS analysis d8-AA and d0-AA were converted to their pentafluorobenzyl (PFB) esters by means of PFB-Br. GC-MS analysis is performed in the electron-capture negative-ion chemical ionization mode by selected-ion monitoring the ions [M-PFB]-, i.e., m/z 311 for d8-AA and m/z 303 for d0-AA. The GC-MS and LC-MS/MS assays were cross-validated. Linear regression analysis between the concentration (range, 0-1μM) of d8-AA measured by LC-MS/MS (y) and that by GC-MS (x) revealed a straight line (r2=0.9848) with the regression equation y=0.003+0.898x, indicating a good agreement. In dog liver, we detected MAGL activity that was inhibitable by the MAGL inhibitor JZL-184. Exogenous eicosatetraynoic acid is suitable as internal standard for the quantitative determination of d8-AA produced from d8-2AG by hepatic MAGL activity. The formation of d8-prostaglandin E2 by the consecutive catalytic action of recombinant MAGL on d8-2AG and recombinant cyclooxygenase-2 (COX) on d8-AA was demonstrated by GC-MS/MS.
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Affiliation(s)
| | - Celina Schauerte
- Centre of Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany
| | - Katharina Kling
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jan Herbers
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Bibiana Beckmann
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Alexander A Zoerner
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Dimitrios Tsikas
- Centre of Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany.
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20
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Affiliation(s)
- Arya M Sharma
- Franz-Volhard-Klinik at the Max-Delbrück-Center for Molecular Medicine, Universitätsklinikum Charité, Humboldt Universität zu Berlin, Germany,
| | - Stefan Engeli
- Franz-Volhard-Klinik at the Max-Delbrück-Center for Molecular Medicine, Universitätsklinikum Charité, Humboldt Universität zu Berlin, Germany
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21
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Jordan J, Stinkens R, Jax T, Engeli S, Blaak EE, May M, Havekes B, Schindler C, Albrecht D, Pal P, Heise T, Goossens GH, Langenickel TH. Improved Insulin Sensitivity With Angiotensin Receptor Neprilysin Inhibition in Individuals With Obesity and Hypertension. Clin Pharmacol Ther 2016; 101:254-263. [DOI: 10.1002/cpt.455] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/27/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Affiliation(s)
- J Jordan
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | | | - S Engeli
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - EE Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - M May
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - B Havekes
- Department of Internal Medicine, Division of Endocrinology; Maastricht University Medical Center; Maastricht The Netherlands
| | - C Schindler
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - D Albrecht
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
| | - P Pal
- Biostatistical Sciences, Integrated Development Functions and Regions; Novartis Healthcare Pvt. Ltd; Hyderabad India
| | | | - GH Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - TH Langenickel
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
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Haufe S, Witt H, Engeli S, Kaminski J, Utz W, Fuhrmann JC, Rein D, Schulz-Menger J, Luft FC, Boschmann M, Jordan J. Branched-chain and aromatic amino acids, insulin resistance and liver specific ectopic fat storage in overweight to obese subjects. Nutr Metab Cardiovasc Dis 2016; 26:637-642. [PMID: 27134061 DOI: 10.1016/j.numecd.2016.03.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 11/05/2015] [Revised: 03/16/2016] [Accepted: 03/21/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS Amino acids may interfere with insulin action, particularly in obese individuals. We hypothesized that increased circulating branched-chain and aromatic amino acids herald insulin resistance and ectopic fat storage, particularly hepatic fat accumulation. METHODS AND RESULTS We measured fasting branched-chain and aromatic amino acids (tryptophan, tyrosine, and phenylalanine) by mass spectrometry in 111 overweight to obese subjects. We applied abdominal magnetic resonance imaging and spectroscopy to assess adipose tissue distribution and ectopic fat storage, respectively. Plasma branched-chain amino acids concentrations were related to insulin sensitivity and intrahepatic fat independent from adiposity, age and gender, but not to abdominal adipose tissue or intramyocellular fat. CONCLUSIONS In weight stable overweight and obese individuals, branched-chain amino acid concentrations are specifically associated with hepatic fat storage and insulin resistance.
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Affiliation(s)
- S Haufe
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - H Witt
- Metanomics Health GmbH, Berlin, Germany
| | - S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - J Kaminski
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - W Utz
- Working Group Cardiac MRI, Clinic for Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Germany; University Medicine Berlin, Charité Campus Buch, and Experimental and Clinical Research Centre Berlin, Germany
| | | | - D Rein
- Metanomics Health GmbH, Berlin, Germany
| | - J Schulz-Menger
- Working Group Cardiac MRI, Clinic for Cardiology and Nephrology, HELIOS Klinikum Berlin-Buch, Germany; University Medicine Berlin, Charité Campus Buch, and Experimental and Clinical Research Centre Berlin, Germany
| | - F C Luft
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M Boschmann
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - J Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
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Jordan J, Fischer-Posovszky P, Reinke J, Daniels M, Wabitsch M, Engeli S, Birkenfeld AL. A novel heart-adipose tissue axis: Atrial natriuretic peptide and leptin interactions in man. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584102] [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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Tsikas D, Jordan J, Engeli S. Blood pressure-lowering effects of propofol or sevoflurane anaesthesia are not due to enhanced nitric oxide formation or bioavailability. Br J Clin Pharmacol 2016; 79:1030-3. [PMID: 25475891 DOI: 10.1111/bcp.12568] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/26/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Dimitrios Tsikas
- Centre of Pharmacology and Toxicology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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Skopp A, May M, Janke J, Kielstein H, Wunder R, Flade-Kuthe R, Kuthe A, Jordan J, Engeli S. Regulation of G0/G1 switch gene 2 (G0S2) expression in human adipose tissue. Arch Physiol Biochem 2016; 122:47-53. [PMID: 26707160 DOI: 10.3109/13813455.2015.1122066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 11/13/2022]
Abstract
The G0/G1 switch gene 2 (G0S2) protein attenuated adipose triglyceride lipase (ATGL) activity and decreased lipolysis in rodent and human adipocytes. We hypothesized that G0S2 mRNA expression in human adipose tissue is influenced by depot, adipocyte size, body weight and caloric intake. Adipose tissue samples were obtained during abdominal surgery and by needle biopsy before and 3 h after an extended glucose load in lean subjects. G0S2 mRNA was 7× higher expressed in mature human adipocytes compared to the stromavascular fraction. Cell size inversely correlated with G0S2 mRNA expression in both, subcutaneous and omental adipose depots. G0S2 mRNA expression was 75% higher in subcutaneous compared to omental adipose tissue. Obesity was associated with lower G0S2 mRNA expression in subcutaneous adipose tissue. Acute glucose ingestion after an overnight fast did not significantly increase G0S2 expression in subcutaneous adipose tissue. In conclusion, differences in G0S2 expression may explain depot-specific and obesity-associated differences in lipolysis on the molecular level.
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Affiliation(s)
- Alexander Skopp
- a Institute of Clinical Pharmacology, Hannover Medical School , Hannover , Germany
| | - Marcus May
- a Institute of Clinical Pharmacology, Hannover Medical School , Hannover , Germany
| | - Juergen Janke
- b Max-Delbrück Center for Molecular Medicine , Berlin , Germany
| | - Heike Kielstein
- c Department of Anatomy and Cell Biology , Martin Luther University Halle-Wittenberg , Halle (Saale) , Germany , and
| | - Ruth Wunder
- d Surgical Department , Clementinenhaus , Hannover , Germany
| | | | - Andreas Kuthe
- d Surgical Department , Clementinenhaus , Hannover , Germany
| | - Jens Jordan
- a Institute of Clinical Pharmacology, Hannover Medical School , Hannover , Germany
| | - Stefan Engeli
- a Institute of Clinical Pharmacology, Hannover Medical School , Hannover , Germany
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Icken D, Feller S, Engeli S, Mayr A, Müller A, Hilbert A, de Zwaan M. Caffeine intake is related to successful weight loss maintenance. Eur J Clin Nutr 2015; 70:532-4. [DOI: 10.1038/ejcn.2015.183] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/28/2015] [Accepted: 09/11/2015] [Indexed: 12/31/2022]
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Engeli S, May M, Jordan J. Pharmacokinetic Issues in Obese Patients. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.136] [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: 11/29/2022]
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28
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Scherbakov N, Bauer M, Sandek A, Szabó T, Töpper A, Jankowska EA, Springer J, von Haehling S, Anker SD, Lainscak M, Engeli S, Düngen HD, Doehner W. Insulin resistance in heart failure: differences between patients with reduced and preserved left ventricular ejection fraction. Eur J Heart Fail 2015. [DOI: 10.1002/ejhf.317] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Nadja Scherbakov
- Center for Stroke Research Berlin; Charite Universitätsmedizin Berlin; Germany
- German Centre for Cardiovascular Research (DZHK); partner site Berlin Germany
| | - Maximiliane Bauer
- Department of Cardiology, Campus Virchow; Charite Universitätsmedizin Berlin; Germany
| | - Anja Sandek
- Department of Cardiology, Campus Virchow; Charite Universitätsmedizin Berlin; Germany
| | - Tibor Szabó
- Department of Cardiology, Campus Virchow; Charite Universitätsmedizin Berlin; Germany
| | - Agnieszka Töpper
- Working Group on Cardiovascular Magnetic Resonance; Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine Berlin; Germany
- HELIOS Klinikum Berlin Buch; Department of Cardiology and Nephrology; Berlin Germany
| | - Ewa A. Jankowska
- Cardiology Department, Centre for Heart Diseases; Military Hospital; Wroclaw Poland
- Department of Heart Diseases; Wroclaw Medical University, Wroclaw; Poland
| | - Jochen Springer
- Innovative Clinical Trials, Dept of Cardiology and Pneumology; University Medicine Göttingen (UMG); Göttingen Germany
| | | | - Stefan D. Anker
- Department of Heart Diseases; Wroclaw Medical University, Wroclaw; Poland
| | - Mitja Lainscak
- Division of Cardiology; General Hospital Celje; Slovenia
| | - Stefan Engeli
- Institute of Clinical Pharmacology; Hannover Medical School; Germany
| | - Hans-Dirk Düngen
- Department of Cardiology, Campus Virchow; Charite Universitätsmedizin Berlin; Germany
| | - Wolfram Doehner
- Center for Stroke Research Berlin; Charite Universitätsmedizin Berlin; Germany
- German Centre for Cardiovascular Research (DZHK); partner site Berlin Germany
- Department of Cardiology, Campus Virchow; Charite Universitätsmedizin Berlin; Germany
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Feller S, Müller A, Mayr A, Engeli S, Hilbert A, de Zwaan M. What distinguishes weight loss maintainers of the German Weight Control Registry from the general population? Obesity (Silver Spring) 2015; 23:1112-8. [PMID: 25864871 DOI: 10.1002/oby.21054] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 11/17/2014] [Accepted: 01/21/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Differences between successful long-term weight loss maintainers and the general population with regard to eating and weighing habits, non-normative eating behaviors, and eating-related and general psychopathological parameters are unknown. METHODS Self-identified weight loss maintainers from the German Weight Control Registry (GWCR, n = 494) were compared with a representative sample of the general German population (n = 2,129). The samples did not differ in current BMI. Using the same assessment instruments in both cohorts, a variety of eating-related and psychological variables were determined. RESULTS The GWCR participants reported more self-weighing and higher eating frequency but less hot meal consumption and more eating-out-of-home. Binge eating, compensatory behaviors, and concerns about shape and weight were reported more often by successful weight loss maintainers. Scores of depression and worrying about health were slightly higher whereas severity of somatic symptoms was less pronounced in the GWCR participants. CONCLUSIONS Overall, our data suggest that successful weight loss maintainers are characterized by more concerns about shape and weight, greater binge eating frequency, and higher use of compensatory behaviors. The latter suggests that weight loss maintenance might not only be achieved by healthy strategies but also by non-normative behaviors which might increase the vulnerability for weight regain.
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Affiliation(s)
- Silke Feller
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Nuthetal, Germany
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May M, Kayacelebi AA, Batkai S, Jordan J, Tsikas D, Engeli S. Plasma and tissue homoarginine concentrations in healthy and obese humans. Amino Acids 2015; 47:1847-52. [PMID: 25655383 DOI: 10.1007/s00726-015-1922-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/12/2015] [Indexed: 11/29/2022]
Abstract
Increased cardiovascular risk associated with obesity cannot be fully explained by traditional risk markers. We therefore assessed plasma and interstitial concentrations of the novel cardiovascular risk biomarker homoarginine (hArg) in 18 individuals without signs of cardiovascular disease, including 4 morbidly obese subjects before and after bariatric surgery and subsequent weight reduction of 36 ± 7 kg. hArg concentrations were greater in skeletal muscle compared with adipose tissue. Plasma and tissue hArg concentrations did not correlate with BMI. Adipose tissue interstitial hArg concentrations were not affected by obesity, an oral glucose load, or dramatic weight loss. In conclusion, obesity seems not to have a major effect on hArg homeostasis, and hArg may not explain the added cardiovascular risk associated with obesity. Yet, given the small sample size of the study, the significance of hArg in obesity should be investigated in a larger population.
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Affiliation(s)
- Marcus May
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany,
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31
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Haufe S, Engeli S, Lichtinghagen R, Utz W, Schulz-Menger J, Luft FC, Birkenfeld AL, Jordan J. Abstract 469: Influences of Dietary Weight Reduction on the Atrial Natriuretic Peptide System in Obese Subjects. Hypertension 2014. [DOI: 10.1161/hyp.64.suppl_1.469] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In obese individuals, reduced atrial natriuretic peptide (ANP) bioavailability appears to promote arterial hypertension and type 2 diabetes likely through direct metabolic actions. Mid-regional pro-ANP is cleaved off during ANP processing, thus, serving as ANP release marker. We hypothesized that dietary weight reduction improves ANP release.
In 75 overweight and obese women and men who had lost >5% body weight during six months hypocaloric dieting (-9.1±3.8 kg), we analyzed venous mid-regional pro-ANP and natriuretic peptide receptor (NPR) expression in abdominal subcutaneous adipose tissue before and after the intervention. Participants underwent ambulatory blood pressure (ABPM) monitoring and cardiac magnetic resonance imaging.
ABPM decreased from 118±9/73±7 to 115±9/71±6 mm Hg and left ventricular mass from 92±20 to 86±19 g (p<0.05 for all). End-diastolic and end-systolic volumes remained unchanged. Mid-regional pro-ANP plasma concentrations did not respond to weight loss (before: 51±24 pmol/; after 53± 24 pmol/l) and increased similarly during exercise testing. Adipose NPR-A mRNA expression remained unchanged whereas NPR-C receptor mRNA decreased from 1.2±0.7 to 1.0±0.5 (p<0.05).
Our data suggest that dietary weight loss does not augment ANP release in overweight and obese subjects. However, weight loss could improve ANP bioavailability through decreased clearance. Possible mechanisms are reduced fat mass and reduced expression of adipose tissue ANP scavenger receptor NPR-C.
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May M, Ahrens J, Menne J, Haller H, Beige J, Eckert S, Jordan J, Engeli S. Limited acute influences of electrical baroreceptor activation on insulin sensitivity and glucose delivery: a randomized, double-blind, crossover clinical study. Diabetes 2014; 63:2833-7. [PMID: 24647740 DOI: 10.2337/db13-1651] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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] [Indexed: 11/13/2022]
Abstract
Arterial baroreflexes may regulate resistance vessels supplying glucose to skeletal muscle by modulating efferent sympathetic nervous system activity. We hypothesized that selective manipulation of baroreflex activity through electrical carotid sinus stimulation influences insulin sensitivity by changing muscular glucose delivery. We enrolled 16 hypertensive patients who responded to treatment with an electrical carotid sinus stimulator. Patients were submitted to a frequently sampled intravenous glucose tolerance test (FSIGT) with the stimulator on and with the stimulator off on separate days in a randomized, double-blind, crossover study. We monitored interstitial glucose, lactate, and pyruvate in the vastus lateralis muscle using microdialysis. Glucose and insulin concentrations in arterialized venous blood before and during FSIGT were virtually identical with the stimulator on and with the stimulator off. Insulin sensitivity, the primary end point of this study, was 3.3 ± 1.0 (mU/L)(-1) ⋅ min(-1) and 4.4 ± 2.6 (mU/L)(-1) ⋅ min(-1) (on vs. off; P = 0.7). Interstitial glucose, lactate, and pyruvate increased similarly during FSIGT regardless of the stimulator settings. In conclusion, acute changes in baroreceptor stimulation did not elicit significant changes in muscular glucose delivery and whole-body insulin sensitivity. Baroreflex-mediated changes in sympathetic vasomotor tone may have a limited acute effect on muscle glucose metabolism in patients with treatment-resistant hypertension.
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Affiliation(s)
- Marcus May
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jelka Ahrens
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jan Menne
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Joachim Beige
- Department of Nephrology, St. Georg Clinic, Leipzig, Germany
| | - Siegfried Eckert
- Heart and Diabetes Center Nodrhein-Westfalen, Bad Oeynhausen, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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Engeli S, Lehmann AC, Kaminski J, Haas V, Janke J, Zoerner AA, Luft FC, Tsikas D, Jordan J. Influence of dietary fat intake on the endocannabinoid system in lean and obese subjects. Obesity (Silver Spring) 2014; 22:E70-6. [PMID: 24616451 DOI: 10.1002/oby.20728] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 01/22/2014] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Endocannabinoid system (ECS) activation promotes obesity-associated metabolic disease. Increased dietary fat intake increases blood endocannabinoids and alters adipose and skeletal muscle ECS gene expression in human. METHODS Two weeks isocaloric low- (LFD) and high-fat diets (HFD) in obese (n = 12) and normal-weight (n = 17) subjects in a randomized cross-over study were compared. Blood endocannabinoids were measured in the fasting condition and after food intake using mass spectrometry. Adipose and skeletal muscle gene expression was determined using real-time RT-PCR. RESULTS Baseline fasting plasma endocannabinoids were similar with both diets. Anandamide decreased similarly with high- or low-fat test meals in both groups. Baseline arachidonoylglycerol plasma concentrations were similar between groups and diets, and unresponsive to eating. In subcutaneous adipose tissue, DAGL-α mRNA was upregulated and fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL) mRNAs were down-regulated in obese subjects, but the diets had no influence. In contrast, the HFD produced pronounced reductions in skeletal muscle CB1-R and MAGL mRNA expression, whereas obesity did not affect muscular gene expression. CONCLUSIONS Weight-neutral changes in dietary fat intake cannot explain excessive endocannabinoid availability in human obesity. Obesity and dietary fat intake affect ECS gene expression in a tissue-specific manner.
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MESH Headings
- Adolescent
- Adult
- Amidohydrolases/genetics
- Amidohydrolases/metabolism
- Arachidonic Acids/blood
- Blood Glucose
- Cholesterol, HDL/blood
- Cholesterol, LDL/blood
- Cross-Over Studies
- Diet, High-Fat
- Dietary Fats/administration & dosage
- Down-Regulation
- Endocannabinoids/blood
- Fasting
- Female
- Humans
- Lipoprotein Lipase/genetics
- Lipoprotein Lipase/metabolism
- Male
- Middle Aged
- Monoacylglycerol Lipases/genetics
- Monoacylglycerol Lipases/metabolism
- Muscle, Skeletal/metabolism
- Obesity/metabolism
- Polyunsaturated Alkamides/blood
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, Cannabinoid, CB1/genetics
- Receptor, Cannabinoid, CB1/metabolism
- Subcutaneous Fat/metabolism
- Thinness/metabolism
- Triglycerides/blood
- Up-Regulation
- Young Adult
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Affiliation(s)
- Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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Tsikas D, Batkai S, Mitschke A, Jordan J, Engeli S. Nitro-oleic acid and epoxy-oleic acid are not altered in obesity and Type 2 diabetes. Cardiovasc Res 2014; 102:517-8. [DOI: 10.1093/cvr/cvu043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Abstract
The influence of dietary sodium intake on cardiovascular risk factors has been a matter of decade-long discussions. Needed is a clear-cut elucidation of the beneficial mechanisms of action of reduced salt intake. In a recent study, lean and obese mice were subjected to a high or low salt diet for 16 weeks. The low salt diet tremendously reduced fasting insulin in obese animals, and HOMA-IR was improved. Reduced adiponectin expression in the heart and in peritoneal adipose tissue in obese animals was restored or even increased compared to normal levels with the low salt diet. Corresponding with the beneficial effect on adiponectin, inflammatory markers were reduced to lean levels by the low salt diet. Whether the increase in adiponectin would have been larger if the rise in aldosterone had been prevented is one of the questions raised by this study. The data obtained in this animal study are based on a robust methodological basis for two reasons: first, the long-term intervention of 16 weeks clearly represents a strength of the study; second, dietary sodium restriction was modest, as judged by only 2-fold increased plasma renin activity. Overall, the data presented by Baudrand et al. in the current issue of NMCD may path the way to a better understanding of the mode of action of modest sodium restriction. However, a replication of the results in a more human-like diet-induced obesity mouse model is warranted.
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Affiliation(s)
- S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
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36
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Gesell FK, Zoerner AA, Brauer C, Engeli S, Tsikas D, Tipold A. Alterations of endocannabinoids in cerebrospinal fluid of dogs with epileptic seizure disorder. BMC Vet Res 2013; 9:262. [PMID: 24370333 PMCID: PMC3883475 DOI: 10.1186/1746-6148-9-262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 07/08/2013] [Accepted: 12/19/2013] [Indexed: 11/10/2022] Open
Abstract
Background Epilepsy is one of the most common chronic neurological disorders in dogs characterized by recurrent seizures. The endocannabinoid (EC) system plays a central role in suppressing pathologic neuronal excitability and in controlling the spread of activity in an epileptic network. Endocannabinoids are released on demand and their dysregulation has been described in several pathological conditions. Recurrent seizures may lead to an adverse reorganization of the EC system and impairment of its protective effect. In the current study, we tested the hypothesis that cerebrospinal fluid (CSF) concentrations of the endocannabinoids anandamide (AEA) and 2-arachidonoyl glycerol (2AG) are altered in epileptic dogs. Concentrations of AEA and total AG (sum of 2AG and 1AG) were measured in 40 dogs with idiopathic epilepsy and in 16 unaffected, healthy control dogs using liquid chromatography combined with tandem mass spectrometry. Results AEA and total AG were measured at 4.94 (3.18 – 9.17) pM and 1.43 (0.90 – 1.92) nM in epileptic dogs and at 3.19 (2.04 – 4.28) pM and 1.76 (1.08 – 2.69) nM in the control group, respectively (median, 25 – 75% percentiles in brackets). The AEA difference between epileptic and healthy dogs was statistically significant (p < 0.05). Values correlated with seizure severity and duration of seizure activity. Dogs with cluster seizures and/or status epilepticus and with seizure activity for more than six months displayed the highest EC concentrations. Conclusion In conclusion, we present the first endocannabinoid measurements in canine CSF and confirm the hypothesis that the EC system is altered in canine idiopathic epilepsy.
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Affiliation(s)
- Felix K Gesell
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany.
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Haufe S, Haas V, Utz W, Birkenfeld AL, Jeran S, Böhnke J, Mähler A, Luft FC, Schulz-Menger J, Boschmann M, Jordan J, Engeli S. Long-lasting improvements in liver fat and metabolism despite body weight regain after dietary weight loss. Diabetes Care 2013; 36:3786-92. [PMID: 23963894 PMCID: PMC3816862 DOI: 10.2337/dc13-0102] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Weight loss reduces abdominal and intrahepatic fat, thereby improving metabolic and cardiovascular risk. Yet, many patients regain weight after successful diet-induced weight loss. Long-term changes in abdominal and liver fat, along with liver test results and insulin resistance, are not known. RESEARCH DESIGN AND METHODS We analyzed 50 overweight to obese subjects (46 ± 9 years of age; BMI, 32.5 ± 3.3 kg/m2; women, 77%) who had participated in a 6-month hypocaloric diet and were randomized to either reduced carbohydrates or reduced fat content. Before, directly after diet, and at an average of 24 (range, 17-36) months follow-up, we assessed body fat distribution by magnetic resonance imaging and markers of liver function and insulin resistance. RESULTS Body weight decreased with diet but had increased again at follow-up. Subjects also partially regained abdominal subcutaneous and visceral adipose tissue. In contrast, intrahepatic fat decreased with diet and remained reduced at follow-up (7.8 ± 9.8% [baseline], 4.5 ± 5.9% [6 months], and 4.7 ± 5.9% [follow-up]). Similar patterns were observed for markers of liver function, whole-body insulin sensitivity, and hepatic insulin resistance. Changes in intrahepatic fat und intrahepatic function were independent of macronutrient composition during intervention and were most effective in subjects with nonalcoholic fatty liver disease at baseline. CONCLUSIONS A 6-month hypocaloric diet induced improvements in hepatic fat, liver test results, and insulin resistance despite regaining of weight up to 2 years after the active intervention. Body weight and adiposity measurements may underestimate beneficial long-term effects of dietary interventions.
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Huebner L, Engeli S, Wrann CD, Goudeva L, Laue T, Kielstein H. Human NK cell subset functions are differentially affected by adipokines. PLoS One 2013; 8:e75703. [PMID: 24098717 PMCID: PMC3787100 DOI: 10.1371/journal.pone.0075703] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 08/20/2013] [Indexed: 01/03/2023] Open
Abstract
Background Obesity is a risk factor for various types of infectious diseases and cancer. The increase in adipose tissue causes alterations in both adipogenesis and the production of adipocyte-secreted proteins (adipokines). Since natural killer (NK) cells are the host’s primary defense against virus-infected and tumor cells, we investigated how adipocyte-conditioned medium (ACM) affects functions of two distinct human NK cell subsets. Methods Isolated human peripheral blood mononuclear cells (PBMCs) were cultured with various concentrations of human and murine ACM harvested on two different days during adipogenesis and analyzed by fluorescent-activated cell sorting (FACS). Results FACS analyses showed that the expression of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), granzyme A (GzmA) and interferon (IFN)-γ in NK cells was regulated in a subset-specific manner. ACM treatment altered IFN-γ expression in CD56dim NK cells. The production of GzmA in CD56bright NK cells was differentially affected by the distinct adipokine compositions harvested at different states of adipogenesis. Comparison of the treatment with either human or murine ACM revealed that adipokine-induced effects on NK cell expression of the leptin receptor (Ob-R), TRAIL and IFN-γ were species-specific. Conclusion Considering the growing prevalence of obesity and the various disorders related to it, the present study provides further insights into the roles human NK cell subsets play in the obesity-associated state of chronic low-grade inflammation.
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Affiliation(s)
- Lena Huebner
- Institute for Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
- Department of General-, Visceral-, Vascular and Thoracic Surgery, Charité, University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Stefan Engeli
- Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Christiane D. Wrann
- Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lilia Goudeva
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - Tobias Laue
- Institute for Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
- * E-mail:
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Engeli S, Utz W, Haufe S, Lamounier-Zepter V, Pofahl M, Traber J, Janke J, Luft FC, Boschmann M, Schulz-Menger J, Jordan J. Fatty acid binding protein 4 predicts left ventricular mass and longitudinal function in overweight and obese women. Heart 2013; 99:944-8. [PMID: 23598540 DOI: 10.1136/heartjnl-2013-303735] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore whether increased adipocyte-derived serum fatty acid binding protein 4 (FABP4) predisposes to cardiac remodelling and left ventricular dysfunction in human obesity. DESIGN Cross-sectional investigation. SETTING Academic clinical research centre. PATIENTS 108 overweight and obese non-diabetic women (body-mass index 33 ± 5 kg/m2). INTERVENTIONS None. MAIN OUTCOME MEASURES Relationship between serum FABP4 and abdominal adipose tissue quantified by MRI. Relationship between serum FABP4 and left ventricular morphology and function assessed by cardiac MRI. RESULTS FABP4 was independently associated with visceral abdominal adipose tissue (β=0.34, p<0.01) and subcutaneous abdominal adipose tissue (β=0.22, p<0.05). After stratification into serum FABP4 tertiles, left ventricular masses were 92 ± 16 g, 86 ± 13 g and 81 ± 12 g in women with high, intermediate and low FABP4 concentrations (p<0.01), respectively. Longitudinal systolic function was reduced by 8% in women with intermediate and high versus low FABP4 concentrations (p<0.01), whereas ejection fraction did not differ among tertiles (p=0.5). In multivariate linear analysis FABP4 remained an independent predictor of left ventricular mass (β=0.17, p<0.05) and reduced longitudinal fractional shortening (β=0.21, p<0.05). CONCLUSIONS In overweight and obese women, FABP4 showed an independent association with parameters of left ventricular remodelling.
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Affiliation(s)
- Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
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Utz W, Haufe S, Engeli S, Pofahl M, Traber J, Luft F, Jordan J, Schulz-Menger J. Moderate dietary weight loss reduces myocardial triglycerides in obese women. J Cardiovasc Magn Reson 2012. [PMCID: PMC3305341 DOI: 10.1186/1532-429x-14-s1-p69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Haufe S, Engeli S, Jordan J. Letter by Haufe et al regarding article, "Adipose tissue inflammation and adiponectin resistance in patients with advanced heart failure: correction after ventricular assist device implantation". Circ Heart Fail 2012; 5:e100; author reply e101. [PMID: 23170023 DOI: 10.1161/circheartfailure.112.970749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jarzimski C, Karst M, Zoerner AA, Rakers C, May M, Suchy MT, Tsikas D, Krauss JK, Scheinichen D, Jordan J, Engeli S. Changes of blood endocannabinoids during anaesthesia: a special case for fatty acid amide hydrolase inhibition by propofol? Br J Clin Pharmacol 2012; 74:54-9. [PMID: 22242687 DOI: 10.1111/j.1365-2125.2012.04175.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Available data from animal studies suggest that the narcotic drug propofol interacts with the endocannabinoid system. Inhibition of enzymatic degradation of anandamide could explain some of the characteristics of propofol. Direct measurements have not been reported yet in humans. WHAT THIS STUDY ADDS • Propofol does not change the time course of anandamide plasma concentrations during anaesthesia. Furthermore, propofol does not inhibit fatty acid amide hydrolase activity ex vivo or in vitro. Thus, specific characteristics of the narcotic drug propofol cannot be explained by peripheral inhibition of anandamide degradation in humans. AIMS The aim of our study was to describe the time course of endocannabinoids during different anaesthesia protocols in more detail, and to challenge the hypothesis that propofol acts as a FAAH inhibitor. METHODS Endocannabinoids were measured during the first hour of anaesthesia in 14 women and 14 men undergoing general anaesthesia with propofol and in 14 women and 14 men receiving thiopental/sevoflurane. We also incubated whole human blood samples ex vivo with propofol and the known FAAH inhibitor oloxa and determined FAAH enzyme kinetics. RESULTS Plasma anandamide decreased similarly with propofol and thiopental/sevoflurane anaesthesia, and reached a nadir after 10 min. Areas under the curve for anandamide (mean and 95% CI) were 53.3 (47.4, 59.2) nmol l(-1) 60 min with propofol and 48.5 (43.1, 53.8) nmol l(-1) 60 min with thiopental/sevoflurane (P= NS). Anandamide and propofol plasma concentrations were not correlated at any time point. Ex vivo FAAH activity was not inhibited by propofol. Enzyme kinetics (mean ± SD) of recombinant human FAAH were K(m) = 16.9 ± 8.8 µmol l(-1) and V(max) = 44.6 ± 15.8 nmol mg(-1) min(-1) FAAH without, and K(m) = 16.6 ± 4.0 µmol l(-1) and V(max) = 44.0 ± 7.6 nmol mg( 1 ) min(-1) FAAH with 50 µmol l(-1) propofol (P= NS for both). CONCLUSIONS Our findings challenge the idea that propofol anaesthesia and also propofol addiction are directly mediated by FAAH inhibition, but we cannot exclude other indirect actions on cannabinoid receptors.
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Affiliation(s)
- Carina Jarzimski
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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Engeli S, Birkenfeld AL, Badin PM, Bourlier V, Louche K, Viguerie N, Thalamas C, Montastier E, Larrouy D, Harant I, de Glisezinski I, Lieske S, Reinke J, Beckmann B, Langin D, Jordan J, Moro C. Natriuretic peptides enhance the oxidative capacity of human skeletal muscle. J Clin Invest 2012; 122:4675-9. [PMID: 23114600 DOI: 10.1172/jci64526] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 09/06/2012] [Indexed: 11/17/2022] Open
Abstract
Cardiac natriuretic peptides (NP) are major activators of human fat cell lipolysis and have recently been shown to control brown fat thermogenesis. Here, we investigated the physiological role of NP on the oxidative metabolism of human skeletal muscle. NP receptor type A (NPRA) gene expression was positively correlated to mRNA levels of PPARγ coactivator-1α (PGC1A) and several oxidative phosphorylation (OXPHOS) genes in human skeletal muscle. Further, the expression of NPRA, PGC1A, and OXPHOS genes was coordinately upregulated in response to aerobic exercise training in human skeletal muscle. In human myotubes, NP induced PGC-1α and mitochondrial OXPHOS gene expression in a cyclic GMP-dependent manner. NP treatment increased OXPHOS protein expression, fat oxidation, and maximal respiration independent of substantial changes in mitochondrial proliferation and mass. Treatment of myotubes with NP recapitulated the effect of exercise training on muscle fat oxidative capacity in vivo. Collectively, these data show that activation of NP signaling in human skeletal muscle enhances mitochondrial oxidative metabolism and fat oxidation. We propose that NP could contribute to exercise training-induced improvement in skeletal muscle fat oxidative capacity in humans.
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Affiliation(s)
- Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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Engeli S, Tsikas D, Lehmann AC, Böhnke J, Haas V, Strauß A, Janke J, Gorzelniak K, Luft FC, Jordan J. Influence of dietary fat ingestion on asymmetrical dimethylarginine in lean and obese human subjects. Nutr Metab Cardiovasc Dis 2012; 22:720-726. [PMID: 21420841 DOI: 10.1016/j.numecd.2011.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [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: 07/20/2010] [Revised: 12/14/2010] [Accepted: 01/03/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Asymmetrical dimethylarginine (ADMA) may contribute to hypertension and cardiovascular disease by decreasing NO formation. In diabetic patients, a high fat meal acutely increased plasma ADMA while impairing endothelial function. We hypothesized that chronic and acute increases in dietary fat intake augment ADMA also in lean and in obese subjects without diabetes. METHODS AND RESULTS Seventeen lean and twelve obese volunteers were randomized to two weeks of isocaloric diets with approximately 20% or >40% calories from fat in a cross-over fashion. At the end of the high and low fat periods, volunteers received corresponding test meals. ADMA was measured by GC-MS/MS using a deuterated standard. Mean fasting plasma ADMA concentration was 0.52 (0.49-0.54; 95% CI) μmol/l in lean and 0.53 (0.50-0.55) μmol/l in obese subjects (p = 0.55). The two week high fat diet did not influence ADMA. Both test meals elicited a 6%increase in circulating ADMA in lean subjects. In obese subjects, plasma ADMA concentration did not change with the low fat meal, and decreased by approximately 4% with the high fat meal. CONCLUSION Our findings challenge the idea that obesity and dietary fat intake have a major effect on plasma ADMA, at least in subjects without overt cardiovascular and metabolic disease. This finding is important with regard to dietary recommendations for weight loss. Overestimation of the influence of dietary fat intake and obesity on circulating ADMA in previous reports was most likely due to methodological issues concerning ADMA measurements.
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Affiliation(s)
- S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Strasse1, 30625 Hannover, Germany.
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Birkenfeld AL, Boschmann M, Engeli S, Moro C, Arafat AM, Luft FC, Jordan J. Atrial natriuretic peptide and adiponectin interactions in man. PLoS One 2012; 7:e43238. [PMID: 22916229 PMCID: PMC3420865 DOI: 10.1371/journal.pone.0043238] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/18/2012] [Indexed: 11/18/2022] Open
Abstract
Reduced circulating natriuretic peptide concentrations are independently associated with insulin resistance and type 2 diabetes, while increased natriuretic peptide levels appear to be protective. Observations in vitro and in heart failure patients suggest that atrial natriuretic peptide (ANP) promotes adiponectin release, an adipokine with insulin sensitizing properties. We tested the hypothesis that ANP acutely raises adiponectin levels in 12 healthy men. We infused ANP intravenously over 135 minutes while collecting venous blood and adipose tissue microdialysates at baseline and at the end of ANP-infusion. We obtained blood samples at identical time-points without ANP infusion in 7 age and BMI matched men. With infusion, venous ANP concentrations increased ∼10 fold. Systemic and adipose tissue glycerol concentrations increased 70% and 80%, respectively (P<0.01). ANP infusion increased total adiponectin 14 ± 5% and high molecular-weight (HMW)-adiponectin 13 ± 5% (P<0.05). Adiponectin did not change in the control group (P<0.05 vs. infusion). ANP-induced changes in HMW adiponectin and adipose tissue lipolysis were directly correlated with each other, possibly suggesting a common mechanism. Our data show that ANP acutely increases systemic total and HMW-adiponectin concentrations in healthy subjects. Our study could have implications for the physiological regulation of adiponectin and for disease states associated with altered natriuretic peptide availability.
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Affiliation(s)
- Andreas L. Birkenfeld
- Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research (CCR), Charité - University School of Medicine, Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Michael Boschmann
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Cedric Moro
- Inserm UMR1048, Institute of Metabolic and Cardiovascular Diseases, Université Paul Sabatier, Toulouse, France
| | - Ayman M. Arafat
- Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research (CCR), Charité - University School of Medicine, Berlin, Germany
| | - Friedrich C. Luft
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- * E-mail:
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Haas V, Schütz T, Engeli S, Schröder C, Westerterp K, Boschmann M. Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water. Eur J Clin Nutr 2012; 66:994-7. [PMID: 22854879 DOI: 10.1038/ejcn.2012.96] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES In this study, we aimed to validate the accuracy of single-frequency bioelectrical impedance analysis (SF-BIA) at 50 kHz to assess total body water (TBW) against the reference technique deuterium dilution (D(2)O) and to explore if the simple clinical parameters extracellular fluid (ECF) composition and body shape explain individual differences between D(2)O and SF-BIA (Diff(BIA-D(2)O)). SUBJECTS/METHODS We assessed TBW with D(2)O and SF-BIA in 26 women and 26 men without known disease or anomalous body shapes. In addition, we measured body shape with anthropometry and ECF composition (osmolality, albumin, glucose, urea, creatinine, sodium and potassium). RESULTS On group average, SF-BIA to predict TBW agreed well with D(2)O (SF-BIA, 39.8 ± 10.1 l; D(2)O, 40.4 ± 10.2 l; and Diff(BIA-D(2)O) -0.7 l). In four individuals ('outliers'; 15% of the study population), Diff(BIA-D(2)O) was high (-6.8 to +3.8 l). Diff(BIA-D(2)O) was associated with individual variations in body shape rather than ECF composition. Using gender-specific analysis, we found that individual variability of waist circumference in men and arm length in women significantly contributed to Diff(BIA-D(2)O). When removing the four 'outliers', these associations were lost. CONCLUSIONS In the majority of our sample, BIA agreed well with D(2)O. Adjusting for individual variability in body shape by anthropometrical assessment could possibly improve the accuracy of SF-BIA for individuals who deviate from mean values with respect to body shape. However, further studies with higher subject numbers are needed to confirm our findings.
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Affiliation(s)
- V Haas
- Experimental and Clinical Research Center, a joint cooperation between Charité Universitätsmedizin and Max-Delbrück Center for Molecular Medicine, Charité Universitätsmedizin, Berlin, Germany.
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Stieger N, Worthmann K, Teng B, Engeli S, Das AM, Haller H, Schiffer M. Impact of high glucose and transforming growth factor-β on bioenergetic profiles in podocytes. Metabolism 2012; 61:1073-86. [PMID: 22365040 DOI: 10.1016/j.metabol.2011.12.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [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: 06/30/2011] [Revised: 12/09/2011] [Accepted: 12/12/2011] [Indexed: 02/04/2023]
Abstract
Diabetic nephropathy is the most common cause of chronic renal failure in industrialized countries. Depletion of podocytes plays an important role in the progression of diabetic glomerulopathy. Various factors in the diabetic milieu lead to serious podocyte stress driving the cells toward cell cycle arrest (p27(Kip1)), hypertrophy, detachment, and apoptosis. Mitochondria are responsible for oxidative phosphorylation and energy supply in podocytes. Recent studies indicated that mitochondrial dysfunction is a key factor in diabetic nephropathy. In the present study, we investigated metabolic profiles of podocytes under diabetic conditions. We examined oxygen consumption rates (OCRs) and oxidative phosphorylation complex activities in murine podocytes. Cells were exposed to high glucose for 48 hours, cultured for 10 passages under high-glucose conditions (30 mmol/L), or incubated with transforming growth factor-β (5 ng/mL) for 24 hours. After prolonged exposure to high glucose, podocytes showed a significantly increased OCR at baseline and also a higher OCR after addition of oligomycin, indicating significant changes in mitochondrial energy metabolism. Higher OCRs after inhibition of respiration by rotenone also indicated changes in nonmitochondrial respiration. Podocytes stimulated with a proapoptotic concentration of transforming growth factor-β displayed similar bioenergetic profiles, even with decreased citrate synthase activity. In all tested conditions, we found a higher cellular nicotinamide adenine dinucleotide content and changes in activities of respiratory chain complexes. In summary, we provide for the first time evidence that key factors of the diabetic milieu induce changes in glucose metabolism and mitochondrial function in podocytes.
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Affiliation(s)
- Nicole Stieger
- Division of Nephrology, Department of Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, Germany
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Affiliation(s)
- Stefan Engeli
- Institut für Klinische Pharmakologie Medizinische, Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Abstract
BACKGROUND Even though patients with class 3 obesity (body mass index ≥ 40 kg/m(2)) are prone to arterial hypertension and respond less to antihypertensive drugs, they are not considered in hypertension treatment guidelines and data from prospective clinical trials are lacking. METHODS In a post hoc analysis of a clinical trial, we compared patients with class 3 obesity with patients with class 1/2 obesity. RESULTS AND CONCLUSIONS Blood pressure control in class 3 obesity was less likely to be achieved with hydrochlorothiazide monotherapy. While addition of amlodipine, irbesartan, or aliskiren to hydrochlorothiazide improved the blood pressure response, amlodipine was less effective and induced peripheral edema in 19% of patients with class 3 obesity.
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Affiliation(s)
- Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
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Tsikas D, Zoerner AA, Haufe S, Engeli S, Stichtenoth DO, Jordan J. Microdialysis of Prostaglandins, Thromboxane, and Other Eicosanoids: Recall Past Knowledge. Hypertension 2012; 59:e39; author reply e40. [DOI: 10.1161/hypertensionaha.112.191908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Dimitrios Tsikas
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
| | - Alexander A. Zoerner
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
| | - Sven Haufe
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
| | - Stefan Engeli
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
| | - Dirk O. Stichtenoth
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
| | - Jens Jordan
- Institute of Clinical Pharmacology Hannover Medical School Hannover, Germany (Tsikas, Zoerner, Haufe, Engeli, Stichtenoth, Jordan)
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