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Gar C, Haschka SJ, Kern-Matschilles S, Rauch B, Sacco V, Prehn C, Adamski J, Seissler J, Wewer Albrechtsen NJ, Holst JJ, Lechner A. The liver-alpha cell axis associates with liver fat and insulin resistance: a validation study in women with non-steatotic liver fat levels. Diabetologia 2021; 64:512-520. [PMID: 33275161 PMCID: PMC7864806 DOI: 10.1007/s00125-020-05334-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Many individuals who develop type 2 diabetes also display increased glucagon levels (hyperglucagonaemia), which we have previously found to be associated with the metabolic syndrome. The concept of a liver-alpha cell axis provides a possible link between hyperglucagonaemia and elevated liver fat content, a typical finding in the metabolic syndrome. However, this association has only been studied in individuals with non-alcoholic fatty liver disease. Hence, we searched for a link between the liver and the alpha cells in individuals with non-steatotic levels of liver fat content. We hypothesised that the glucagon-alanine index, an indicator of the functional integrity of the liver-alpha cell axis, would associate with liver fat and insulin resistance in our cohort of women with low levels of liver fat. METHODS We analysed data from 79 individuals participating in the Prediction, Prevention and Subclassification of Type 2 Diabetes (PPSDiab) study, a prospective observational study of young women at low to high risk for the development of type 2 diabetes. Liver fat content was determined by MRI. Insulin resistance was calculated as HOMA-IR. We conducted Spearman correlation analyses of liver fat content and HOMA-IR with the glucagon-alanine index (the product of fasting plasma levels of glucagon and alanine). The prediction of the glucagon-alanine index by liver fat or HOMA-IR was tested in multivariate linear regression analyses in the whole cohort as well as after stratification for liver fat content ≤0.5% (n = 39) or >0.5% (n = 40). RESULTS The glucagon-alanine index significantly correlated with liver fat and HOMA-IR in the entire cohort (ρ = 0.484, p < 0.001 and ρ = 0.417, p < 0.001, respectively). These associations resulted from significant correlations in participants with a liver fat content >0.5% (liver fat, ρ = 0.550, p < 0.001; HOMA-IR, ρ = 0.429, p = 0.006). In linear regression analyses, the association of the glucagon-alanine index with liver fat remained significant after adjustment for age and HOMA-IR in all participants and in those with liver fat >0.5% (β = 0.246, p = 0.0.23 and β = 0.430, p = 0.007, respectively) but not in participants with liver fat ≤0.5% (β = -0.184, p = 0.286). CONCLUSIONS/INTERPRETATION We reproduced the previously reported association of liver fat content and HOMA-IR with the glucagon-alanine index in an independent study cohort of young women with low to high risk for type 2 diabetes. Furthermore, our data indicates an insulin-resistance-independent association of liver fat content with the glucagon-alanine index. In summary, our study supports the concept that even lower levels of liver fat (from 0.5%) are connected to relative hyperglucagonaemia, reflecting an imminent impairment of the liver-alpha cell axis.
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Affiliation(s)
- Christina Gar
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Stefanie J Haschka
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Stefanie Kern-Matschilles
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Barbara Rauch
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Vanessa Sacco
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Cornelia Prehn
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Jerzy Adamski
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Chair of Experimental Genetics, Technical University of Munich, Freising-Weihenstephan, Germany
| | - Jochen Seissler
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Nicolai J Wewer Albrechtsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Novo Nordisk Foundation (NNF) Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation (NNF) Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Lechner
- Diabetes Research Group, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Neuherberg, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
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Lopes IDCC, Schütze M, Bolina MB, de Oliveira Sobrinho TÂ, Ramos LFM, Diniz RLFC, Fernandes JDL, Siqueira MHA. Comparison of automated and manual protocols for magnetic resonance imaging assessment of liver iron concentration. Radiol Bras 2020; 53:148-154. [PMID: 32587421 PMCID: PMC7302902 DOI: 10.1590/0100-3984.2019.0029] [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] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective To compare automated and manual magnetic resonance imaging protocols for estimating liver iron concentrations at 1.5 T. Materials and Methods Magnetic resonance imaging examination of the liver was performed in 53 patients with clinically suspected hepatic iron overload and in 21 control subjects. Liver iron concentrations were then estimated by two examiners who were blinded to the groups. The examiners employed automated T2* and T1 mapping, as well as manual T2* and signal-intensity-ratio method. We analyzed accuracy by using ROC curves. Interobserver and intraobserver agreement were analyzed by calculating two-way intraclass correlation coefficients. Results The area under the ROC curve (to discriminate between patients and controls) was 0.912 for automated T2* mapping, 0.934 for the signal-intensity-ratio method, 0.908 for manual T2*, and 0.80 for T1 mapping, the last method differing significantly from the other three. The level of interobserver and intraobserver agreement was good (intraclass correlation coefficient, 0.938-0.998; p < 0.05). Correlations involving T1 mapping, although still significant, were lower. Conclusion At 1.5 T, T2* mapping is a rapid tool that shows promise for the diagnosis of liver iron overload, whereas T1 mapping shows less accuracy. The performance of T1 mapping is poorer than is that of T2* methods.
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Affiliation(s)
- Izabella de Campos Carvalho Lopes
- Radiology and Diagnostic Imaging, Hospital Mater Dei, Pós-Graduação Ciências Médicas de Minas Gerais (PGCM-MG), Belo Horizonte, MG, Brazil
| | - Manuel Schütze
- Radiology and Diagnostic Imaging, Hospital Mater Dei, Pós-Graduação Ciências Médicas de Minas Gerais (PGCM-MG), Belo Horizonte, MG, Brazil
| | - Marina Borges Bolina
- Radiology and Diagnostic Imaging, Hospital Mater Dei, Pós-Graduação Ciências Médicas de Minas Gerais (PGCM-MG), Belo Horizonte, MG, Brazil
| | | | - Laura Filgueiras Mourão Ramos
- Radiology and Diagnostic Imaging, Hospital Mater Dei, Pós-Graduação Ciências Médicas de Minas Gerais (PGCM-MG), Belo Horizonte, MG, Brazil
| | | | | | - Maria Helena Albernaz Siqueira
- Radiology and Diagnostic Imaging, Hospital Mater Dei, Pós-Graduação Ciências Médicas de Minas Gerais (PGCM-MG), Belo Horizonte, MG, Brazil
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Yeung CW, Yau MM, Ma CK, Siu TS, Tam S, Lam CW. Diagnosis of dihydropyrimidinase deficiency in a Chinese boy with dihydropyrimidinuria. Hong Kong Med J 2013; 19:272-5. [PMID: 23732435 DOI: 10.12809/hkmj133598] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Dihydropyrimidinase deficiency is an autosomal recessive inborn error of metabolism characterised by the presence of dihydropyrimidinuria. Its clinical presentation is variable and has also been reported in asymptomatic subjects. We report the first case of dihydropyrimidinase deficiency in Hong Kong, which is also the first reported in a Chinese subject. The patient was a 32-month-old boy who presented with language development delay. Biochemical analysis confirmed markedly increased urinary excretion of dihydrouracil and dihydrothymine, whilst DNA testing confirmed that the patient was compound heterozygous for two missense mutations, one known (p.R302Q) and the other was novel (p.N16K).
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Affiliation(s)
- C W Yeung
- Division of Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
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Chen XM, Liu JC, Xu RL, Ma XH, Zhao YC, Han DW. Difference between periportal and pericentral Kupffer cells in lipopolysaccharide uptake in rats. World J Gastroenterol 1997; 3:168. [PMID: 27239138 PMCID: PMC4842879 DOI: 10.3748/wjg.v3.i3.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/1996] [Revised: 12/22/1996] [Accepted: 01/30/1997] [Indexed: 02/06/2023] Open
Abstract
AIM: To reveal the difference in the ability of Kupffer cells in the periportal and pericentral regions of the liver to uptake lipopolysaccharides (LPS) injected into the portal vein.
METHODS: Male Wistar rats were divided into two groups: normal control group (n = 6) and GdCl3-treated group (n = 8). Sixteen hours before the experiment, rats in the GdCl3-treated group were injected with GdCl3via the tail vein to eliminate Kupffer cell function specifically in the periportal region. LPS at a dose of 20 μg/100 g body weight was injected into rats of both groups via the portal vein. Zero, 2, 5, 10, 30, and 60 min after LPS injection, liver samples were obtained and the distribution of LPS in Kupffer cells was observed by immunofluorescence imaging of monoclonal antibody-specific LPS staining using a confocal laser scanning microscope.
RESULTS: In the normal control group, positive reactions to LPS were found in Kupffer cells in the periportal region with the peak at two minutes after LPS injection. Kupffer cells in the pericentral region showed the peak at five minutes after LPS injection, but its fluorescent intensity to LPS at the peak time in the cytoplasm was significantly lower than that of Kupffer cells in the pericentral region. In the GdCl3-treated group, Kupffer cells in the pericentral region showed the peak at two minutes following LPS injection, and the LPS fluorescent intensity showed no significant difference from that of the normal control rats at the peak point. No significant changes of LPS fluorescent intensities were found in Kupffer cells in the periportal region at various time points following LPS injection in GdCl3-treated rats.
CONCLUSION: Kupffer cells in the periportal and pericentral regions showed differences in LPS uptake via the portal vein.
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