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Warmbrunn MV, Boulund U, Aron-Wisnewsky J, de Goffau MC, Abeka RE, Davids M, Bresser LRF, Levin E, Clement K, Galenkamp H, Ferwerda B, van den Born BJJH, Kurilshikov A, Fu J, Zwinderman AH, Soeters MR, van Raalte DH, Herrema H, Groen AK, Nieuwdorp M. Networks of gut bacteria relate to cardiovascular disease in a multi-ethnic population: the HELIUS study. Cardiovasc Res 2024; 120:372-384. [PMID: 38289866 PMCID: PMC10981523 DOI: 10.1093/cvr/cvae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/25/2023] [Accepted: 11/30/2023] [Indexed: 02/01/2024] Open
Abstract
AIMS Gut microbiota have been linked to blood lipid levels and cardiovascular diseases (CVDs). The composition and abundance of gut microbiota trophic networks differ between ethnicities. We aim to evaluate the relationship between gut microbiotal trophic networks and CVD phenotypes. METHODS AND RESULTS We included cross-sectional data from 3860 individuals without CVD history from 6 ethnicities living in the Amsterdam region participating in the prospective Healthy Life in Urban Setting (HELIUS) study. Genetic variants were genotyped, faecal gut microbiota were profiled, and blood and anthropometric parameters were measured. A machine learning approach was used to assess the relationship between CVD risk (Framingham score) and gut microbiota stratified by ethnicity. Potential causal relationships between gut microbiota composition and CVD were inferred by performing two-sample Mendelian randomization with hard CVD events from the Pan-UK Biobank and microbiome genome-wide association studies summary data from a subset of the HELIUS cohort (n = 4117). Microbial taxa identified to be associated with CVD by machine learning and Mendelian randomization were often ethnic-specific, but some concordance across ethnicities was found. The microbes Akkermansia muciniphila and Ruminococcaceae UCG-002 were protective against ischaemic heart disease in African-Surinamese and Moroccans, respectively. We identified a strong inverse association between blood lipids, CVD risk, and the combined abundance of the correlated microbes Christensenellaceae-Methanobrevibacter-Ruminococcaceae (CMR). The CMR cluster was also identified in two independent cohorts and the association with triglycerides was replicated. CONCLUSION Certain gut microbes can have a potentially causal relationship with CVD events, with possible ethnic-specific effects. We identified a trophic network centred around Christensenellaceae, Methanobrevibacter, and various Ruminococcaceae, frequently lacking in South-Asian Surinamese, to be protective against CVD risk and associated with low triglyceride levels.
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Affiliation(s)
- Moritz V Warmbrunn
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ulrika Boulund
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Judith Aron-Wisnewsky
- Nutrition and Obesities: Systemic Approaches Research Unit (Nutriomics), Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
- Nutrition Department, Assistantea Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centres de Recherche en Nutrition Humaine, Paris, Ile de France, France
| | - Marcus C de Goffau
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- HorAIzon BV, 2625 GZ Delft, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Centers, Meibergdreef 69, 1105 BK Amsterdam, The Netherlands
| | - Rosamel E Abeka
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Mark Davids
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Lucas R F Bresser
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- HorAIzon BV, 2625 GZ Delft, The Netherlands
| | - Evgeni Levin
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- HorAIzon BV, 2625 GZ Delft, The Netherlands
| | - Karine Clement
- Nutrition and Obesities: Systemic Approaches Research Unit (Nutriomics), Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
- Nutrition Department, Assistantea Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centres de Recherche en Nutrition Humaine, Paris, Ile de France, France
| | - Henrike Galenkamp
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Bart Ferwerda
- Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Bert-Jan J H van den Born
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Alexander Kurilshikov
- Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jingyuan Fu
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aeilko H Zwinderman
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maarten R Soeters
- Department of Endocrinology and Metabolism, Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Daniel H van Raalte
- Department of Internal Medicine, Amsterdam University Medical Center (UMC), Vrije Universiteit (VU) University Medical Center, Amsterdam, The Netherlands
| | - Hilde Herrema
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Albert K Groen
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Max Nieuwdorp
- Department of Internal and Vascular Medicine, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Eymard F, Aron-Wisnewsky J. Osteoarthritis in patients with obesity: The bariatric surgery impacts on its evolution. Joint Bone Spine 2024; 91:105639. [PMID: 37734439 DOI: 10.1016/j.jbspin.2023.105639] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
Obesity is one of the main modifiable risk factors for osteoarthritis (OA). Moreover, obesity is associated with greater pain intensity and functional limitation, but also with a significantly lower responder rate to intra-articular treatments. Consequently, an arthroplasty is indicated earlier and more frequently in patients with obesity. However, pain and functional symptoms improve slightly less after arthroplasty in patients with obesity, who display higher incidence of early and late complications following prosthetic surgery. Bariatric surgery (BS) has increased worldwide and is efficient to induce major and sustainable weight-loss. Importantly, BS significantly reduces pain and functional limitation in patients with symptomatic knee OA. Biomarkers analysis also revealed a decrease in catabolic factors and an increase in anabolic one after BS suggesting a structural protective effect in knee OA. Nevertheless, the impact of BS prior to arthroplasty remains unclear. BS seems to decrease short- and mid-term complications such as infections or thrombosis. However, BS does not appear to modify long-term complications rate, and may even increase it, especially revisions and infections. Although few studies have compared the symptomatic and functional outcomes of joint replacement with or without BS, these are not significantly improved by prior BS. Despite these heterogeneous results, medico-economic studies found that BS prior to arthroplasty was cost-effective. To conclude, BS could significantly reduce the symptoms of OA and potentially slow its progression, but appears more disappointing in preventing long-term complications of arthroplasties and improving their functional results.
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Affiliation(s)
- Florent Eymard
- Department of Rheumatology, Henri-Mondor University Hospital, Assistance publique-Hôpitaux de Paris, AP-HP, 1, rue Gustave-Eiffel, 94000 Créteil, France.
| | - Judith Aron-Wisnewsky
- Department of Nutrition, Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, AP-HP, 75013 Paris, France; Sorbonne université, Inserm, Nutrition and Obesity: Systemic Approaches, NutriOmics, 75013 Paris, France
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Chalopin S, Bel Lassen P, Genser L, Aron-Wisnewsky J, Poitou C, Ciangura C, Torcivia A, Oppert JM, Bedock D, Faucher P. Management of Severe Malnutrition Post-bariatric Surgery Using Artificial Nutrition. Obes Surg 2024; 34:363-370. [PMID: 38123784 DOI: 10.1007/s11695-023-06842-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/12/2023] [Accepted: 09/24/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Bariatric surgery (BS) results in major and sustained weight loss and improves comorbidities in patients with obesity but can also lead to malnutrition, especially through severe malabsorption and/or surgical complications. Little is known about the efficacy of artificial nutrition (AN) in this setting. METHODS In this case series, we describe data from consecutive severely malnourished patients after BS (resectional and non-resectional), managed by AN at our hospital unit over a 4-year period. RESULTS Between January 2018 and June 2022, 18 patients (mean ± SD age 42.2 ± 10.4 years, 94% women) required AN following BS complications. At the time of AN initiation, more than half of the patients (53%) had multiple revisional surgeries (up to four). Mean BMI was 49.7 ± 11.3 kg/m2 before BS and 29.6 ± 9.6 kg/m2 when AN was initiated. Most patients (n=16, 90%) received enteral nutrition. AN management resulted in weight regain (+4.7kg ± 8.0, p=0.034), increased serum albumin (+28%, p=0.02), pre-albumin (+88%, p=0.002), and handgrip strength (+38%, p=0.078). No major AN complication nor death was observed. Median total AN duration was 4.5 months [1-12]. During follow-up, the cumulative duration of hospitalization was 33 days [4-88] with a median of 2.5 hospitalizations [1-8] per patient. CONCLUSION Malnutrition can occur after any BS procedure, and AN when required in this setting appears safe and effective on nutritional parameters. It is important to recognize the potential risk factors for malnutrition, which include excessive weight loss resulting from surgical complications, eating disorders, multiple revisional BS, and pregnancy.
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Affiliation(s)
- Sarah Chalopin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Pierre Bel Lassen
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | - Laurent Genser
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne University, Paris, France
| | - Judith Aron-Wisnewsky
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | - Christine Poitou
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | - Cécile Ciangura
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Adriana Torcivia
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne University, Paris, France
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Dorothée Bedock
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Pauline Faucher
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France.
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Lafarge JC, Aron-Wisnewsky J, Pattou F, Cucherat M, Blondet E, Lascols S, Le Guludec D, David DJ, Carbonneil C. French National Authority for Health assessment of metabolic surgery for type 2 diabetes remission-A meta-analysis in patients with class I to III obesity. Diabetes Metab 2024; 50:101495. [PMID: 38000504 DOI: 10.1016/j.diabet.2023.101495] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVE Randomized controlled trials (RCTs) have demonstrated the superiority of metabolic surgery (MS) over medical therapy (MT) in patients with obesity and type 2 diabetes, leading, to a joint statement in 2016 proposing MS to patients with class I obesity and uncontrolled glycemia. Yet, these RCTs included few patients with class I obesity (body mass index 30-35 kg/m2) and even fewer patients with overweight. Our aim was to provide an updated systematic review (SR) with meta-analysis (MA) of RCTs reporting diabetes remission (DR) after MS in these patients. RESEARCH DESIGN AND METHODS We included in the SR with MA only RCTs with at least 24-month follow-up found in Medline, Cochrane Library, Embase, and LiSSA between January 2008 and September 2022 comparing DR post-MT versus post-MS. We calculated relative risk (RR) and 95 % confidence intervals (CIs) using the Mantel-Haenszel random-effects approach to examine differences in DR between patients allocated to MS versus MT. RESULTS DR was significantly higher in MS versus MT after 36 months' follow-up in patients with obesity (RR = 6.65 [95 %CI 2.24;19.79]; I² = 27 %; 5 trials, 404 patients), but also specifically in patients with class I obesity (RR = 5.27 [1.31;21.23]; I² = 0 %; 4 trials, 80 patients). Furthermore, and in line with previous results, all additional MAs performed in patients with obesity in this work favor MS (specifically Roux-en-Y gastric bypass) over MT at 24, 36 (only) and 60 months of follow-up. CONCLUSIONS Although the data available in patients with class I obesity and type 2 diabetes remains limited, MA shows higher rates of DR after MS compared with MT after 36 months' follow-up in these patients. Consequently, the French National Authority for Health French (HAS) recommends MS for these patients.
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Affiliation(s)
- Jean-Charles Lafarge
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France.
| | - Judith Aron-Wisnewsky
- Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière, Department of Nutrition, 75013 Paris, France; Sorbonne Université, INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, 75013 Paris, France
| | - François Pattou
- Université Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Translational research in diabetes, Lille, France
| | - Michel Cucherat
- Service Hospitalo Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Lyon, France
| | - Emmanuelle Blondet
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Sylvie Lascols
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Dominique Le Guludec
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Denis-Jean David
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
| | - Cédric Carbonneil
- Health Technology Assessment Department, Haute Autorité de Santé, La Plaine Saint-Denis, France
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Fabron C, Laville M, Aron-Wisnewsky J, Disse E, Gatta-Cherifi B, Jacobi D, Montastier E, Oppert JM, Gaillard L, Detournay B, Czernichow S. Out-of-Pocket Expenses in Households of People Living with Obesity in France. Obes Facts 2023; 16:606-613. [PMID: 37879296 PMCID: PMC10870127 DOI: 10.1159/000533342] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/28/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND/OBJECTIVES Overweight and obesity result in a substantial economic burden in both low- and high-income countries. Moreover, this burden is often underestimated because it only partially accounts for unreimbursed out-of-pocket expenses (OOPE) related to obesity. The objective of our study was not only to evaluate OOPE incurred by people with obesity in relation to their disease with respect to direct medical expenditures and direct non-medical expenditures but also the proportion of people living with obesity who have forgone obesity-related healthcare due to the costs of such care. METHODS An observational descriptive survey was conducted among people with class II/III obesity attending six obesity treatment centers in France. Volunteer adult participants completed a written/phone questionnaire on their related expenditures over the last 6 months for current expenditures and over the last 5 years for occasional ones. The costs were expressed in 2022 EUR. RESULTS 299 people participated (age: 46 years [SD: 13.9], women: 72%, BMI ≥40 kg/m2: 62% and 48% with comorbidities). 65% had a professional activity. 83% declared that they had OOPE related to obesity representing annually EUR 2027/individual on average (5% of the household revenue), including weight loss and nutritional products, vitamins, meal programs, gym memberships, psychologists, but mainly adapted clothing, additional travel costs, and others. 15% of the respondents had to modify their professional activity due to obesity and 15% forwent some medical care in the last 12 months. CONCLUSIONS OOPE is a significant part of the economic burden of obesity. Despite some limitations due to the specificities of the participants and because some costs may be more related to social activities affected by obesity than to healthcare, it seems important to consider these expenditures in cost estimates for obesity.
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Affiliation(s)
| | - Martine Laville
- Endocrinology-Diabetology-Nutrition Department, F-CRIN-FORCE network, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon University, Pierre-Bénite, France
| | - Judith Aron-Wisnewsky
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, France and INSERM UMRS 1269 NutriOmics, Sorbonne University, Paris, France
| | - Emmanuel Disse
- Endocrinology-Diabetology-Nutrition Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon University, Pierre-Bénite, France
| | - Blandine Gatta-Cherifi
- Endocrinology-Diabetology-Nutrition Department, Haut-Lévêque Hospital, Bordeaux University Hospital, France and Neurocentre Magendie, INSERMU1215, Bordeaux University, Bordeaux, France
| | - David Jacobi
- Nantes Université, CHU Nantes, CNRS, INSERM, L’institut du Thorax, Nantes, France
| | - Emilie Montastier
- Nantes University Hospital, CNRS, INSERM, L’institut du Thorax, Nantes University, Nantes, France
| | - Jean-Michel Oppert
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, France and INSERM UMRS 1269 NutriOmics, Sorbonne University, Paris, France
| | | | | | - Sébastien Czernichow
- Nutrition Department, Georges-Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, France and Paris Cité University, Paris, France
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Destan C, Baratte C, Torcivia A, Brevart C, Malgras B, Clément K, Poitou C, Oppert JM, Aron-Wisnewsky J, Genser L. Revisional Roux-en-Y Gastric Bypass After Sleeve Gastrectomy for Gastro-esophageal Reflux Disease and or Insufficient Weight-Loss: a Comparative Study. Obes Surg 2023; 33:3077-3089. [PMID: 37594673 DOI: 10.1007/s11695-023-06784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Sleeve gastrectomy (SG) is a popular surgical weight-loss procedure, but there are increasing reports of revisional Roux-Y-gastric-bypass (R-RYGB) to manage weight-loss failure (WLF) or proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) after SG, with little data available in these settings. METHODS This retrospective study included all consecutive patients undergoing R-RYGB for WLF or RGERD after SG in two bariatric care centers from 2012 to 2018. RESULTS Of 720 patients, 46 (3.6%) underwent R-RYGB (RGERD, n = 25; 54.4%; WLF, n = 21; 45.6%) within 44.8 ± 27.5 months post-SG. SG had enabled 27% ± 11.6 total weight loss (TWL) in the RGERD group vs. 7.2% ± 12.5% TWL in the WLF group (p < 0.001). At R-RYGB, WLF-group patients had a higher BMI (47.8 ± 8.4 vs. 34.7 ± 6.1 kg/m2; p < 0.001) and a higher number of comorbidities (2.4 ± 1.5 vs 1.5 ± 1.2; p < 0.02) compared to RGERD-group patients, while severe morbidity (Clavien-Dindo ≥ IIIb) was not significantly different between groups (6.5% vs 2.1%, p = 0.6). %TWL was still higher in the RGERD group at 12 months post-R-RYGB (35.6% ± 10.4 vs. 23.8% ± 9.2; p < 0.01) but not after 24 months post-R-RYGB. R-RYGB corrected reflux symptoms in 32 (94%) patients and reduced PPI use in 29 (97%) patients (p < 0.001), with no significant between-group difference. A history of adjustable gastric banding (AGB) (N = 8;17.4%) prior to SG was associated with a similar prevalence of GERD at R-RYGB and a lower %TWL (AGB:13.1 ± 10.2 vs. No AGB:31.6 ± 8.5; p < 0.05) at 3 years post-R-RYGB. CONCLUSION R-RYGB following SG provides remission of reflux symptoms in 94% of patients and extra weight loss in patients with WLF, except in patients with a history of AGB prior to SG.
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Affiliation(s)
- Clément Destan
- Sorbonne Université, Assistance Publique- Hôpitaux de Paris, AP-HP, Department of Hepato-Biliary and Pancreatic Surgery, liver transplantation, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- Department of Digestive Surgery, Begin Military Teaching Hospital, 69 Avenue de Paris, 94160, Saint Mandé, France
- Val de Grace Academy, 1 Place Alphonse Laveran, 75005, Paris, France
| | - Clément Baratte
- Sorbonne Université, Assistance Publique- Hôpitaux de Paris, AP-HP, Department of Hepato-Biliary and Pancreatic Surgery, liver transplantation, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Adriana Torcivia
- Sorbonne Université, Assistance Publique- Hôpitaux de Paris, AP-HP, Department of Hepato-Biliary and Pancreatic Surgery, liver transplantation, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Christophe Brevart
- Department of Digestive Surgery, Begin Military Teaching Hospital, 69 Avenue de Paris, 94160, Saint Mandé, France
- Val de Grace Academy, 1 Place Alphonse Laveran, 75005, Paris, France
| | - Brice Malgras
- Department of Digestive Surgery, Begin Military Teaching Hospital, 69 Avenue de Paris, 94160, Saint Mandé, France
- Val de Grace Academy, 1 Place Alphonse Laveran, 75005, Paris, France
| | - Karine Clément
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Nutrition, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and ObesitiesSystemic Approaches, NutriOmicsResearch Unit, Sorbonne Université, 91 Boulevard de L'hôpital, Paris, France
| | - Christine Poitou
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Nutrition, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and ObesitiesSystemic Approaches, NutriOmicsResearch Unit, Sorbonne Université, 91 Boulevard de L'hôpital, Paris, France
| | - Jean-Michel Oppert
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Nutrition, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Nutrition, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and ObesitiesSystemic Approaches, NutriOmicsResearch Unit, Sorbonne Université, 91 Boulevard de L'hôpital, Paris, France
| | - Laurent Genser
- Sorbonne Université, Assistance Publique- Hôpitaux de Paris, AP-HP, Department of Hepato-Biliary and Pancreatic Surgery, liver transplantation, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
- INSERM, Nutrition and ObesitiesSystemic Approaches, NutriOmicsResearch Unit, Sorbonne Université, 91 Boulevard de L'hôpital, Paris, France.
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Andrikopoulos P, Aron-Wisnewsky J, Chakaroun R, Myridakis A, Forslund SK, Nielsen T, Adriouch S, Holmes B, Chilloux J, Vieira-Silva S, Falony G, Salem JE, Andreelli F, Belda E, Kieswich J, Chechi K, Puig-Castellvi F, Chevalier M, Le Chatelier E, Olanipekun MT, Hoyles L, Alves R, Helft G, Isnard R, Køber L, Coelho LP, Rouault C, Gauguier D, Gøtze JP, Prifti E, Froguel P, Zucker JD, Bäckhed F, Vestergaard H, Hansen T, Oppert JM, Blüher M, Nielsen J, Raes J, Bork P, Yaqoob MM, Stumvoll M, Pedersen O, Ehrlich SD, Clément K, Dumas ME. Evidence of a causal and modifiable relationship between kidney function and circulating trimethylamine N-oxide. Nat Commun 2023; 14:5843. [PMID: 37730687 PMCID: PMC10511707 DOI: 10.1038/s41467-023-39824-4] [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: 11/02/2022] [Accepted: 06/30/2023] [Indexed: 09/22/2023] Open
Abstract
The host-microbiota co-metabolite trimethylamine N-oxide (TMAO) is linked to increased cardiovascular risk but how its circulating levels are regulated remains unclear. We applied "explainable" machine learning, univariate, multivariate and mediation analyses of fasting plasma TMAO concentration and a multitude of phenotypes in 1,741 adult Europeans of the MetaCardis study. Here we show that next to age, kidney function is the primary variable predicting circulating TMAO, with microbiota composition and diet playing minor, albeit significant, roles. Mediation analysis suggests a causal relationship between TMAO and kidney function that we corroborate in preclinical models where TMAO exposure increases kidney scarring. Consistent with our findings, patients receiving glucose-lowering drugs with reno-protective properties have significantly lower circulating TMAO when compared to propensity-score matched control individuals. Our analyses uncover a bidirectional relationship between kidney function and TMAO that can potentially be modified by reno-protective anti-diabetic drugs and suggest a clinically actionable intervention for decreasing TMAO-associated excess cardiovascular risk.
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Affiliation(s)
- Petros Andrikopoulos
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK.
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Rima Chakaroun
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Antonis Myridakis
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, 86 Wood Lane, London, W12 0BZ, UK
| | - Sofia K Forslund
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin and the Max-Delbrück Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- Charité University Hospital, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Solia Adriouch
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | | | - Julien Chilloux
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sara Vieira-Silva
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Joe-Elie Salem
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Fabrizio Andreelli
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Eugeni Belda
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Julius Kieswich
- Diabetic Kidney Disease Centre, Renal Unit, Barts Health National Health Service Trust, The Royal London Hospital, London, UK
- Centre for Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kanta Chechi
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Francesc Puig-Castellvi
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
| | - Mickael Chevalier
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
| | | | - Michael T Olanipekun
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Lesley Hoyles
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Renato Alves
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Gerard Helft
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, INSERM, 1166, Paris, France
| | - Richard Isnard
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Luis Pedro Coelho
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Christine Rouault
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | - Dominique Gauguier
- INSERM UMR 1124, Université de Paris, 45 rue des Saint-Pères, 75006, Paris, France
- McGill Genome Centre, McGill University, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada
| | - Jens Peter Gøtze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Edi Prifti
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Philippe Froguel
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
- Section of Genetics and Genomics, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, W12 0NN, UK
| | - Jean-Daniel Zucker
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Fredrik Bäckhed
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Bornholms Hospital, Rønne, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Michel Oppert
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Matthias Blüher
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Jeroen Raes
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
- Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- Department of Bioinformatics, Biocenter, University of Würzburg, Würzburg, Germany
- Yonsei Frontier Lab (YFL), Yonsei University, Seoul, 03722, South Korea
| | - Muhammad M Yaqoob
- Diabetic Kidney Disease Centre, Renal Unit, Barts Health National Health Service Trust, The Royal London Hospital, London, UK
- Centre for Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Michael Stumvoll
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Metabolic Research, Gentofte University Hospital, Copenhagen, Denmark
| | - S Dusko Ehrlich
- Department of Clinical and Movement Neurosciences, University College London, London, NW3 2PF, UK
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France.
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France.
| | - Marc-Emmanuel Dumas
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK.
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France.
- McGill Genome Centre, McGill University, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada.
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8
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Molinaro A, Nemet I, Bel Lassen P, Chakaroun R, Nielsen T, Aron-Wisnewsky J, Bergh PO, Li L, Henricsson M, Køber L, Isnard R, Helft G, Stumvoll M, Pedersen O, Smith JG, Tang WHW, Clément K, Hazen SL, Bäckhed F. Microbially Produced Imidazole Propionate Is Associated With Heart Failure and Mortality. JACC Heart Fail 2023; 11:810-821. [PMID: 37115134 DOI: 10.1016/j.jchf.2023.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Over the past years, it has become clear that the microbial ecosystem in the gut has a profound capacity to interact with the host through the production of a wide range of bioactive metabolites. The microbially produced metabolite imidazole propionate (ImP) is clinically and mechanistically linked with insulin resistance and type 2 diabetes, but it is unclear how ImP is associated with heart failure. OBJECTIVES The authors aimed to explore whether ImP is associated with heart failure and mortality. METHODS ImP serum measurements in 2 large and independent clinical cohorts of patients (European [n = 1,985] and North American [n = 2,155]) with a range of severity of cardiovascular disease including heart failure. Univariate and multivariate Cox regression analyses were performed to delineate the impact of ImP on 5-year mortality in the North American cohort, independent of other covariates. RESULTS ImP is independently associated with reduced ejection fraction and heart failure in both cohorts, even after adjusting for traditional risk factors. Elevated ImP was a significant independent predictor of 5-year mortality (for the highest quartile, adjusted HR: 1.85 [95% CI: 1.20-2.88]; P < 0.01). CONCLUSIONS The gut microbial metabolite ImP is increased in individuals with heart failure and is a predictor of overall survival.
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Affiliation(s)
- Antonio Molinaro
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Department of Medicine, Gothenburg, Sweden
| | - Ina Nemet
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland, Ohio, USA; Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Pierre Bel Lassen
- Sorbonne Université, INSERM, Nutrition and Obesities: Systemic Approaches (NutriOmics), Paris, France; Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Rima Chakaroun
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden; Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities: Systemic Approaches (NutriOmics), Paris, France; Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Per-Olof Bergh
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden
| | - Lin Li
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland, Ohio, USA; Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marcus Henricsson
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden
| | - Lars Køber
- Department of Cardiology, Rigshospialet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Richard Isnard
- Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Cardiology Department, Paris, France
| | - Gerard Helft
- Sorbonne Université, INSERM UMRS1166, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
| | - Michael Stumvoll
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Gustav Smith
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden; Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University, Lund, Sweden
| | - W H Wilson Tang
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland, Ohio, USA; Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, Ohio, USA; Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities: Systemic Approaches (NutriOmics), Paris, France; Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Stanley L Hazen
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland, Ohio, USA; Center for Microbiome and Human Health, Cleveland Clinic, Cleveland, Ohio, USA; Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Fredrik Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Gothenburg, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg, Sweden.
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9
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Bouazizi K, Zarai M, Noufaily A, Prigent M, Dietenbeck T, Bollache E, Nguyen T, Della Valle V, Blondiaux E, Clément K, Aron-Wisnewsky J, Andreelli F, Redheuil A, Kachenoura N. Associations of aortic stiffness and intra-aortic flow parameters with epicardial adipose tissue in patients with type-2 diabetes. Front Clin Diabetes Healthc 2023; 4:1106342. [PMID: 37304050 PMCID: PMC10250660 DOI: 10.3389/fcdhc.2023.1106342] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023]
Abstract
Background It has been shown that increased aortic stiffness is related to type-2 diabetes (T2D) which is considered as a risk factor for cardiovascular disease. Among other risk factors is epicardial adipose tissue (EAT) which is increased in T2D and is a relevant biomarker of metabolic severity and adverse outcome. Purpose To assess aortic flow parameters in T2D patients as compared to healthy individuals and to evaluate their associations with EAT accumulation as an index of cardiometabolic severity in T2D patients. Materials and methods Thirty-six T2D patients as well as 29 healthy controls matched by age and sex were included in this study. Participants had cardiac and aortic MRI exams at 1.5 T. Imaging sequences included cine SSFP for left ventricle (LV) function and EAT assessment and aortic cine and phase-contrast imaging for strain and flow parameters quantification. Results In this study, we found LV phenotype to be characterized by concentric remodeling with decreased stroke volume index despite global LV mass within a normal range. EAT was increased in T2D patients compared to controls (p<0.0001). Moreover, EAT, a biomarker of metabolic severity, was negatively correlated to ascending aortic (AA) distensibility (p=0.048) and positively to the normalized backward flow volume (p=0.001). These relationships remained significant after further adjustment for age, sex and central mean blood pressure. In a multivariate model, presence/absence of T2D and AA normalized backward flow (BF) to forward flow (FF) volumes ratio are both significant and independent correlates of EAT. Conclusion In our study, aortic stiffness as depicted by an increased backward flow volume and decreased distensibility seems to be related to EAT volume in T2D patients. This observation should be confirmed in the future on a larger population while considering additional biomarkers specific to inflammation and using a longitudinal prospective study design.
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Affiliation(s)
- Khaoula Bouazizi
- Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Institut National de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Paris, France
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Mohamed Zarai
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Abdallah Noufaily
- Unité d’Imagerie Cardiovasculaire et Thoracique (ICT), Pitié-Salpêtrière Hospital, Paris, France
| | - Mikaël Prigent
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Thomas Dietenbeck
- Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Institut National de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Paris, France
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Emilie Bollache
- Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Institut National de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Paris, France
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Toan Nguyen
- Assistance Publique Hôpitaux de Paris, Radiology Department, Armand-Trousseau Hospital, Paris, France
| | - Valéria Della Valle
- Assistance Publique Hôpitaux de Paris, Radiology Department, Armand-Trousseau Hospital, Paris, France
| | - Eléonore Blondiaux
- Assistance Publique Hôpitaux de Paris, Radiology Department, Armand-Trousseau Hospital, Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Centre de Recherche en Nutrition Humaine (CRNH) Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Centre de Recherche en Nutrition Humaine (CRNH) Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
| | - Fabrizio Andreelli
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Assistance Publique Hôpitaux de Paris, Diabetology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Alban Redheuil
- Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Institut National de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Paris, France
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Unité d’Imagerie Cardiovasculaire et Thoracique (ICT), Pitié-Salpêtrière Hospital, Paris, France
| | - Nadjia Kachenoura
- Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Institut National de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Paris, France
- ICAN Imaging, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
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10
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Daouadji-Ghazouani A, Aron-Wisnewsky J, Torcivia A, Irigoin-Guichandut M, Poitou C, Faucher P, Ciangura C, Lassen PB, Clément K, Vaillant JC, Oppert JM, Genser L. Correction: Follow-Up, Safety, and Satisfaction with Tele-bariatric Follow-Up Implemented During the COVID-19 French Lockdown: a 2-Year Follow-Up Study. Obes Surg 2023:10.1007/s11695-023-06612-4. [PMID: 37099253 PMCID: PMC10132429 DOI: 10.1007/s11695-023-06612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Ahmed Daouadji-Ghazouani
- Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Judith Aron-Wisnewsky
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Adriana Torcivia
- Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Marc Irigoin-Guichandut
- Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Christine Poitou
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Pauline Faucher
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Cécile Ciangura
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Pierre Bel Lassen
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Karine Clément
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Jean-Christophe Vaillant
- Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Jean-Michel Oppert
- Department of Nutrition, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
| | - Laurent Genser
- Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
- INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.
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11
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Genser L, Thabut D, Aron-Wisnewsky J. Precision Bariatric/Metabolic Medicine and Surgery. J Clin Med 2023; 12:1909. [PMID: 36902695 PMCID: PMC10004069 DOI: 10.3390/jcm12051909] [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] [Received: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Indications and techniques of bariatric surgery (BS) have constantly evolved in recent decades and now face new challenges [...].
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Affiliation(s)
- Laurent Genser
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Hepato-Biliary and Pancreatic Surgery, Pitié-Salpêtrière University Hospital, 47-83 boulevard de l’Hôpital, 75013 Paris, France
- Sorbonne Université, INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, 75013 Paris, France
| | - Dominique Thabut
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Hepato-Gastroenterology, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesity: Systemic Approaches, NutriOmics, 75013 Paris, France
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, AP-HP, Department of Nutrition, Pitié-Salpêtrière University Hospital, 47-83 Boulevard de l’Hôpital, 75013 Paris, France
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12
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Cano A, Vazquez-Chantada M, Conde-Vancells J, Gonzalez-Lahera A, Mosen-Ansorena D, Blanco FJ, Clément K, Aron-Wisnewsky J, Tran A, Gual P, García-Monzón C, Caballería J, Castro A, Martínez-Chantar ML, Mato JM, Zhu H, Finnell RH, Aransay AM. Impaired Function of Solute Carrier Family 19 Leads to Low Folate Levels and Lipid Droplet Accumulation in Hepatocytes. Biomedicines 2023; 11:biomedicines11020337. [PMID: 36830876 PMCID: PMC9953281 DOI: 10.3390/biomedicines11020337] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Low serum folate levels are inversely related to metabolic associated fatty liver disease (MAFLD). The role of the folate transporter gene (SLC19A1) was assessed to clarify its involvement in lipid accumulation during the onset of MAFLD in humans and in liver cells by genomic, transcriptomic, and metabolomic techniques. Genotypes of 3 SNPs in a case-control cohort were initially correlated to clinical and serum MAFLD markers. Subsequently, the expression of 84 key genes in response to the loss of SLC19A1 was evaluated with the aid of an RT2 profiler-array. After shRNA-silencing of SLC19A1 in THLE2 cells, folate and lipid levels were measured by ELISA and staining techniques, respectively. In addition, up to 482 amino acids and lipid metabolites were semi-quantified in SLC19A1-knockdown (KD) cells through ultra-high-performance liquid chromatography coupled with mass spectrometry. SNPs, rs1051266 and rs3788200, were significantly associated with the development of fatty liver for the single-marker allelic test. The minor alleles of these SNPs were associated with a 0.6/-1.67-fold decreased risk of developing MAFLD. When SLC19A1 was KD in THLE2 cells, intracellular folate content was four times lower than in wild-type cells. The lack of functional SLC19A1 provoked significant changes in the regulation of genes associated with lipid droplet accumulation within the cell and the onset of NAFLD. Metabolomic analyses showed a highly altered profile, where most of the species that accumulated in SLC19A1-KD-cells belong to the chemical groups of triacylglycerols, diacylglycerols, polyunsaturated fatty acids, and long chain, highly unsaturated cholesterol esters. In conclusion, the lack of SLC19A1 gene expression in hepatocytes affects the regulation of key genes for normal liver function, reduces intracellular folate levels, and impairs lipid metabolism, which entails lipid droplet accumulation in hepatocytes.
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Affiliation(s)
- Ainara Cano
- Food Research, AZTI, Basque Research and Technology Alliance (BRTA), Parque Tecnologico de Bizkaia, Astondo Bidea, Building 609, 48160 Derio, Spain
- OWL Metabolomics, Parque Tecnologico de Bizkaia, Building 502, 48160 Derio, Spain
| | - Mercedes Vazquez-Chantada
- OWL Metabolomics, Parque Tecnologico de Bizkaia, Building 502, 48160 Derio, Spain
- Department of Nutritional Sciences, Dell Paediatric Research Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - Javier Conde-Vancells
- Department of Nutritional Sciences, Dell Paediatric Research Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - Aintzane Gonzalez-Lahera
- CIC bioGUNE, Parque Tecnologico de Bizkaia, Building 801-A, 48160 Derio, Spain
- CIBERehd, ISCIII, 28029 Madrid, Spain
| | | | - Francisco J. Blanco
- CIC bioGUNE, Parque Tecnologico de Bizkaia, Building 801-A, 48160 Derio, Spain
- Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - Karine Clément
- Nutriomics Research Group, Nutrition Department, Pitié-Salpétrière Hospital, INSERM, Sorbonne Université, F-75013 Paris, France
- INSERM, UMR_S 1166, NutriOmics Team 6, F-75013 Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department ICAN and CRNH-Ile de France, Pitié-Salpêtrière Hospital, F-75013 Paris, France
| | - Judith Aron-Wisnewsky
- Nutriomics Research Group, Nutrition Department, Pitié-Salpétrière Hospital, INSERM, Sorbonne Université, F-75013 Paris, France
- INSERM, UMR_S 1166, NutriOmics Team 6, F-75013 Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department ICAN and CRNH-Ile de France, Pitié-Salpêtrière Hospital, F-75013 Paris, France
| | - Albert Tran
- Team 8 “Chronic Liver Diseases Associated with Obesity and Alcohol”, INSERM, U1065, Centre Hospitalier Universitaire de Nice, C3M, Université Côte d’Azur, 06000 Nice, France
| | - Philippe Gual
- Team 8 “Chronic Liver Diseases Associated with Obesity and Alcohol”, INSERM, U1065, Centre Hospitalier Universitaire de Nice, C3M, Université Côte d’Azur, 06000 Nice, France
| | - Carmelo García-Monzón
- CIBERehd, ISCIII, 28029 Madrid, Spain
- Liver Research Unit, Santa Cristina University Hospital, Instituto de Investigación Sanitaria Princesa, 28009 Madrid, Spain
| | - Joan Caballería
- CIBERehd, ISCIII, 28029 Madrid, Spain
- Liver Unit, Hospital Clinic, 08036 Barcelona, Spain
| | - Azucena Castro
- OWL Metabolomics, Parque Tecnologico de Bizkaia, Building 502, 48160 Derio, Spain
| | - María Luz Martínez-Chantar
- CIC bioGUNE, Parque Tecnologico de Bizkaia, Building 801-A, 48160 Derio, Spain
- CIBERehd, ISCIII, 28029 Madrid, Spain
| | - José M. Mato
- CIC bioGUNE, Parque Tecnologico de Bizkaia, Building 801-A, 48160 Derio, Spain
- CIBERehd, ISCIII, 28029 Madrid, Spain
| | - Huiping Zhu
- Department of Nutritional Sciences, Dell Paediatric Research Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - Richard H. Finnell
- Department of Nutritional Sciences, Dell Paediatric Research Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - Ana M. Aransay
- CIC bioGUNE, Parque Tecnologico de Bizkaia, Building 801-A, 48160 Derio, Spain
- CIBERehd, ISCIII, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-944-061-325 or +34-946-572-524; Fax: +34-946-572-530
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13
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Lambert F, Chalopin S, Bedock D, Ciangura C, Aron-Wisnewsky J, Faucher P, Aviles Marquez L, Louhou R, Poitou C, Oppert JM, Bel Lassen P. From Dyspnea to Skin Grafting: The Difficulties of Managing a Patient with Extreme Obesity. Obes Facts 2023; 16:212-215. [PMID: 36521446 PMCID: PMC10028363 DOI: 10.1159/000527092] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/11/2022] [Indexed: 12/23/2022] Open
Abstract
While the prevalence of severe obesity is increasing worldwide, caregivers are often challenged with the management of patients with extreme weight. A 30-year-old woman (weight 245 kg, body mass index 85 kg/m2) presented with dyspnea, for which investigations led to suspect pulmonary embolism. The patient's weight made it impossible to perform adapted imaging; thus, an empirical anticoagulant treatment was initiated. A hematoma of the thigh occurred as a consequence of a transient antivitamin K overdose, leading to a 15-cm necrotic wound worsened by a state of malnutrition. Multidisciplinary and comprehensive care was performed including wound trimming, antibiotics, skin grafting, treatment of malnutrition, and psychological support, but with marked difficulties due to the lack of adapted medical equipment and facilities as well as appropriate medical guidelines. Overall, 7 months of hospitalization including 4 months of physiotherapy and rehabilitation were needed before the patient could return home. This case highlights how difficult managing patients with extreme obesity can be and points to the importance for healthcare systems to adapt to the specific needs of these patients and to design specific guidelines for treatment dosage and malnutrition prevention and treatment in this setting.
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Affiliation(s)
- Flora Lambert
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Sarah Chalopin
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Dorothée Bedock
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Cécile Ciangura
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Judith Aron-Wisnewsky
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), Paris, France
| | - Pauline Faucher
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Laura Aviles Marquez
- Nutrition department, Assistance Publique Hôpitaux de Paris, Hôpital Maritime de Berck, Berck, France
| | - Rufin Louhou
- Nutrition department, Assistance Publique Hôpitaux de Paris, Hôpital Maritime de Berck, Berck, France
| | - Christine Poitou
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), Paris, France
| | - Jean-Michel Oppert
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
| | - Pierre Bel Lassen
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH Ile-de-France, Sorbonne Université, Paris, France
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), Paris, France
- *Pierre Bel Lassen,
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14
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Belda E, Voland L, Tremaroli V, Falony G, Adriouch S, Assmann KE, Prifti E, Aron-Wisnewsky J, Debédat J, Le Roy T, Nielsen T, Amouyal C, André S, Andreelli F, Blüher M, Chakaroun R, Chilloux J, Coelho LP, Dao MC, Das P, Fellahi S, Forslund S, Galleron N, Hansen TH, Holmes B, Ji B, Krogh Pedersen H, Le P, Le Chatelier E, Lewinter C, Mannerås-Holm L, Marquet F, Myridakis A, Pelloux V, Pons N, Quinquis B, Rouault C, Roume H, Salem JE, Sokolovska N, Søndertoft NB, Touch S, Vieira-Silva S, Galan P, Holst J, Gøtze JP, Køber L, Vestergaard H, Hansen T, Hercberg S, Oppert JM, Nielsen J, Letunic I, Dumas ME, Stumvoll M, Pedersen OB, Bork P, Ehrlich SD, Zucker JD, Bäckhed F, Raes J, Clément K. Impairment of gut microbial biotin metabolism and host biotin status in severe obesity: effect of biotin and prebiotic supplementation on improved metabolism. Gut 2022; 71:2463-2480. [PMID: 35017197 PMCID: PMC9664128 DOI: 10.1136/gutjnl-2021-325753] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/15/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Gut microbiota is a key component in obesity and type 2 diabetes, yet mechanisms and metabolites central to this interaction remain unclear. We examined the human gut microbiome's functional composition in healthy metabolic state and the most severe states of obesity and type 2 diabetes within the MetaCardis cohort. We focused on the role of B vitamins and B7/B8 biotin for regulation of host metabolic state, as these vitamins influence both microbial function and host metabolism and inflammation. DESIGN We performed metagenomic analyses in 1545 subjects from the MetaCardis cohorts and different murine experiments, including germ-free and antibiotic treated animals, faecal microbiota transfer, bariatric surgery and supplementation with biotin and prebiotics in mice. RESULTS Severe obesity is associated with an absolute deficiency in bacterial biotin producers and transporters, whose abundances correlate with host metabolic and inflammatory phenotypes. We found suboptimal circulating biotin levels in severe obesity and altered expression of biotin-associated genes in human adipose tissue. In mice, the absence or depletion of gut microbiota by antibiotics confirmed the microbial contribution to host biotin levels. Bariatric surgery, which improves metabolism and inflammation, associates with increased bacterial biotin producers and improved host systemic biotin in humans and mice. Finally, supplementing high-fat diet-fed mice with fructo-oligosaccharides and biotin improves not only the microbiome diversity, but also the potential of bacterial production of biotin and B vitamins, while limiting weight gain and glycaemic deterioration. CONCLUSION Strategies combining biotin and prebiotic supplementation could help prevent the deterioration of metabolic states in severe obesity. TRIAL REGISTRATION NUMBER NCT02059538.
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Affiliation(s)
- Eugeni Belda
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Integrative Phenomics, Paris, France
| | - Lise Voland
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Valentina Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Gwen Falony
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | - Solia Adriouch
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Karen E Assmann
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Edi Prifti
- Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Sorbonne Université, IRD, Bondy, France
| | - Judith Aron-Wisnewsky
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Jean Debédat
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Tiphaine Le Roy
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Trine Nielsen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Chloé Amouyal
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Sébastien André
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Fabrizio Andreelli
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Matthias Blüher
- Medical Department III - Endocrinology, Nephrology, Rheumatology - Medical Center, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Rima Chakaroun
- Medical Department III - Endocrinology, Nephrology, Rheumatology - Medical Center, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Julien Chilloux
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London Faculty of Medicine, London, UK
| | - Luis Pedro Coelho
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany,Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Maria Carlota Dao
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Promi Das
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | - Soraya Fellahi
- Functional Unit, Biochemistry and Hormonology Department, enon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France,Saint-Antoine Research Center, Sorbonne Université, INSERM, Paris, France
| | - Sofia Forslund
- Max Delbrück Center for Molecular Medicine, MDC, Berlin-Buch, Germany
| | - Nathalie Galleron
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Tue H Hansen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Bridget Holmes
- Centre Daniel Carasso, Global Nutrition Department, Danone Nutricia Research, Palaiseau, France
| | - Boyang Ji
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | - Helle Krogh Pedersen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Phuong Le
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | | | | | - Louise Mannerås-Holm
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Florian Marquet
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Antonis Myridakis
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Veronique Pelloux
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Nicolas Pons
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Benoit Quinquis
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Christine Rouault
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Hugo Roume
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France
| | - Joe-Elie Salem
- Department of Pharmacology and CIC-1421, Assistance Publique-Hôpitaux de Paris, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Nataliya Sokolovska
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Nadja B Søndertoft
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Sothea Touch
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France
| | - Sara Vieira-Silva
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | | | - Pilar Galan
- Nutritional Epidemiology Unit, INSERM, INRAE, CNAM, Paris 13 University, Bobigny, France
| | - Jens Holst
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Jens Peter Gøtze
- Department of Clinical Biochemistry, Rigshospitalet, Kobenhavn, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Kobenhavn, Denmark
| | - Henrik Vestergaard
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark,Steno Diabetes Center, Copenhagen, Gentofte, Denmark
| | - Torben Hansen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Serge Hercberg
- Nutritional Epidemiology Unit, INSERM, INRAE, CNAM, Paris 13 University, Bobigny, France
| | - Jean-Michel Oppert
- Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Jens Nielsen
- Department of Biology, Chalmers University of Technology, Goteborg, Sweden
| | | | - Marc-Emmanuel Dumas
- Department of Surgery and Cancer, Section of Computational and Systems Medicine, Imperial College London, London, UK,National Heart & Lung Institute, Section of Genomic & Environmental Medicine, Imperial College London, London, UK
| | - Michael Stumvoll
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München, University of Leipzig Faculty of Medicine, Leipzig, Germany
| | - Oluf Borbye Pedersen
- Center for Basic Metabolic Research, Novo Nordisk Foundation, University of Copenhagen, Kobenhavn, Denmark
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany,Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Stanislav Dusko Ehrlich
- MetaGenoPolis, Université Paris-Saclay, INRAE, Jouy-en-Josas, France,Center for Host Microbiome Interactions, King's College London Dental Institute, London, UK
| | - Jean-Daniel Zucker
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Sorbonne Université, IRD, Bondy, France
| | - Fredrik Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, Goteborg, Sweden
| | - Jeroen Raes
- Center for Microbiology, VIB, Leuven, Belgium,Vlaams Instituut voor Biotechnologie, VIB-KU Leuven, Heverlee, Flanders, Belgium
| | - Karine Clément
- Nutrition and Obesities: Systemic Approaches, NutriOmics, Research Unit, Sorbonne Université, INSERM, Paris, France .,Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
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15
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Bialobroda J, Bouazizi K, Zarai M, Kachenoura N, Clement K, Aron-Wisnewsky J, Hatem S, Redheuil A. Epicardial adipose tissue of atrioventricular grooves is a reliable and early MRI biomarker of the effect of metabolic diseases on atrial myocardium. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.224] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT), the visceral adipose tissue surrounding the heart, is implicated in a host of cardiovascular diseases playing a transducer role between systemic metabolic conditions and the myocardium, as illustrated by higher risk of atrial fibrillation in patients with diabetes or obesity. MRI affords comprehensive and non-invasive insights into myocardial structure, function and tissue properties. However, the clinical usefulness of whole atrial EAT is limited by its challenging measurability in clinical routine in several imaging modalities, including MRI.
Purpose
We hypothesized that atrioventricular groove epicardial adipose tissue (GEAT) which can be measured routinely based on established anatomic landmarks may be: 1) a relevant surrogate of atrial EAT and 2) a relevant imaging biomarker to characterize atrial alterations in patients with varied degrees of metabolic disorders.
Methods
Ninety-nine patients from the METACARDIS cohort (EU FP7) who had MRI, all in sinus rhythm and without overt clinical heart disease, were divided into 4 groups based on distinct metabolic profiles: metabolic syndrome (MS, n=24), severe obesity (SO, BMI ≥35 kg/m2, n=17), type-2 diabetes (T2D, n=41) and healthy controls (n=17). Atrioventricular groove EAT volume was measured from cine SSFP MRI images in four-, three-, two-chamber and short-axis views; atrial EAT volume was measured from four- and two-chamber views. Native T1-mapping values of EAT at the anterior atrioventricular groove excluding the coronary vessels were measured from the MOLLI sequence (basal short-axis slice).
Results
We found a high correlation between GEAT and atrial EAT volumes (r=0.96; p<0.0001) indicating that GEAT may reflect global atrial EAT volume. Next, we compared GEAT volume across study groups and found an increased GEAT volume in the 3 groups of patients with metabolic diseases compared to controls, with a significantly higher volume in MS (4.7±1.5 ml), SO (4.1±1.2 ml), and T2D (3.7±1.1 ml) than in Controls (2.6±0.6 ml; p≤0.001, p≤0.01, p≤0.05, respectively). In addition, T2D patients had lower native T1 values within GEAT compared to healthy controls (250±26 ms versus 280±31 ms; p≤0.01).
Conclusion
Atrioventricular groove EAT can be easily measured from conventional cine SSFP MRI images and could be used as a surrogate of global atrial EAT. Both volume and properties of GEAT are related to the metabolic status of patients. Furthermore, given its pure epicardial origin and pericoronary distribution, GEAT appears as a relevant biomarker of metabolic impacts on atrial myocardium.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Annee-recherche, Agence Regionale de Sante Ile-de-France
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Affiliation(s)
- J Bialobroda
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM UMRS1166, Sorbonne University, Institute of Cardiology, Pitié-Salpêtrière Hospital , Paris , France
| | - K Bouazizi
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
| | - M Zarai
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
| | - N Kachenoura
- Sorbonne University, Biomedical Imaging Laboratory, CNRS, INSERM , Paris , France
| | - K Clement
- Pitie Salpetriere APHP University Hospital, Nutrition Department, CRNH Ile de France , Paris , France
| | - J Aron-Wisnewsky
- Pitie Salpetriere APHP University Hospital, Nutrition Department, CRNH Ile de France , Paris , France
| | - S Hatem
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM UMRS1166, Sorbonne University, Institute of Cardiology, Pitié-Salpêtrière Hospital , Paris , France
| | - A Redheuil
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
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16
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Pais R, Aron-Wisnewsky J, Bedossa P, Ponnaiah M, Oppert JM, Siksik JM, Genser L, Charlotte F, Thabut D, Clement K, Ratziu V. Persistence of severe liver fibrosis despite substantial weight loss with bariatric surgery. Hepatology 2022; 76:456-468. [PMID: 35076966 DOI: 10.1002/hep.32358] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/26/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS It remains unclear to what extent and which components of advanced liver disease improve after bariatric surgery. We herein describe the histological outcome in patients with advanced NASH and its relationship with weight loss and metabolic improvement. APPROACH AND RESULTS One hundred ninety-six patients with advanced NASH underwent bariatric surgery, 66 of whom agreed to a follow-up liver biopsy at 6 ± 3 years (36 with advanced fibrosis [AF] and 30 with high activity [HA] grade without AF). Liver biopsies LBs were centrally read and histological response was defined as the disappearance of AF or HA. Bariatric surgery induced major histological improvement: 29% of patients had normal histology at follow-up biopsy; 74% had NASH resolution without fibrosis progression; and 70% had ≥1 stage fibrosis regression. However, AF persisted in 47% of patients despite NASH resolution and some degree of fibrosis reversal, only evidenced by the EPoS seven-tier staging classification. These patients had lower weight loss and reduced hypertension or diabetes remission rates. Older age and sleeve gastrectomy were the only independent predictors for persistent AF after adjustment for duration of follow-up. All HA patients had major histological improvement: 50% normal histology, 80% NASH resolution, and 86% a ≥1 grade steatosis reduction. Patients with normal liver at follow-up had the largest weight loss and metabolic improvement. Independent predictors of normal liver were amount of weight loss, high histological activity, and the absence of AF before surgery. CONCLUSIONS Although bariatric surgery successfully reverses active steatohepatitis, AF can persist for many years and is associated with lesser weight loss and metabolic improvement. Weight loss alone may not be sufficient to reverse AF.
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Affiliation(s)
- Raluca Pais
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,Institute of Cardiometabolism and Nutrition, Paris, France.,Centre de Recherche Saint Antoine, INSERM UMRS_938, Paris, France
| | - Judith Aron-Wisnewsky
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,CRNH Ile de France, INSERM, UMRS U1269, Nutrition and Obesities Systemic Approaches (NutriOmics), Paris, France
| | - Pierre Bedossa
- INSERM UMRS 1138 CRC, Paris, France.,LiverPat, Paris, France
| | | | - Jean-Michel Oppert
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France
| | - Jean-Michel Siksik
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurent Genser
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,CRNH Ile de France, INSERM, UMRS U1269, Nutrition and Obesities Systemic Approaches (NutriOmics), Paris, France
| | - Frederic Charlotte
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France
| | - Dominique Thabut
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,Centre de Recherche Saint Antoine, INSERM UMRS_938, Paris, France
| | - Karine Clement
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,CRNH Ile de France, INSERM, UMRS U1269, Nutrition and Obesities Systemic Approaches (NutriOmics), Paris, France
| | - Vlad Ratziu
- Assistance Publique Hôpitaux De Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,Institute of Cardiometabolism and Nutrition, Paris, France.,INSERM UMRS 1138 CRC, Paris, France
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17
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Bellicha A, Ciangura C, Roda C, Torcivia A, Aron-Wisnewsky J, Poitou C, Oppert JM. Effect of exercise training after bariatric surgery: A 5-year follow-up study of a randomized controlled trial. PLoS One 2022; 17:e0271561. [PMID: 35839214 PMCID: PMC9286216 DOI: 10.1371/journal.pone.0271561] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background and objectives
We previously showed in a 6-month randomized controlled trial that resistance training and protein supplementation after bariatric surgery (Roux-en-Y gastric bypass, RYGB) improved muscle strength without significant effect on weight loss and body composition changes. We performed a 5-year follow-up study in these subjects with the aim 1) to assess the long-term effect of this exercise training intervention and 2) to analyze associations between habitual physical activity (PA) and weight regain at 5 years.
Methods
Fifty-four out of 76 initial participants (follow-up rate of 71%) completed the 5-year follow-up examination (controls, n = 17; protein supplementation, n = 22; protein supplementation and resistance training, n = 15). We measured body weight and composition (DXA), lower-limb strength (leg-press one-repetition maximum) and habitual PA (Actigraph accelerometers and self-report). Weight regain at 5 years was considered low when <10% of 12-month weight loss.
Results
Mean (SD) time elapse since RYGB was 5.7 (0.9) y. At 5 years, weight loss was 32.8 (10.1) kg, with a mean weight regain of 5.4 (SD 5.9) kg compared with the 12-month assessment. Moderate-to-vigorous PA (MVPA) assessed by accelerometry did not change significantly compared with pre-surgery values (+5.2 [SD 21.7] min/d, P = 0.059), and only 4 (8.2%) patients reported participation in resistance training. Muscle strength decreased over time (overall mean [SD]: -49.9 [53.5] kg, respectively, P<0.001), with no statistically significant difference between exercise training intervention groups. An interquartile increase in MVPA levels was positively associated with lower weight regain (OR [95% CI]: 3.27 [1.41;9.86]).
Conclusions
Early postoperative participation in a resistance training protocol after bariatric surgery was not associated with improved muscle strength after 5 years of follow-up; however, increasing physical activity of at least moderate intensity may promote weight maintenance after surgery. PA may therefore play an important role in the long-term management of patients with obesity after undergoing bariatric procedure.
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Affiliation(s)
- Alice Bellicha
- Department of Nutrition, Center for Research on Human Nutrition (CRNH) Ile de France, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
- Nutrition and Obesities: Systemic Approaches (NutriOmics) Team, INSERM, Sorbonne University, Paris, France
- Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center—University Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
- * E-mail:
| | - Cecile Ciangura
- Department of Nutrition, Center for Research on Human Nutrition (CRNH) Ile de France, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
| | - Celina Roda
- Health Environmental Risk Assessment (HERA) Team, CRESS, Inserm, INRAE, Université Paris Cité, Paris, France
- Faculté de Pharmacie de Paris, Université Paris Cité, Paris, France
| | - Adriana Torcivia
- Department of Hepato-bilio-pancreatic Digestive Surgery and Liver Transplantation, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
| | - Judith Aron-Wisnewsky
- Department of Nutrition, Center for Research on Human Nutrition (CRNH) Ile de France, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
- Nutrition and Obesities: Systemic Approaches (NutriOmics) Team, INSERM, Sorbonne University, Paris, France
| | - Christine Poitou
- Department of Nutrition, Center for Research on Human Nutrition (CRNH) Ile de France, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
- Nutrition and Obesities: Systemic Approaches (NutriOmics) Team, INSERM, Sorbonne University, Paris, France
| | - Jean-Michel Oppert
- Department of Nutrition, Center for Research on Human Nutrition (CRNH) Ile de France, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France
- Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center—University Paris Cité (CRESS), Sorbonne Paris Nord University, Bobigny, France
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18
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Debédat J, Le Roy T, Voland L, Belda E, Alili R, Adriouch S, Bel Lassen P, Kasahara K, Hutchison E, Genser L, Torres L, Gamblin C, Rouault C, Zucker JD, Kapel N, Poitou C, Marcelin G, Rey FE, Aron-Wisnewsky J, Clément K. The human gut microbiota contributes to type-2 diabetes non-resolution 5-years after Roux-en-Y gastric bypass. Gut Microbes 2022; 14:2050635. [PMID: 35435140 PMCID: PMC9037437 DOI: 10.1080/19490976.2022.2050635] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 02/04/2023] Open
Abstract
Roux-en-Y gastric bypass (RYGB) is efficient at inducing drastic albeit variable weight loss and type-2 diabetes (T2D) improvements in patients with severe obesity and T2D. We hypothesized a causal implication of the gut microbiota (GM) in these metabolic benefits, as RYGB is known to deeply impact its composition. In a cohort of 100 patients with baseline T2D who underwent RYGB and were followed for 5-years, we used a hierarchical clustering approach to stratify subjects based on the severity of their T2D (Severe vs Mild) throughout the follow-up. We identified via nanopore-based GM sequencing that the more severe cases of unresolved T2D were associated with a major increase of the class Bacteroidia, including 12 species comprising Phocaeicola dorei, Bacteroides fragilis, and Bacteroides caecimuris. A key observation is that patients who underwent major metabolic improvements do not harbor this enrichment in Bacteroidia, as those who presented mild cases of T2D at all times. In a separate group of 36 patients with similar baseline clinical characteristics and preoperative GM sequencing, we showed that this increase in Bacteroidia was already present at baseline in the most severe cases of T2D. To explore the causal relationship linking this enrichment in Bacteroidia and metabolic alterations, we selected 13 patients across T2D severity clusters at 5-years and performed fecal matter transplants in mice. Our results show that 14 weeks after the transplantations, mice colonized with the GM of Severe donors have impaired glucose tolerance and insulin sensitivity as compared to Mild-recipients, all in the absence of any difference in body weight and composition. GM sequencing of the recipient animals revealed that the hallmark T2D-severity associated bacterial features were transferred and were associated with the animals' metabolic alterations. Therefore, our results further establish the GM as a key contributor to long-term glucose metabolism improvements (or lack thereof) after RYGB.
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Affiliation(s)
- Jean Debédat
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Tiphaine Le Roy
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Lise Voland
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | | | - Rohia Alili
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Solia Adriouch
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Pierre Bel Lassen
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance,Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, France
| | - Kazuyuki Kasahara
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Evan Hutchison
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laurent Genser
- Visceral Surgery Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, France
| | - Licia Torres
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Camille Gamblin
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Christine Rouault
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Jean-Daniel Zucker
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Sorbonne Universités, Institut de Recherche pour le Développement (IRD), France
| | - Nathalie Kapel
- Functional Coprology Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, France
| | - Christine Poitou
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance,Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, France
| | - Geneviève Marcelin
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance
| | - Federico E. Rey
- Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Judith Aron-Wisnewsky
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance,Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, France,CONTACT Judith Aron-Wisnewsky Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Nutrition and obesities; systemic approaches (NutriOmics)75013, Paris, France
| | - Karine Clément
- Nutrition and obesities; systemic approaches (NutriOmics), Sorbonne Université, INSERM, ParisFrance,Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Nutrition Department, France,Karine Clément Nutrition and obesities; systemic approaches (NutriOmics) Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, ParisFranceNutrition Department
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19
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Pellegrinelli V, Rodriguez-Cuenca S, Rouault C, Figueroa-Juarez E, Schilbert H, Virtue S, Moreno-Navarrete JM, Bidault G, Vázquez-Borrego MC, Dias AR, Pucker B, Dale M, Campbell M, Carobbio S, Lin YH, Vacca M, Aron-Wisnewsky J, Mora S, Masiero MM, Emmanouilidou A, Mukhopadhyay S, Dougan G, den Hoed M, Loos RJF, Fernández-Real JM, Chiarugi D, Clément K, Vidal-Puig A. Dysregulation of macrophage PEPD in obesity determines adipose tissue fibro-inflammation and insulin resistance. Nat Metab 2022; 4:476-494. [PMID: 35478031 DOI: 10.1038/s42255-022-00561-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/18/2022] [Indexed: 02/02/2023]
Abstract
Resulting from impaired collagen turnover, fibrosis is a hallmark of adipose tissue (AT) dysfunction and obesity-associated insulin resistance (IR). Prolidase, also known as peptidase D (PEPD), plays a vital role in collagen turnover by degrading proline-containing dipeptides but its specific functional relevance in AT is unknown. Here we show that in human and mouse obesity, PEPD expression and activity decrease in AT, and PEPD is released into the systemic circulation, which promotes fibrosis and AT IR. Loss of the enzymatic function of PEPD by genetic ablation or pharmacological inhibition causes AT fibrosis in mice. In addition to its intracellular enzymatic role, secreted extracellular PEPD protein enhances macrophage and adipocyte fibro-inflammatory responses via EGFR signalling, thereby promoting AT fibrosis and IR. We further show that decreased prolidase activity is coupled with increased systemic levels of PEPD that act as a pathogenic trigger of AT fibrosis and IR. Thus, PEPD produced by macrophages might serve as a biomarker of AT fibro-inflammation and could represent a therapeutic target for AT fibrosis and obesity-associated IR and type 2 diabetes.
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Affiliation(s)
- V Pellegrinelli
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
| | - S Rodriguez-Cuenca
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China
| | - C Rouault
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
| | - E Figueroa-Juarez
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - H Schilbert
- Genetics and Genomics of Plants, Centre for Biotechnology (CeBiTec) & Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - S Virtue
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - J M Moreno-Navarrete
- Department of Diabetes, Endocrinology and Nutrition, Girona Biomedical Research Institute (IDIBGI), University Hospital of Girona Dr Josep Trueta, Girona, Spain
- Department of Medicine, University of Girona, Girona, Spain
- CIBERobn Pathophysiology of Obesity and Nutrition, Institut of Salud Carlos III, Madrid, Spain
| | - G Bidault
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - M C Vázquez-Borrego
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - A R Dias
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - B Pucker
- Genetics and Genomics of Plants, Centre for Biotechnology (CeBiTec) & Faculty of Biology, Bielefeld University, Bielefeld, Germany
- Evolution and Diversity, Department of Plant Sciences, University of Cambridge, Cambridge, UK
| | - M Dale
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - M Campbell
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China
| | - S Carobbio
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Centro de Investigacion Principe Felipe, Valencia, Spain
| | - Y H Lin
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - M Vacca
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Insterdisciplinary Department of Medicine, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - J Aron-Wisnewsky
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
- Assistance-Publique Hôpitaux de Paris, Nutrition department, Pitié-Salpêtrière hospital, Paris, France
| | - S Mora
- Dept Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona (IBUB), Barcelona, Spain
| | - M M Masiero
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - A Emmanouilidou
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - S Mukhopadhyay
- MRC Centre for Transplantation Peter Gorer Department of Immunobiology School of Immunology & Microbial Sciences King's College, London, UK
| | - G Dougan
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
- Division of Infectious Diseases, Department of Medicine, University of Cambridge, Cambridge, UK
| | - M den Hoed
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - R J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - J M Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Girona Biomedical Research Institute (IDIBGI), University Hospital of Girona Dr Josep Trueta, Girona, Spain
- Department of Medicine, University of Girona, Girona, Spain
- CIBERobn Pathophysiology of Obesity and Nutrition, Institut of Salud Carlos III, Madrid, Spain
| | - D Chiarugi
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - K Clément
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
- Assistance-Publique Hôpitaux de Paris, Nutrition department, Pitié-Salpêtrière hospital, Paris, France
| | - A Vidal-Puig
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China.
- Centro de Investigacion Principe Felipe, Valencia, Spain.
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20
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Bel Lassen P, Nori N, Bedossa P, Genser L, Aron-Wisnewsky J, Poitou C, Surabattula R, Juul Nielsen M, Asser Karsdal M, Julie Leeming D, Schuppan D, Clément K. Fibrogenesis Marker PRO-C3 Is Higher in Advanced Liver Fibrosis and Improves in Patients Undergoing Bariatric Surgery. J Clin Endocrinol Metab 2022; 107:e1356-e1366. [PMID: 34905051 DOI: 10.1210/clinem/dgab897] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Serum propeptides of type III and type VI collagen (PRO-C3 and PRO-C6) are elevated in advanced nonalcoholic fatty liver disease (NAFLD), but their value in patients with severe obesity and their evolution after bariatric surgery (BS) is unknown. It is unclear if these markers of fibrogenesis are affected by adipose tissue fibrosis (ATF). OBJECTIVE We studied the association of PRO-C3 and PRO-C6 with liver fibrosis before BS, examined their evolution after BS, and evaluated how much patients' ATF contribute to their levels. METHODS Serum PRO-C3 and PRO-C6 were measured in 158 BS patients and compared with liver, subcutaneous, and omental adipose tissue histology obtained during surgery. PRO-C3 and PRO-C6 levels of 63 patients were determined in follow-up at 3 and 12 months post-BS. RESULTS Patients in the highest quartile of PRO-C3 had a higher risk of advanced liver fibrosis (stage F3-4; odds ratio 5.8; 95% CI [1.5-29.9]; P = 0.017) vs the lowest quartile (adjustment for age, gender, and BMI). PRO-C3 was positively correlated with markers of insulin resistance and liver enzymes. After BS, PRO-C3 levels decreased in patients with high baseline liver fibrosis. This decrease correlated with improvement of metabolic and liver parameters. PRO-C6 was not related to stage of liver fibrosis. ATF did not correlate with PRO-C3 or PRO-C6 levels at baseline or after BS. CONCLUSION PRO-C3 was associated with advanced liver fibrosis in patients with severe obesity, and decreased after BS, without being affected by ATF. These data suggest that BS prominently eliminates drivers of hepatic fibrogenesis in NAFLD.
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Affiliation(s)
- Pierre Bel Lassen
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Nicole Nori
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
| | | | - Laurent Genser
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Department of Digestive Surgery, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Christine Poitou
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Rambabu Surabattula
- Institute of Translational Immunology and Research Center for Immune Therapy, Mainz University Medical Center, 55131 Mainz, Germany
| | | | | | | | - Detlef Schuppan
- Institute of Translational Immunology and Research Center for Immune Therapy, Mainz University Medical Center, 55131 Mainz, Germany
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition & Obesities: Systemic Approaches Research Group (NutriOmics), F-75013, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, 75013 Paris, France
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21
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Gaucher J, Vial G, Montellier E, Guellerin M, Bouyon S, Lemarie E, Pelloux V, Bertrand A, Pernet-Gallay K, Lamarche F, Borel AL, Arnaud C, Belaidi E, Clément K, Godin Ribuot D, Aron-Wisnewsky J, Pépin JL. Intermittent Hypoxia Rewires the Liver Transcriptome and Fires up Fatty Acids Usage for Mitochondrial Respiration. Front Med (Lausanne) 2022; 9:829979. [PMID: 35252260 PMCID: PMC8894659 DOI: 10.3389/fmed.2022.829979] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
Sleep Apnea Syndrome (SAS) is one of the most common chronic diseases, affecting nearly one billion people worldwide. The repetitive occurrence of abnormal respiratory events generates cyclical desaturation-reoxygenation sequences known as intermittent hypoxia (IH). Among SAS metabolic sequelae, it has been established by experimental and clinical studies that SAS is an independent risk factor for the development and progression of non-alcoholic fatty liver disease (NAFLD). The principal goal of this study was to decrypt the molecular mechanisms at the onset of IH-mediated liver injury. To address this question, we used a unique mouse model of SAS exposed to IH, employed unbiased high-throughput transcriptomics and computed network analysis. This led us to examine hepatic mitochondrial ultrastructure and function using electron microscopy, high-resolution respirometry and flux analysis in isolated mitochondria. Transcriptomics and network analysis revealed that IH reprograms Nuclear Respiratory Factor- (NRF-) dependent gene expression and showed that mitochondria play a central role. We thus demonstrated that IH boosts the oxidative capacity from fatty acids of liver mitochondria. Lastly, the unbalance between oxidative stress and antioxidant defense is tied to an increase in hepatic ROS production and DNA damage during IH. We provide a comprehensive analysis of liver metabolism during IH and reveal the key role of the mitochondria at the origin of development of liver disease. These findings contribute to the understanding of the mechanisms underlying NAFLD development and progression during SAS and provide a rationale for novel therapeutic targets and biomarker discovery.
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Affiliation(s)
- Jonathan Gaucher
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France,*Correspondence: Jonathan Gaucher
| | - Guillaume Vial
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Emilie Montellier
- CNRS 5309, INSERM U1209, Institute for Advanced Biosciences, University Grenoble-Alpes, Grenoble, France
| | - Maëlle Guellerin
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Sophie Bouyon
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Emeline Lemarie
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Véronique Pelloux
- Nutrition and Obesities, Systemic Approaches, NutriOmics, Laboratory, Sorbonne University, Paris, France,Nutrition Department, CRNH Ile de France, Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Anne Bertrand
- INSERM U1216, Grenoble Institute of Neurosciences, University Grenoble-Alpes, Grenoble, France
| | - Karin Pernet-Gallay
- INSERM U1216, Grenoble Institute of Neurosciences, University Grenoble-Alpes, Grenoble, France
| | - Frederic Lamarche
- Laboratory of Fundamental and Applied Bioenergetics (LBFA), INSERM U1055, University Grenoble Alpes, Grenoble, France
| | - Anne-Laure Borel
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Claire Arnaud
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Elise Belaidi
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Karine Clément
- Nutrition and Obesities, Systemic Approaches, NutriOmics, Laboratory, Sorbonne University, Paris, France,Nutrition Department, CRNH Ile de France, Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Diane Godin Ribuot
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Judith Aron-Wisnewsky
- Nutrition and Obesities, Systemic Approaches, NutriOmics, Laboratory, Sorbonne University, Paris, France,Nutrition Department, CRNH Ile de France, Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Jean-Louis Pépin
- Hypoxia and PhysioPathology (HP2) Laboratory, INSERM U1300, CHU Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France,Jean-Louis Pépin
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22
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Aron-Wisnewsky J, Bel Lassen P. [new recommandation for medical and surgical care of obesity]. Rev Prat 2022; 72:152-154. [PMID: 35289521] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
TOWARDS NEW RECOMMANDATIONS The french NICE has produced a document describing the current limits to the optimal care of obesity, in particular concerning bariatric surgery. This document also states the perspectives and work that needs to be undergone to improve obesity care. Since october 2020, a working group appointed by the French NICE is writing the clinical recommandations for obesity care in 2nd and 3rd care referral, addressing both the medical and surgical care of obesity. This work has known some delay mainly due to the several waves of COVID-19.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, Inserm, Nutrition et obésité (NutriOmics), Paris, France ; AP-HP, hôpital de La Pitié-Salpêtrière, service de nutrition, Paris France
| | - Pierre Bel Lassen
- Sorbonne Université, Inserm, Nutrition et obésité (NutriOmics), Paris, France ; AP-HP, hôpital de La Pitié-Salpêtrière, service de nutrition, Paris France
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23
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Bastard JP, Pelloux V, Alili R, Fellahi S, Aron-Wisnewsky J, Capel E, Fève B, Assoumou L, Prifti E, Katlama C, Clément K, Capeau J. Altered subcutaneous adipose tissue parameters after switching ART-controlled HIV+ patients to raltegravir/maraviroc. AIDS 2021; 35:1625-1630. [PMID: 33831906 DOI: 10.1097/qad.0000000000002900] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effect on anthropometric, metabolic and adipose tissue parameters of switching ART-controlled persons living with HIV (PLWH) from a protease inhibitor regimen to raltegravir/maraviroc. DESIGN Sub-study of the ANRS157 ROCnRAL study with the investigation of subcutaneous abdominal adipose tissue (SCAT) biopsy at inclusion and study end. METHODS We performed lipoaspiration of paired SCAT samples, histology on fresh/fixed samples and examined the transcriptomic profile analyzed using Illumina microarrays after RNA extraction. Statistical analyses used the Wilcoxon-paired test. RESULTS The patients (n = 8) were mainly male (7/8), aged (mean ± standard error of the mean) 54.9 ± 1.2 years, BMI 26.1 ± 1.2 kg/m2, CD4+ 699 ± 56 cells/mm3, all viral load (VL) <50 copies/ml. After a follow-up of 6 ± 0.5 months, all PLWH remained with VL <50 copies/ml. BMI, trunk and limb fat amounts were unchanged yet systemic insulin resistance increased. Adipose tissue histology was unchanged except for borderline increased adipocyte diameter (P = 0.1). Among the 16 094 RNA transcripts, 458 genes were up-regulated and 244 were down-regulated. Analyses of the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology databases, evaluating modifications in the main functional pathways, revealed that genes related to immune recognition/function were less expressed as were genes encoding T-cell receptor and receptor signaling pathways. The gene expression profiles indicated decreased inflammation but genes involved in adipogenesis and insulin resistance were overexpressed. CONCLUSION After 6 months of raltegravir/maraviroc, adipogenesis-related gene profile was enhanced in SCAT, in agreement with a tendency for increased adipocyte size. Enhanced SCAT insulin resistance-related profile was concordant with higher systemic insulin resistance. However, the immune activation/inflammation profile was globally lowered. We propose that raltegravir/maraviroc might favor SCAT gain but reduce inflammation/immune activation.
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Affiliation(s)
- Jean-Philippe Bastard
- Sorbonne Université, Inserm, Faculty of Medicine, Centre de Recherche Saint-Antoine (CRSA), ICAN, Paris
- Department of Biochemistry-Pharmacology-Molecular Biology, APHP, Henri-Mondor Hospital, Université Paris Est Créteil
| | - Véronique Pelloux
- Sorbonne Université, Inserm, Faculty of Medicine, Nutrition and Obesities: Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Sorbonne Université, Nutrition Department, Pitié-Salpétrière hospital, CRNH Ile-de-France, GH APHP-Sorbonne Université
| | - Rohia Alili
- Sorbonne Université, Inserm, Faculty of Medicine, Nutrition and Obesities: Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Sorbonne Université, Nutrition Department, Pitié-Salpétrière hospital, CRNH Ile-de-France, GH APHP-Sorbonne Université
| | - Soraya Fellahi
- Sorbonne Université, Inserm, Faculty of Medicine, Centre de Recherche Saint-Antoine (CRSA), ICAN, Paris
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Inserm, Faculty of Medicine, Nutrition and Obesities: Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Sorbonne Université, Nutrition Department, Pitié-Salpétrière hospital, CRNH Ile-de-France, GH APHP-Sorbonne Université
| | - Emilie Capel
- Sorbonne Université, Inserm, Faculty of Medicine, Centre de Recherche Saint-Antoine (CRSA), ICAN, Paris
| | - Bruno Fève
- Sorbonne Université, Inserm, Faculty of Medicine, Centre de Recherche Saint-Antoine (CRSA), ICAN, Paris
- Department of Endocrinology, CRMR Prisis, Saint-Antoine Hospital, GH APHP-Sorbonne Université
| | - Lambert Assoumou
- Sorbonne Université, Inserm, Faculty of Medicine, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris
| | - Edi Prifti
- IRD, Sorbonne University, UMMISCO, Bondy
| | - Christine Katlama
- Sorbonne Université, Inserm, Faculty of Medicine, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris
- Department of Infectious Diseases, Pitié-Salpétrière Hospital, GH APHP-Sorbonne Université, Paris, France
| | - Karine Clément
- Sorbonne Université, Inserm, Faculty of Medicine, Nutrition and Obesities: Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Sorbonne Université, Nutrition Department, Pitié-Salpétrière hospital, CRNH Ile-de-France, GH APHP-Sorbonne Université
| | - Jacqueline Capeau
- Sorbonne Université, Inserm, Faculty of Medicine, Centre de Recherche Saint-Antoine (CRSA), ICAN, Paris
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24
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Bouazizi K, Zarai M, Marquet F, Aron-Wisnewsky J, Clément K, Redheuil A, Kachenoura N. Adipose tissue fibrosis assessed by high resolution ex vivo MRI as a hallmark of tissue alteration in morbid obesity. Quant Imaging Med Surg 2021; 11:2162-2168. [PMID: 33936996 DOI: 10.21037/qims-20-879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To determine whether magnetic resonance imaging (MRI) when used in an optimal ex vivo setting can help detecting and quantifying the 3D fibrosis fraction in human subcutaneous adipose tissue (SAT) samples, as compared to histology. This prospective observational study was approved by our institutional review board 3D MRI acquisitions were performed at 4.0 T (Bruker) on XX human SAT samples (around 1 cm3) collected from biopsy in morbidly obese patients. Such acquisitions included saturation-recovery T1 mapping (spatial resolution: 200 µm, acquisition time: ~16 minutes) and DIXON imaging (spatial resolution: 200 µm, acquisition time: ~20 minutes). After MRI, histological quantification of fibrosis was performed using picrosirius staining. T1 maps were clustered based on a k-means algorithm allowing quantification of fibrosis within the adipose tissue and percentage of fibrosis over the entire sample volume was calculated. Fat maps were computed from DIXON in-phase and out-of-phase images. The 3D MRI fibrosis percentage within the SAT samples were comprised between 6% and 15%. Excellent correlations and levels of agreement were observed between single slice MRI and histology (r=0.9, P=0.08) and between 3D MRI and histology in terms fibrosis percentages within SAT samples (r=0.9, P=0.01). High Field ex vivo MRI was able to quantify fibrosis in human SAT samples with high agreement with histology and moreover to provide 3D SAT fibrosis quantification avoiding histological sampling errors.
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Affiliation(s)
- Khaoula Bouazizi
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.,Sorbonne Université, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Mohamed Zarai
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Florian Marquet
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.,Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition department, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition department, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition department, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
| | - Alban Redheuil
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.,Sorbonne Université, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France.,Unité d'Imagerie Cardiovasculaire et Thoracique (ICT), Pitié-Salpêtrière Hospital, Paris, France
| | - Nadjia Kachenoura
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.,Sorbonne Université, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
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25
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Bouazizi K, Zarai M, Dietenbeck T, Aron-Wisnewsky J, Clément K, Redheuil A, Kachenoura N. Abdominal adipose tissue components quantification in MRI as a relevant biomarker of metabolic profile. Magn Reson Imaging 2021; 80:14-20. [PMID: 33872732 DOI: 10.1016/j.mri.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/15/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Abnormal accumulation of adipose tissue (AT) alters the metabolic profile and underlies cardiovascular complications. Conventional measures provide global measurements for the entire body. The purpose of this study was to propose a new approach to quantify the amount and type of truncal AT automatically from MRI in metabolic patients and controls. MATERIALS AND METHODS DIXON acquisitions were performed at 1.5 T in 30 metabolic syndrome (MS) (59 ± 6 years), 12 obese (50 ± 11 years), 35 type 2 diabetes (T2DM) patients (56 ± 11 years) and 19 controls (52 ± 11 years). AT was segmented into: subcutaneous AT "SAT", visceral AT "VAT", deep VAT "dVAT", peri-organ VAT "pVAT" using active contours and k-means clustering algorithms. Subsequently, organ AT infiltration index "oVAT" was calculated as the normalized fat signal magnitude in organs. RESULTS Excellent intra- and inter-operator reproducibility was obtained for AT segmentation. MS and obese patients had the highest amount of total AT. SAT increased in MS (1144 ± 621 g) and T2DM patients (1024 ± 634 g), and twice the level of SAT in controls (505 ± 238 g), and further increased in obese patients (1429 ± 621 g). While VAT, pVAT and dVAT increased to a similar degree in the metabolic patients compared to controls, the oVAT index was able to differentiate controls from MS and T2DM patients and to discriminate the three metabolic patient groups (p < 0.01). Local AT sub-types were not related to BMI in all groups except for SAT in controls (p = 0.03). CONCLUSION Reproducible truncal AT sub-types quantification using 3D MRI was able to characterize patients with metabolic diseases. It may serve in the future as a non-invasive predictor of cardiovascular complications in such patients.
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Affiliation(s)
- Khaoula Bouazizi
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France; Sorbonne University, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France.
| | - Mohamed Zarai
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France
| | - Thomas Dietenbeck
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France; Sorbonne University, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Judith Aron-Wisnewsky
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities; approches systémiques (NutriOmique), Pitié-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Alban Redheuil
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France; Sorbonne University, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France; Unité d'Imagerie Cardiovasculaire et Thoracique (ICT), Pitié-Salpêtrière Hospital, Paris, France
| | - Nadjia Kachenoura
- Institute of Cardiometabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, Paris, France; Sorbonne University, INSERM 1146, CNRS 7371, Laboratoire d'Imagerie Biomédicale, Paris, France
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26
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Perger E, Aron-Wisnewsky J, Arnulf I, Oppert JM, Redolfi S. Diagnostic approach to sleep disordered-breathing among patients with grade III obesity. Sleep Med 2021; 82:18-22. [PMID: 33887555 DOI: 10.1016/j.sleep.2021.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/15/2021] [Accepted: 03/22/2021] [Indexed: 12/22/2022]
Abstract
Sleep apnea test (SAT) is a cost-effective approach to evaluate subjects without associated comorbidities suspected for obstructive sleep apnea (OSA), a disorder particularly common in obese subjects. The association of obesity with awake hypercapnia (carbon dioxide arterial pressure, PaCO2 ≥45 mmHg) defines the obesity-hypoventilation syndrome (OHS), which in turn results in increased morbidity and mortality compared to simple OSA. Isolated hypoventilation during sleep in obese patients (obesity-related sleep hypoventilation, ORSH) is now considered as an early stage of OHS. The aim of this study was to assess the performance of SAT in diagnosing OSA and predicting the presence of ORHS among patients with grade III obesity without awake hypercapnia. METHODS Over a 14-months period, patients with grade III obesity (body mass index≥40 kg/m2) presenting moderate-to-severe OSA (apnea-hypopnea index [AHI]≥15) upon SAT and normal awake PaCO2 at arterial blood gas analysis, systematically underwent in-lab nocturnal polysomnography combined with transcutaneous carbon dioxide pressure (PtcCO2) monitoring. RESULTS Among 48 patients included in the study, 16 (33%) presented an AHI<15 upon polysomnography and 14 (29%) had ORSH. The test revealed no difference in ORSH prevalence between patients with AHI <15 or ≥15 (31% vs. 25%). No SAT variables were independently associated with increased PtCO2. CONCLUSIONS This study shows that SAT overestimates OSA severity and ORSH affects one third of patients with grade III obesity without awake hypercapnia and with moderate-to-severe OSA at SAT, suggesting how polysomnography combined with PtCO2 monitoring is the most appropriate diagnostic approach for OSA and ORSH in this population.
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Affiliation(s)
- Elisa Perger
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pathologies Du Sommeil (Département R3S), F-75013 Paris, France; Istituto Auxologico Italiano IRCCS San Luca Hospital, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy; University of Milano-Bicocca, Milan, Italy.
| | - Judith Aron-Wisnewsky
- APHP, Groupe Hospitalier Pitié-Salpêtrière, Service de Nutrition, Sorbonne Université, Paris, France; Nutriomics, INSERM, Sorbonne Université, Paris, France
| | - Isabelle Arnulf
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pathologies Du Sommeil (Département R3S), F-75013 Paris, France
| | - Jean-Michel Oppert
- APHP, Groupe Hospitalier Pitié-Salpêtrière, Service de Nutrition, Sorbonne Université, Paris, France
| | - Stefania Redolfi
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pathologies Du Sommeil (Département R3S), F-75013 Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
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27
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Barbois S, Stürm N, Aron-Wisnewsky J, Clément K, Bedossa P, Genser L, Hilleret MN, Costentin C, Reche F, Arvieux C, Borel AL. Decision Tree for the Performance of Intraoperative Liver Biopsy During Bariatric Surgery. Obes Surg 2021; 31:2641-2648. [PMID: 33665755 DOI: 10.1007/s11695-021-05309-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Bariatric surgery provides a useful opportunity to perform intraoperative liver biopsy to screen for non-alcoholic steatohepatitis (NASH). There is currently no consensus on whether intraoperative liver biopsy should be systematically performed. The aim of this study was to develop and validate a decision tree to guide that choice. APPROACH AND RESULTS This prospective study included 102 consecutive patients from the severe obesity outcome network (SOON) cohort in whom liver biopsy was systematically performed during bariatric surgery. A classification and regression tree (CART) was created to identify the nodes that best classified patients with and without NASH. External validation was performed. Seventy-one biopsies were of sufficient quality for analysis (median body mass index 43.3 [40.7; 48.0] kg/m2). NASH was diagnosed in 32.4% of cases. None of the patients with no steatosis on ultrasound had NASH. The only CART node that differentiated between a "high-risk" and a "low-risk" of NASH was alanine aminotransferase (ALT). ALT>53IU/L predicted NASH with a positive predictive value (PPV) of 68% and a negative predictive value (NPP) of 89%, a sensitivity of 77%, and a specificity of 84%. In the external cohort (n=258), PPV was 68%, NPV was 62%, sensitivity was 27%, and specificity was 90%. CONCLUSIONS The present work supports intraoperative liver biopsy to screen for NASH in patients with ALT>53IU/L; however, patients with no steatosis on ultrasound should not undergo biopsy. The CART failed to identify an algorithm with a good sensitivity to screen for NASH in patients with ultrasonography-proven steatosis and ALT≤53IU/L.
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Affiliation(s)
- Sandrine Barbois
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France. .,Hypoxia Physiopathology (HP2) Laboratory, INSERM U1042, Grenoble Alpes University, 38043, Grenoble, France.
| | - N Stürm
- Department of Anatomopathology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - J Aron-Wisnewsky
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - K Clément
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - P Bedossa
- Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Laurent Genser
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Digestive Surgery Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - M N Hilleret
- Department of Hepatology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - C Costentin
- Department of Hepatology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - F Reche
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - C Arvieux
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - A L Borel
- Hypoxia Physiopathology (HP2) Laboratory, INSERM U1042, Grenoble Alpes University, 38043, Grenoble, France.,Department of Nutrition, University Hospital Grenoble Alpes, 38043, Grenoble, France
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28
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Schmidt L, Medawar E, Aron-Wisnewsky J, Genser L, Poitou C, Clément K, Plassmann H. Resting-state connectivity within the brain's reward system predicts weight loss and correlates with leptin. Brain Commun 2021; 3:fcab005. [PMID: 33615220 PMCID: PMC7884604 DOI: 10.1093/braincomms/fcab005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/15/2020] [Revised: 11/12/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Weight gain is often associated with the pleasure of eating food rich in calories. This idea is based on the findings that people with obesity showed increased neural activity in the reward and motivation systems of the brain in response to food cues. Such correlations, however, overlook the possibility that obesity may be associated with a metabolic state that impacts the functioning of reward and motivation systems, which in turn could be linked to reactivity to food and eating behaviour and weight gain. In a study involving 44 female participants [14 patients with obesity, aged 20–63 years (mean: 42, SEM: 3.2 years), and 30 matched lean controls, aged 22–60 years (mean: 37, SEM: 1.8 years)], we investigated how ventromedial prefrontal cortex seed-to-voxel resting-state connectivity distinguished between lean and obese participants at baseline. We used the results of this first step of our analyses to examine whether changes in ventromedial prefrontal cortex resting-state connectivity over 8 months could formally predict weight gain or loss. It is important to note that participants with obesity underwent bariatric surgery at the beginning of our investigation period. We found that ventromedial prefrontal cortex–ventral striatum resting-state connectivity and ventromedial–dorsolateral prefrontal cortex resting-state connectivity were sensitive to obesity at baseline. However, only the ventromedial prefrontal cortex–ventral striatum resting-state connectivity predicted weight changes over time using cross-validation, out-of-sample prediction analysis. Such an out-of-sample prediction analysis uses the data of all participants of a training set to predict the actually observed data in one independent participant in the hold-out validation sample and is then repeated for all participants. In seeking to explain the reason why ventromedial pre-frontal cortex–ventral striatum resting-state connectivity as the central hub of the brain’s reward and motivational system may predict weight change over time, we linked weight loss surgery-induced changes in ventromedial prefrontal cortex–ventral striatum resting-state connectivity to surgery-induced changes in homeostatic hormone regulation. More specifically, we focussed on changes in fasting state systemic leptin, a homeostatic hormone signalling satiety, and inhibiting reward-related dopamine signalling. We found that the surgery-induced increase in ventromedial prefrontal cortex–ventral striatum resting-state connectivity was correlated with a decrease in fasting-state systemic leptin. These findings establish the first link between individual differences in brain connectivity in reward circuits in a more tonic state at rest, weight change over time and homeostatic hormone regulation.
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Affiliation(s)
- Liane Schmidt
- Control-Interoception-Attention Team, Institut du Cerveau et de la Moelle épinière (ICM), Inserm UMR 1127, CNRS UMR 7225, Sorbonne Université, 75013 Paris, France
| | - Evelyn Medawar
- Laboratoire de Neuroscience Cognitive, Ecole Normale Supérieure, Inserm U960, 75005 Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Inserm, UMRS Nutrition et Obésités; Systemic Approaches (NutriOmics), 75013 Paris, France.,Nutrition Department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 75013 Paris, France
| | - Laurent Genser
- Visceral Surgery Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Christine Poitou
- Sorbonne Université, Inserm, UMRS Nutrition et Obésités; Systemic Approaches (NutriOmics), 75013 Paris, France
| | - Karine Clément
- Sorbonne Université, Inserm, UMRS Nutrition et Obésités; Systemic Approaches (NutriOmics), 75013 Paris, France
| | - Hilke Plassmann
- Control-Interoception-Attention Team, Institut du Cerveau et de la Moelle épinière (ICM), Inserm UMR 1127, CNRS UMR 7225, Sorbonne Université, 75013 Paris, France.,Marketing Area, INSEAD 77305, Fontainebleau, France
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Bel Lassen P, Poitou C, Genser L, Marchelli F, Aron-Wisnewsky J, Ciangura C, Jacques F, Moreau P, Oppert JM, Clément K. COVID-19 and its Severity in Bariatric Surgery-Operated Patients. Obesity (Silver Spring) 2021; 29:24-28. [PMID: 32875723 DOI: 10.1002/oby.23026] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 07/14/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Obesity is a major risk factor for severe forms of coronavirus disease (COVID-19), but little is known about the post-bariatric surgery (BS) setting. The prevalence of likely COVID-19 and its risk factors in patients followed up after BS was assessed. METHODS A total of 738 patients who underwent BS and were followed up at a university medical center were surveyed. A retrospective comparison of characteristics at baseline, 1 year after BS, and at the time of lockdown was performed between patients with COVID-19-likely events (CL) based on a combination of reported symptoms and those for whom COVID-19 was unlikely. RESULTS CL occurred in 62 (8.4%) patients, among whom 4 (6.4%) had a severe form requiring hospitalization and 1 (1.6%) died. The CL group had a higher proportion of persistent type 2 diabetes (T2D) at last follow-up (36.2% vs. 20.3%, P = 0.01). BMI at the time of lockdown was lower in the CL group (30.2 ± 5.1 vs. 32.8 ± 6.5 kg/m2 ; P < 0.01) with higher percent weight loss since BS in the CL group. Severe forms of COVID-19 requiring hospitalization were associated with persistent T2D at the last follow-up visit. CONCLUSIONS In BS patients, CL were associated with persistent T2D and lower BMI.
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Affiliation(s)
- Pierre Bel Lassen
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
| | - Christine Poitou
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
| | - Laurent Genser
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
- Digestive Surgery Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Florence Marchelli
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
| | - Judith Aron-Wisnewsky
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
| | - Cécile Ciangura
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
| | - Flavien Jacques
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
| | - Pauline Moreau
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
| | | | - Jean-Michel Oppert
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
| | - Karine Clément
- Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, CRNH-Ile de France Paris, Sorbonne Université, Paris, France
- INSERM, Nutrition and Obesity: Systemic Approach (NutriOmics) Research Unit, Sorbonne Université, Paris, France
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30
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Rouault C, Marcelin G, Adriouch S, Rose C, Genser L, Ambrosini M, Bichet JC, Zhang Y, Marquet F, Aron-Wisnewsky J, Poitou C, André S, Dérumeaux G, Guerre-Millo M, Clément K. Senescence-associated β-galactosidase in subcutaneous adipose tissue associates with altered glycaemic status and truncal fat in severe obesity. Diabetologia 2021; 64:240-254. [PMID: 33125520 DOI: 10.1007/s00125-020-05307-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 09/01/2020] [Indexed: 01/02/2023]
Abstract
AIM/HYPOTHESIS Altered adipose tissue secretory profile contributes to insulin resistance and type 2 diabetes in obesity. Preclinical studies have identified senescent cells as a cellular source of proinflammatory factors in adipose tissue of obese mice. In humans, potential links with obesity comorbidities are poorly defined. Here, we investigated adipose tissue senescent status and relationships with metabolic complications in human obesity. METHODS The study includes a prospective cohort of 227 individuals with severe obesity. A photometric method was used to quantify senescence-associated β-galactosidase (SA-β-gal) activity in paired subcutaneous and omental adipose tissue biopsies obtained during gastric surgery. Gene and secretory profiling was performed in adipose tissue biopsies and in human primary pre-adipocytes in the presence or absence of senolytic drugs targeting senescent cells. Participants were phenotyped for anthropometric and bioclinical variables, metabolic complications and gastric surgery-induced improvement to address relationships with adipose tissue SA-β-gal. RESULTS SA-β-gal activity was sevenfold higher in subcutaneous than in omental adipose tissue and not associated with BMI or chronological age. Several factors, including insulin-like growth factor binding protein 3 (IGFBP3), plasminogen activator inhibitor 1 (PAI1), C-C motif chemokine ligand 2 (CCL2) and IL-6, were upregulated in subcutaneous adipose tissue in relation with SA-β-gal (p for linear trend across tertiles <0.05) and in pre-adipocytes cultured with inflammatory macrophage conditioned media. Senolytic treatment reduced SA-β-gal staining and normalised these alterations. In the whole population, subcutaneous adipose tissue SA-β-gal activity was positively associated with serum leptin, markers of insulin resistance and increased trunk fat mass. Metabolic complications, including type 2 diabetes and dyslipidaemia, were more prevalent in patients with high levels of SA-β-gal, but improved with bariatric surgery whatever the initial adipose tissue senescent status. CONCLUSIONS/INTERPRETATION This study highlights a phenotype of senescence in adipose tissue of severely obese individuals, which characterises prominently subcutaneous fat depots. Subcutaneous adipose tissue senescence is significantly linked to altered glucose metabolism and body fat distribution. Elimination of senescent cells through senolytic treatment could alleviate metabolic complications in severely obese people. Graphical abstract.
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Affiliation(s)
- Christine Rouault
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Geneviève Marcelin
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Solia Adriouch
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Cindy Rose
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Laurent Genser
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
- Assistance Publique Hôpitaux de Paris, Visceral Surgery Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Marc Ambrosini
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Jean-Christophe Bichet
- Assistance Publique Hôpitaux de Paris, Service de Chirurgie et Cancérologie Gynécologique et Mammaire, Pitié-Salpêtrière Hospital, Paris, France
| | - Yanyan Zhang
- Inserm U955, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Florian Marquet
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Paris, France
| | - Christine Poitou
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Paris, France
| | - Sébastien André
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Geneviève Dérumeaux
- Inserm U955, Université Paris-Est Créteil (UPEC), Créteil, France
- Assistance Publique Hôpitaux de Paris, Department of Cardiology, Henri Mondor Hospital, DHU-ATVB, Créteil, France
| | - Michèle Guerre-Millo
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France
| | - Karine Clément
- Sorbonne Université, Inserm, Nutrition and Obesities: Systemic Approaches (Nutriomics), Paris, France.
- Assistance Publique Hôpitaux de Paris, Nutrition Department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Paris, France.
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31
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Aron-Wisnewsky J, Warmbrunn MV, Nieuwdorp M, Clément K. Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health-Pathophysiology and Therapeutic Strategies. Gastroenterology 2021; 160:573-599. [PMID: 33253685 DOI: 10.1053/j.gastro.2020.10.057] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
Changes in the intestinal microbiome have been associated with obesity and type 2 diabetes, in epidemiological studies and studies of the effects of fecal transfer in germ-free mice. We review the mechanisms by which alterations in the intestinal microbiome contribute to development of metabolic diseases, and recent advances, such as the effects of the microbiome on lipid metabolism. Strategies have been developed to modify the intestinal microbiome and reverse metabolic alterations, which might be used as therapies. We discuss approaches that have shown effects in mouse models of obesity and metabolic disorders, and how these might be translated to humans to improve metabolic health.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Nutrition and Obesities: Systemic Approaches Research Unit (Nutriomics), Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France; Nutrition Department, Assistante Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centres de Recherche en Nutrition Humaine Ile de France, Paris, France; Department of Vascular Medicine, Amsterdam Universitair Medische Centra, location Academisch Medisch Centrum, and VUMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Moritz V Warmbrunn
- Department of Vascular Medicine, Amsterdam Universitair Medische Centra, location Academisch Medisch Centrum, and VUMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam Universitair Medische Centra, location Academisch Medisch Centrum, and VUMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Karine Clément
- Nutrition and Obesities: Systemic Approaches Research Unit (Nutriomics), Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France; Nutrition Department, Assistante Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centres de Recherche en Nutrition Humaine Ile de France, Paris, France.
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32
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Molinaro A, Bel Lassen P, Henricsson M, Wu H, Adriouch S, Belda E, Chakaroun R, Nielsen T, Bergh PO, Rouault C, André S, Marquet F, Andreelli F, Salem JE, Assmann K, Bastard JP, Forslund S, Le Chatelier E, Falony G, Pons N, Prifti E, Quinquis B, Roume H, Vieira-Silva S, Hansen TH, Pedersen HK, Lewinter C, Sønderskov NB, Køber L, Vestergaard H, Hansen T, Zucker JD, Galan P, Dumas ME, Raes J, Oppert JM, Letunic I, Nielsen J, Bork P, Ehrlich SD, Stumvoll M, Pedersen O, Aron-Wisnewsky J, Clément K, Bäckhed F. Author Correction: Imidazole propionate is increased in diabetes and associated with dietary patterns and altered microbial ecology. Nat Commun 2020; 11:6448. [PMID: 33349634 PMCID: PMC7752903 DOI: 10.1038/s41467-020-20412-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Antonio Molinaro
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pierre Bel Lassen
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Marcus Henricsson
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Hao Wu
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Solia Adriouch
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Eugeni Belda
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Integromics Unit, Institute of Cardiometabolism and Nutrition, 75013, Paris, France
| | - Rima Chakaroun
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Per-Olof Bergh
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Christine Rouault
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Sébastien André
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Florian Marquet
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Fabrizio Andreelli
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Joe-Elie Salem
- Assistance Publique Hôpitaux de Paris, Clinical Investigation Center Paris East, 75013, Paris, France
| | - Karen Assmann
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Jean-Philippe Bastard
- Assistance Publique Hôpitaux de Paris, Biochemistry and Hormonology Department, Tenon Hospital, 75020, Paris, France
| | - Sofia Forslund
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin and the Max-Delbrück Center, Berlin, Germany
| | | | - Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.,Center for Microbiology, VIB, Leuven, Belgium
| | - Nicolas Pons
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Edi Prifti
- Integromics Unit, Institute of Cardiometabolism and Nutrition, 75013, Paris, France.,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, 93143, Bondy, France
| | - Benoit Quinquis
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Hugo Roume
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Sara Vieira-Silva
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.,Center for Microbiology, VIB, Leuven, Belgium
| | - Tue H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Helle Krogh Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Christian Lewinter
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Nadja B Sønderskov
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | | | - Lars Køber
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Jean-Daniel Zucker
- Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, 93143, Bondy, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Marc-Emmanuel Dumas
- Computational and Systems Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK.,Genomic and Environmental Medicine, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, SW3 6KY, UK
| | - Jeroen Raes
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France.,Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Jean-Michel Oppert
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Ivica Letunic
- Biobyte Solutions GmbH, Bothestr. 142, 69117, Heidelberg, Germany
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, SE41128, Gothenburg, Sweden
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany.,Molecular Medicine Partnership Unit, University of Heidelberg and European Molecular Biology Laboratory, Heidelberg, Germany
| | - S Dusko Ehrlich
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Michael Stumvoll
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Judith Aron-Wisnewsky
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Karine Clément
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France. .,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France.
| | - Fredrik Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden. .,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark. .,Department of Clinical Physiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
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33
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Molinaro A, Bel Lassen P, Henricsson M, Wu H, Adriouch S, Belda E, Chakaroun R, Nielsen T, Bergh PO, Rouault C, André S, Marquet F, Andreelli F, Salem JE, Assmann K, Bastard JP, Forslund S, Le Chatelier E, Falony G, Pons N, Prifti E, Quinquis B, Roume H, Vieira-Silva S, Hansen TH, Pedersen HK, Lewinter C, Sønderskov NB, Køber L, Vestergaard H, Hansen T, Zucker JD, Galan P, Dumas ME, Raes J, Oppert JM, Letunic I, Nielsen J, Bork P, Ehrlich SD, Stumvoll M, Pedersen O, Aron-Wisnewsky J, Clément K, Bäckhed F. Imidazole propionate is increased in diabetes and associated with dietary patterns and altered microbial ecology. Nat Commun 2020; 11:5881. [PMID: 33208748 PMCID: PMC7676231 DOI: 10.1038/s41467-020-19589-w] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [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: 09/02/2019] [Accepted: 10/22/2020] [Indexed: 12/13/2022] Open
Abstract
Microbiota-host-diet interactions contribute to the development of metabolic diseases. Imidazole propionate is a novel microbially produced metabolite from histidine, which impairs glucose metabolism. Here, we show that subjects with prediabetes and diabetes in the MetaCardis cohort from three European countries have elevated serum imidazole propionate levels. Furthermore, imidazole propionate levels were increased in subjects with low bacterial gene richness and Bacteroides 2 enterotype, which have previously been associated with obesity. The Bacteroides 2 enterotype was also associated with increased abundance of the genes involved in imidazole propionate biosynthesis from dietary histidine. Since patients and controls did not differ in their histidine dietary intake, the elevated levels of imidazole propionate in type 2 diabetes likely reflects altered microbial metabolism of histidine, rather than histidine intake per se. Thus the microbiota may contribute to type 2 diabetes by generating imidazole propionate that can modulate host inflammation and metabolism. Gut microbial metabolism of nutrients contributes to metabolic diseases, and the histidine metabolite imidazole propionate (ImP) is produced by type 2 diabetes (T2D) associated microbiome. Here the authors report that circulating ImP levels are increased in subjects with prediabetes or T2D in three European populations, and this increase associates with altered gut microbiota rather than dietary histidine.
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Affiliation(s)
- Antonio Molinaro
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pierre Bel Lassen
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Marcus Henricsson
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Hao Wu
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Solia Adriouch
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Eugeni Belda
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Integromics Unit, Institute of Cardiometabolism and Nutrition, 75013, Paris, France
| | - Rima Chakaroun
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Per-Olof Bergh
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Christine Rouault
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Sébastien André
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Florian Marquet
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Fabrizio Andreelli
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Joe-Elie Salem
- Assistance Publique Hôpitaux de Paris, Clinical Investigation Center Paris East, 75013, Paris, France
| | - Karen Assmann
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France
| | - Jean-Philippe Bastard
- Assistance Publique Hôpitaux de Paris, Biochemistry and Hormonology Department, Tenon Hospital, 75020, Paris, France
| | - Sofia Forslund
- Experimental and Clinical Research Center, A Cooperation of Charité-Universitätsmedizin and the Max-Delbrück Center, Berlin, Germany
| | | | - Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.,Center for Microbiology, VIB, Leuven, Belgium
| | - Nicolas Pons
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Edi Prifti
- Integromics Unit, Institute of Cardiometabolism and Nutrition, 75013, Paris, France.,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, 93143, Bondy, France
| | - Benoit Quinquis
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Hugo Roume
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Sara Vieira-Silva
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium.,Center for Microbiology, VIB, Leuven, Belgium
| | - Tue H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Helle Krogh Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Christian Lewinter
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Nadja B Sønderskov
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | | | - Lars Køber
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Jean-Daniel Zucker
- Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, 93143, Bondy, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Centre (CRESS), U1153 Inserm, U1125, Inra, Cnam, University of Paris 13, Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Marc-Emmanuel Dumas
- Computational and Systems Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK.,Genomic and Environmental Medicine, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, SW3 6KY, UK
| | - Jeroen Raes
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France.,Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Jean-Michel Oppert
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Ivica Letunic
- Biobyte Solutions GmbH, Bothestr. 142, 69117, Heidelberg, Germany
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, SE41128, Gothenburg, Sweden
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany.,Molecular Medicine Partnership Unit, University of Heidelberg and European Molecular Biology Laboratory, Heidelberg, Germany
| | - S Dusko Ehrlich
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, Paris, France
| | - Michael Stumvoll
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Judith Aron-Wisnewsky
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France
| | - Karine Clément
- INSERM, Nutrition and Obesities; Systemic Approaches (NutriOmics), Sorbonne Université, Paris, France. .,Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition department, CRNH Ile de France, Paris, France.
| | - Fredrik Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine and Sahlgrenska Center for Cardiovascular and Metabolic Research, University of Gothenburg, 413 45, Gothenburg, Sweden. .,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark. .,Department of Clinical Physiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Olsson LM, Poitou C, Tremaroli V, Coupaye M, Aron-Wisnewsky J, Bäckhed F, Clément K, Caesar R. Gut microbiota of obese subjects with Prader-Willi syndrome is linked to metabolic health. Gut 2020; 69:1229-1238. [PMID: 31611297 PMCID: PMC7306984 DOI: 10.1136/gutjnl-2019-319322] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The gut microbiota has been implicated in the aetiology of obesity and associated comorbidities. Patients with Prader-Willi syndrome (PWS) are obese but partly protected against insulin resistance. We hypothesised that the gut microbiota of PWS patients differs from that of non-genetically obese controls and correlate to metabolic health. Therefore, here we used PWS as a model to study the role of gut microbiota in the prevention of metabolic complications linked to obesity. DESIGN We conducted a case-control study with 17 adult PWS patients and 17 obese subjects matched for body fat mass index, gender and age. The subjects were metabolically characterised and faecal microbiota was profiled by 16S ribosomal RNA gene sequencing. The patients' parents were used as a non-obese control group. Stool samples from two PWS patients and two obese controls were used for faecal microbiota transplantations in germ-free mice to examine the impact of the microbiota on glucose metabolism. RESULTS The composition of the faecal microbiota in patients with PWS differed from that of obese controls, and was characterised by higher phylogenetic diversity and increased abundance of several taxa such as Akkermansia, Desulfovibrio and Archaea, and decreased abundance of Dorea. Microbial taxa prevalent in the PWS microbiota were associated with markers of insulin sensitivity. Improved insulin resistance of PWS was partly transmitted by faecal microbiota transplantations into germ-free mice. CONCLUSION The gut microbiota of PWS patients is similar to that of their non-obese parents and might play a role for the protection of PWS patients from metabolic complications.
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Affiliation(s)
- Lisa M Olsson
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christine Poitou
- INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Sorbonne Universite, Paris, Île-de-France, France
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (Prader-Willi Syndrome), Nutrition Department, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Valentina Tremaroli
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Muriel Coupaye
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (Prader-Willi Syndrome), Nutrition Department, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Judith Aron-Wisnewsky
- INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Sorbonne Universite, Paris, Île-de-France, France
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (Prader-Willi Syndrome), Nutrition Department, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Fredrik Bäckhed
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karine Clément
- INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Sorbonne Universite, Paris, Île-de-France, France
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (Prader-Willi Syndrome), Nutrition Department, University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Robert Caesar
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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35
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Beghdadi N, Lim C, Aron-Wisnewsky J, Torcivia A, Goumard C, Turco C, Vaillant JC, Siksik JM, Oppert JM, Scatton O, Genser L. Cholangiocarcinoma Following Bariatric Surgery: a Prospective Follow-Up Single-Center Audit. Obes Surg 2020; 30:3590-3594. [PMID: 32385663 DOI: 10.1007/s11695-020-04661-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cholangiocarcinoma (CC) incidence is rising worldwide. Obesity and its related metabolic impairments are associated with primitive liver malignancies including CC. While bariatric surgery (BS) is associated with decreased risk of incident cancer, few data are available regarding CC incidence, presentation, and management issues after BS. METHODS We retrospectively reviewed collected data on 1911 consecutive patients undergoing BS from 2010 to 2019. RESULTS We recorded three cases (0.16%) of CC during the postoperative follow-up. All cases underwent a Roux-en-Y gastric bypass (RYGB) for class III obesity with metabolic diseases (i.e., type 2 diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea) without any personal or familial history of biliary disease. The patients presented with an inaugural jaundice or pruritus at 8, 12, and 13 months after RYBG, which enabled the diagnosis of metastatic CCs in all cases. In such palliative setting without access to the pancreato-biliary system, biliary drainage was ensured by a percutaneous trans-hepatic biliary drain. Chemotherapy was initiated in two patients. All the patients died within a delay of 2, 11, and 17 months after the diagnosis, respectively. CONCLUSION The incidence of post-BS CC appears low, but the prognosis is poor because of advanced stages at diagnosis. These cases illustrate the difficulty to make both on-time diagnosis and optimal management of CC especially in patients operated of RYGB with limited access to the excluded anatomy.
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Affiliation(s)
- Nassiba Beghdadi
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Chetana Lim
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Judith Aron-Wisnewsky
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France.,NutriOmics INSERM UMRS U1269, Sorbonne Université, Paris, France
| | - Adriana Torcivia
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Claire Goumard
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Celia Turco
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France.,Department of Digestive Surgical Oncology, Liver Transplantation Unit, University Hospital of Besançon, 25000, Besançon, France
| | - Jean-Christophe Vaillant
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Jean-Michel Siksik
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Olivier Scatton
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Laurent Genser
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France. .,NutriOmics INSERM UMRS U1269, Sorbonne Université, Paris, France.
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36
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Aron-Wisnewsky J, Warmbrunn MV, Nieuwdorp M, Clément K. Nonalcoholic Fatty Liver Disease: Modulating Gut Microbiota to Improve Severity? Gastroenterology 2020; 158:1881-1898. [PMID: 32044317 DOI: 10.1053/j.gastro.2020.01.049] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 02/06/2023]
Abstract
Gut microbiota plays a role in the pathophysiology of metabolic diseases, which include nonalcoholic fatty liver diseases, through the gut-liver axis. To date, clinical guidelines recommend a weight loss goal of 7%-10% to improve features of nonalcoholic fatty liver diseases. Because this target is not easily achieved by all patients, alternative therapeutic options are currently being evaluated. This review focuses on therapeutics that aim to modulate the gut microbiota and the gut-liver axis. We discuss how probiotics, prebiotics, synbiotic, fecal microbiota transfer, polyphenols, specific diets, and exercise interventions have been found to modify gut microbiota signatures; improve nonalcoholic fatty liver disease outcomes; and detail, when available, the different mechanisms by which these beneficial outcomes might occur. Apart from probiotics that have already been tested in human randomized controlled trials, most of these potential therapeutics have been studied in animals. Their efficacy still warrants confirmation in humans using appropriate design.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, UMRS U1269, Nutriomics Research Unit, Paris, France; Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centre de Recherche en Nutrition Humaine d'Ile de France, Paris, France; Department of Vascular Medicine, University of Amsterdam Medical Center, Amsterdam, The Netherlands.
| | - Moritz V Warmbrunn
- Department of Vascular Medicine, University of Amsterdam Medical Center, Amsterdam, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, University of Amsterdam Medical Center, Amsterdam, The Netherlands; Department of Internal Medicine, University of Amsterdam Medical Center, Free University, Amsterdam, The Netherlands
| | - Karine Clément
- Sorbonne Université, INSERM, UMRS U1269, Nutriomics Research Unit, Paris, France; Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centre de Recherche en Nutrition Humaine d'Ile de France, Paris, France.
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37
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Dicker D, Golan R, Aron-Wisnewsky J, Zucker JD, Sokolowska N, Comaneshter DS, Yahalom R, Vinker S, Clément K, Rudich A. Prediction of Long-Term Diabetes Remission After RYGB, Sleeve Gastrectomy, and Adjustable Gastric Banding Using DiaRem and Advanced-DiaRem Scores. Obes Surg 2020; 29:796-804. [PMID: 30467708 DOI: 10.1007/s11695-018-3583-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 12/31/2022]
Abstract
PURPOSE DiaRem is a clinical scoring system designed to predict diabetes remission (DR) 1-year post-Roux-en-Y gastric bypass (RYGB). We examined long-term (2- and 5-year) postoperative DR prediction by DiaRem and an advanced-DiaRem (Ad-DiaRem) score following RYGB, sleeve gastrectomy (SG), and gastric banding (GB). METHODS We accessed data from a computerized database of persons with type 2 diabetes and BMI ≥ 30 kg/m2 who underwent RYGB, SG, or GB, and determined DR status 2- and 5-year postoperative according to preoperative DiaRem and the Ad-DiaRem calculated scores. RESULTS Among 1459 patients with 5-year postoperative diabetes status data, 53.6% exhibited DR. For RYGB, Ad-DiaRem trended to exhibit mildly improved predictive capacity 5-year postoperatively compared to DiaRem: Areas under receiver operating characteristic [AUROC] curves were 0.85 (0.76-0.93) and 0.78 (0.69-0.88), respectively. The positive predictive values (PPVs) detecting > 80% of those achieving DR (i.e., sensitivity ≥ 0.8) were 78.2% and 73.2%, respectively, and higher Ad-DiaRem scores more consistently associated with decreased DR rates. Following SG, both scores had an AUROC of 0.82, but Ad-DiaRem still had a higher PPV for predicting > 80% of those with 5-year postoperative DR (76.2% and 71.0%). Predictive capacity parameters were comparatively lower, for both scores, when considering DR 5-year post-GB (AUROC: 0.73 for both scores, PPV: 66.3% and 64.3%, respectively). CONCLUSIONS Ad-DiaRem provides modest improvement compared to DiaRem in predicting long-term DR 5-years post-RYGB. Both scores similarly provide fair predictive capacity for 5-year postoperative DR after SG.
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Affiliation(s)
- Dror Dicker
- Department of Internal Medicine D, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St., 49100, Petah Tikva, Israel. .,Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
| | - Rachel Golan
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel
| | - Judith Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France.,INSERM, UMR S U1166, Nutriomics Team, Paris, France.,Sorbonne Universités, UPMC University Paris, 06, UMR_S 1166 I, Nutriomics Team, Paris, France
| | - Jean-Daniel Zucker
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics team, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, IHU ICAN, IRD, unité de modélisation mathématique et informatique des systèmes complexes (UMMISCO), F-93143, Bondy, France
| | - Natalyia Sokolowska
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France.,INSERM, UMR S U1166, Nutriomics Team, Paris, France.,Sorbonne Universités, UPMC University Paris, 06, UMR_S 1166 I, Nutriomics Team, Paris, France
| | | | - Rina Yahalom
- Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Shlomo Vinker
- Central Headquarters, Clalit Health Services, Tel Aviv, Israel
| | - Karine Clément
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France.,INSERM, UMR S U1166, Nutriomics Team, Paris, France.,Sorbonne Universités, UPMC University Paris, 06, UMR_S 1166 I, Nutriomics Team, Paris, France
| | - Assaf Rudich
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, and the National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel
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38
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Lecronier M, Tashk P, Tamzali Y, Tenaillon O, Denamur E, Barrou B, Aron-Wisnewsky J, Tourret J. Gut microbiota composition alterations are associated with the onset of diabetes in kidney transplant recipients. PLoS One 2020; 15:e0227373. [PMID: 31910227 PMCID: PMC6946168 DOI: 10.1371/journal.pone.0227373] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background The gut dysbiosis associated with diabetes acquired before or after kidney transplantation (KT) has not been explored.
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Affiliation(s)
- Marie Lecronier
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Parvine Tashk
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Yanis Tamzali
- AP-HP, Département d’Urologie, Néphrologie et Transplantation, GH Pitié-Salpêtrière Charles Foix, Paris, France
| | - Olivier Tenaillon
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Erick Denamur
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- AP-HP, Laboratoire de Génétique Moléculaire, Hôpital Bichat, Paris, France
| | - Benoit Barrou
- AP-HP, Département d’Urologie, Néphrologie et Transplantation, GH Pitié-Salpêtrière Charles Foix, Paris, France
- Sorbonne Université, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Paris, France
- AP-HP, Institute of Cardiometabolism and Nutrition, ICAN, Service de nutrition, GH Pitié-Salpêtrière Charles Foix, Paris, France
- INSERM, UMR_S U1166, équipe NutriOmics, Paris, France
| | - Jérôme Tourret
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- AP-HP, Département d’Urologie, Néphrologie et Transplantation, GH Pitié-Salpêtrière Charles Foix, Paris, France
- Sorbonne Université, Paris, France
- * E-mail:
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39
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Warmbrunn MV, Herrema H, Aron-Wisnewsky J, Soeters MR, Van Raalte DH, Nieuwdorp M. Gut microbiota: a promising target against cardiometabolic diseases. Expert Rev Endocrinol Metab 2020; 15:13-27. [PMID: 32066294 DOI: 10.1080/17446651.2020.1720511] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/21/2020] [Indexed: 02/06/2023]
Abstract
Introduction: Cardiometabolic diseases (CMD) are a group of interrelated disorders such as metabolic syndrome, type 2 diabetes mellitus and cardiovascular diseases (CVD). As the prevalence of these diseases increases globally, efficient new strategies are necessary to target CMD and modifiable risk factors. In the past decade, evidence has accumulated regarding the influence of gut microbiota (GM) on CMD, providing new targets for therapeutic interventions.Areas covered: This narrative review discusses the pathophysiologic link between CMD, GM, and potential microbiota-based targets against atherosclerosis and modifiable risk factors for atherosclerosis. Low-grade inflammation can be induced through GM and its derived metabolites. CMD are influenced by GM and microbiota-derived metabolites such as short-chain fatty acids (SCFA), secondary bile acids, trimethylamine N-oxide (TMAO), and the composition of GM can modulate host metabolism. All of the above can lead to promising therapeutic targets.Expert opinion: Most data are derived from animal models or human association studies; therefore, more translational and interventional research in humans is necessary to validate these promising findings. Reproduced findings such as aberrant microbiota patterns or circulating biomarkers could be targeted depending on individual metabolic profiles, moving toward personalized medicine in CMD.
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Affiliation(s)
- Moritz V Warmbrunn
- Department of Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
| | - Hilde Herrema
- Department of Experimental Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
| | - Judith Aron-Wisnewsky
- Department of Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches (Nutriomics), Paris, France
- Assistance Publique Hôpitaux De Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Maarten R Soeters
- Department of Endocrinology and Metabolism, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
| | - Daniel H Van Raalte
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Location VUMC at Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
- Department of Experimental Vascular Medicine, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, Location AMC at University of Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Location VUMC at Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC, ICar at Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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40
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Abstract
PURPOSE OF REVIEW This article summarizes recent literature concerning vitamin deficiency and required supplementation post-bariatric surgery, focusing on vitamin D (and associated clinical adverse effect on bone loss) and on the potential implication of the gut microbiota. RECENT FINDINGS Bariatric surgery induces weight loss and metabolic improvements yet with major inter-individual variability. If it is efficient in most patients, some display poor response (i.e. patients with the lowest weight loss at 1 year or weight regain afterwards, or patients without metabolic disease remission). Despite systematic vitamin supplementation, some patients develop vitamin deficiencies leading to poor clinical outcomes, among which vitamin D deficiency associated with observed bone mass loss and fractures. Recent mechanistic studies led to understand better the involved physiopathology. Furthermore, different intervention studies tested on top of bariatric surgery (using vitamin, diet, or nutrients acting as functional food) have evaluated whether nutritional adverse outcomes could be improved. Importantly, gut microbiota involved in food digestion and metabolization and vitamin synthesis is largely perturbed during severe obesity and is partially restored post-surgery, yet again with large interindividual variability. Whether differential gut microbiota modification could be associated with vitamin deficiencies is an open question. SUMMARY Future clinical research studies will need to evaluate whether add-on intervention to bariatric surgery using vitamin, diet, or specific food items could help prevent nutritional deficiencies and improve clinical response observed post-surgery. Importantly, personalizing the add-on intervention post-surgery upon gut microbiota composition should be tested in predicted poor-responders to surgery as already performed during diet intervention to further improve metabolic health.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities, Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities, Systemic Approaches (NutriOmics)
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, Paris, France
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Anty R, Morvan M, Le Corvec M, Canivet CM, Patouraux S, Gugenheim J, Bonnafous S, Bailly-Maitre B, Sire O, Tariel H, Bernard J, Piche T, Loréal O, Aron-Wisnewsky J, Clément K, Tran A, Iannelli A, Gual P. The mid-infrared spectroscopy: A novel non-invasive diagnostic tool for NASH diagnosis in severe obesity. JHEP Rep 2019; 1:361-368. [PMID: 32039387 PMCID: PMC7005664 DOI: 10.1016/j.jhepr.2019.09.005] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/23/2019] [Accepted: 09/28/2019] [Indexed: 02/07/2023] Open
Abstract
There is an urgent medical need to develop non-invasive tests for non-alcoholic steatohepatitis (NASH). This study evaluates the diagnostic performance of an innovative model based on mid-infrared (MIR) spectroscopy for the diagnosis of NASH. Methods Severely obese patients who underwent a bariatric procedure at the University Hospital of Nice, France (n = 395) were prospectively recruited. The clinico-biological characteristics were measured prior to surgery. Liver biopsies were collected during the surgical procedure and assessed by a pathologist. A training group (316 patients, NASH: 16.8%) and a validation group (79 patients, NASH: 16.5%) were randomly defined. MIR spectra were acquired by fiber evanescent wave spectroscopy, using chalcogenide glass fiber optic sensors and a spectrometer. This absorption spectroscopic technique delivers a spectrum that identifies the molecular composition of a sample, defining a patient's metabolic fingerprint. Results The areas under the receiver operating curve (AUROC) for the diagnosis of NASH were 0.82 and 0.77 in the training and validation groups, respectively. The best threshold was 0.15, which was associated with a sensitivity of 0.75 and 0.69, and a specificity of 0.72 and 0.76. Negative predictive values of 0.94 and 0.93 and positive predictive values of 0.35 and 0.36, as well as correctly classified patient rates of 72% and 75% were obtained in the training and validation groups, respectively. A composite model using aspartate aminotransferase level, triglyceride level and waist circumference alongside the MIR spectra led to an increase in AUROC (0.88 and 0.84 for the training and validations groups, respectively). Conclusions MIR spectroscopy provides good sensitivity and negative predictive values for NASH screening in patients with severe obesity. Lay summary There is an urgent need for tools to non-invasively diagnose and monitor non-alcoholic steatohepatitis (NASH). This study evaluates the performance of a new tool for fast NASH diagnosis based on mid-infrared (MIR) spectroscopy. Using serum samples from severely obese patients who underwent a bariatric procedure, which enabled a concomitant liver biopsy to be performed, the MIR spectroscopy model performed well in screening patients for NASH compared to a traditional, histological diagnosis. There is no validated non-invasive diagnostic tool for NASH in routine care. NASH follow-up requires a non-invasive diagnostic method. Using a simple drop of serum, the mid-infrared spectrum captures a patient’s metabolic fingerprint. A model based on mid-infrared spectroscopy provides efficient NASH screening for patients with severe obesity.
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Affiliation(s)
- Rodolphe Anty
- Université Côte d'Azur, CHU, INSERM, U1065, C3M, France
| | - Marie Morvan
- University of Rennes, CNRS, IRMAR - UMR, 6625, Rennes, France
| | | | | | | | | | | | | | | | | | | | - Thierry Piche
- Université Côte d'Azur, CHU, INSERM, U1065, C3M, France
| | - Olivier Loréal
- INSERM, Univ Rennes, INRA, Nutrition Metabolisms and Cancer (NuMeCan), UMR-1241, Rennes, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université/Inserm Unité UMRS NutriOmics, Assistance publique hôpitaux de Paris, service de Nutrition, Paris, France
| | - Karine Clément
- Sorbonne Université/Inserm Unité UMRS NutriOmics, Assistance publique hôpitaux de Paris, service de Nutrition, Paris, France
| | - Albert Tran
- Université Côte d'Azur, CHU, INSERM, U1065, C3M, France
| | | | - Philippe Gual
- Université Côte d'Azur, CHU, INSERM, U1065, C3M, France
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Kayser BD, Prifti E, Lhomme M, Belda E, Dao MC, Aron-Wisnewsky J, Kontush A, Zucker JD, Rizkalla SW, Dugail I, Clément K. Elevated serum ceramides are linked with obesity-associated gut dysbiosis and impaired glucose metabolism. Metabolomics 2019; 15:140. [PMID: 31605240 PMCID: PMC7165363 DOI: 10.1007/s11306-019-1596-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/25/2019] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Low gut microbiome richness is associated with dyslipidemia and insulin resistance, and ceramides and other sphingolipids are implicated in the development of diabetes. OBJECTIVES Determine whether circulating sphingolipids, particularly ceramides, are associated with alterations in the gut microbiome among obese patients with increased diabetes risk. METHODS This was a cross-sectional and longitudinal retrospective analysis of a dietary/weight loss intervention. Fasted serum was collected from 49 participants (41 women) and analyzed by HPLC-MS/MS to quantify 45 sphingolipids. Shotgun metagenomic sequencing of stool was performed to profile the gut microbiome. RESULTS Confirming the link to deteriorated glucose homeostasis, serum ceramides were positively correlated with fasting glucose, but inversely correlated with fasting and OGTT-derived measures of insulin sensitivity and β-cell function. Significant associations with gut dysbiosis were demonstrated, with SM and ceramides being inversely correlated with gene richness. Ceramides with fatty acid chain lengths of 20-24 carbons were the most associated with low richness. Diet-induced weight loss, which improved gene richness, decreased most sphingolipids. Thirty-one MGS, mostly corresponding to unidentified bacteria species, were inversely correlated with ceramides, including a number of Bifidobacterium and Methanobrevibacter smithii. Higher ceramide levels were also associated with increased metagenomic modules for lipopolysaccharide synthesis and flagellan synthesis, two pathogen-associated molecular patterns, and decreased enrichment of genes involved in methanogenesis and bile acid metabolism. CONCLUSION This study identifies an association between gut microbiota richness, ceramides, and diabetes risk in overweight/obese humans, and suggests that the gut microbiota may contribute to dysregulation of lipid metabolism in metabolic disorders.
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Affiliation(s)
- Brandon D Kayser
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
| | - Edi Prifti
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes, Paris, France
| | - Marie Lhomme
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
| | - Eugeni Belda
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
| | - Maria-Carlota Dao
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France
- Assistance-Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, CRNH Ile de France, 43-83 Boulevard de L'Hôpital, IE3 M, 75013, Paris, France
| | - Anatol Kontush
- Sorbonne Université, INSERM, UMRS 1166, Dyslipidemia, Inflammation, and Atherosclerosis Team, Paris, France
| | - Jean-Daniel Zucker
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes, Paris, France
| | - Salwa W Rizkalla
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Paris, France
| | - Isabelle Dugail
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities; Systemic Approaches Research Unit (NutriOmics), Paris, France.
- Assistance-Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Nutrition Department, CRNH Ile de France, 43-83 Boulevard de L'Hôpital, IE3 M, 75013, Paris, France.
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Abstract
PURPOSE OF REVIEW In this review, we summarize what is currently described in terms of gut microbiota (GM) dysbiosis modification post-bariatric surgery (BS) and their link with BS-induced clinical improvement. We also discuss how the major inter-individual variability in terms of GM changes could impact the clinical improvements seen in patients. RECENT FINDINGS The persisting increase in severe obesity prevalence has led to the subsequent burst in BS number. Indeed, it is to date the best treatment option to induce major and sustainable weight loss and metabolic improvement in these patients. During obesity, the gut microbiota displays distinctive features such as low microbial gene richness and compositional and functional alterations (termed dysbiosis) which have been associated with low-grade inflammation, increased body weight and fat mass, as well as type-2 diabetes. Interestingly, GM changes post-BS is currently being proposed as one the many mechanism explaining BS beneficial clinical outcomes. BS enables partial rescue of GM dysbiosis observed during obesity. Some of the GM characteristics modified post-BS (composition in terms of bacteria and functions) are linked to BS beneficial outcomes such as weight loss or metabolic improvements. Nevertheless, the changes in GM post-BS display major variability from one patient to the other. As such, further large sample size studies associated with GM transfer studies in animals are still needed to completely decipher the role of GM in the clinical improvements observed post-surgery.
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Affiliation(s)
- Jean Debédat
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France
| | - Karine Clément
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.
- Assistance Publique Hôpitaux de Paris, Nutrition Departement, Pitié-Salpêtrière Hospital, Sorbonne Université, 47-83 bd de l'Hôpital, 75013, Paris, France.
| | - Judith Aron-Wisnewsky
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.
- Assistance Publique Hôpitaux de Paris, Nutrition Departement, Pitié-Salpêtrière Hospital, Sorbonne Université, 47-83 bd de l'Hôpital, 75013, Paris, France.
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Dao MC, Belda E, Prifti E, Everard A, Kayser BD, Bouillot JL, Chevallier JM, Pons N, Le Chatelier E, Ehrlich SD, Doré J, Aron-Wisnewsky J, Zucker JD, Cani PD, Clément K. Akkermansia muciniphila abundance is lower in severe obesity, but its increased level after bariatric surgery is not associated with metabolic health improvement. Am J Physiol Endocrinol Metab 2019; 317:E446-E459. [PMID: 31265324 DOI: 10.1152/ajpendo.00140.2019] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The gut bacterial species Akkermansia muciniphila is associated with a healthier clinical profile. The purpose of this study was to determine the association between A. muciniphila and glucose homeostasis in patients undergoing bariatric surgery (BS): gastric banding (GB) or Roux-en-Y gastric bypass (RYGB). This nonrandomized prospective study included 65 women with severe obesity. Longitudinal analysis included subjects for whom A. muciniphila data were available at follow-up [1, 3, and 12 mo; GB (n = 10) or RYGB (n = 11)]. Glucose homeostasis markers were measured under fasting conditions (glucose, insulin, and HbA1c) or during an oral glucose tolerance test. Fecal microbiota was analyzed using shotgun metagenomics, and A. muciniphila relative abundance was assessed with 16S rRNA quantitative PCR. A. muciniphila relative abundance was significantly lower in severe obesity [mean body mass index, 45.7 kg/m2 (SD 5.4)] than in moderate obesity [33.2 kg/m2 (SD 3.8)] but not associated with glucose homeostasis markers. A significant increase in A. muciniphila relative abundance after RYGB was not correlated with metabolic improvement. Baseline A. muciniphila abundance was correlated with bacterial gene richness and was highest in the high-richness Ruminococcaceae enterotype. A. muciniphila increased in relative abundance after BS in patients with low baseline A. muciniphila abundance, especially those with a Bacteroides type 2 enterotype classification. Although decreased in severe obesity, relative abundance of A. muciniphila was not associated with glucose homeostasis before or after BS. A certain level of A. muciniphila abundance might be required to observe a beneficial link to health. The severity of obesity and gut dysbiosis may partly explain the discrepancy with previous findings in less obese populations.
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Affiliation(s)
- Maria Carlota Dao
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Nutrition & Obesity-Systemic Approaches Research Group (NutriOmics), Institute of Cardiometabolism and Nutrition, Paris, France
| | - Eugeni Belda
- Integromics, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Edi Prifti
- Integromics, Institute of Cardiometabolism and Nutrition, Paris, France
- Sorbonne Université, Institut de Recherche pour le Développement, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, Bondy, France
| | - Amandine Everard
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Walloon Excellence in Life Sciences and Biotechnology, Brussels, Belgium
| | - Brandon D Kayser
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Nutrition & Obesity-Systemic Approaches Research Group (NutriOmics), Institute of Cardiometabolism and Nutrition, Paris, France
| | - Jean-Luc Bouillot
- Visceral Surgery Department, Ambroise Paré Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jean-Marc Chevallier
- Visceral Surgery Department, Hôpital Européen Georges-Pompido, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nicolas Pons
- Micalis Institute, Institut National de la Recherche Agronomique, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Emmanuelle Le Chatelier
- Micalis Institute, Institut National de la Recherche Agronomique, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Stanislav Dusko Ehrlich
- Micalis Institute, Institut National de la Recherche Agronomique, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Joel Doré
- Micalis Institute, Institut National de la Recherche Agronomique, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Judith Aron-Wisnewsky
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Nutrition & Obesity-Systemic Approaches Research Group (NutriOmics), Institute of Cardiometabolism and Nutrition, Paris, France
- Nutrition Department, Centre de Recherche en Nutrition Humaine Île-de-France, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jean-Daniel Zucker
- Integromics, Institute of Cardiometabolism and Nutrition, Paris, France
- Sorbonne Université, Institut de Recherche pour le Développement, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, Bondy, France
| | - Patrice D Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Walloon Excellence in Life Sciences and Biotechnology, Brussels, Belgium
| | - Karine Clément
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Nutrition & Obesity-Systemic Approaches Research Group (NutriOmics), Institute of Cardiometabolism and Nutrition, Paris, France
- Nutrition Department, Centre de Recherche en Nutrition Humaine Île-de-France, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize the current data available on the metabolic effects of fecal microbiota transplantation (FMT) including obesity and glucose metabolism in humans. RECENT FINDINGS Gut microbiota dysbiosis is a frequent characteristic observed in obesity and related metabolic diseases. Pieces of evidence mostly generated in mouse models suggest that rescuing this dysbiosis associates with improved metabolism. In humans, dietary or bariatric surgery interventions are often accompanied by complete or partial restoration of this dysbiosis together with weight reduction and metabolic amelioration. FMT is an interesting option to modify gut microbiota and has been associated with improved clinical outcomes, albeit only used in routine care for Clostridium difficile infection. However, there are only limited data on using FMT in the metabolic context. FMT from lean donors significantly improves insulin sensitivity in obese subjects with metabolic syndrome. However, there is a wide range of clinical responses. Interestingly in subjects with high microbial gene richness at baseline and when FMT donors that are metabolically compromised are used, no metabolic improvement is seen. Moreover, more studies evaluating the effect of FMT in patients with overt type 2 diabetes are warranted. Furthermore, interventions (in the receiver prior to FMT) aiming to enhance FMT response also need evaluation.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and Obesities: Systemic Approaches (NutriOMics) Research Unit, Paris, France.
- Assistante Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, 75013, Paris, France.
- Amsterdam UMC, Location AMC and VUMC, Department of Internal and Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands.
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesities: Systemic Approaches (NutriOMics) Research Unit, Paris, France
- Assistante Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, 75013, Paris, France
| | - Max Nieuwdorp
- Amsterdam UMC, Location AMC and VUMC, Department of Internal and Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands
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Debédat J, Amouyal C, Aron-Wisnewsky J, Clément K. Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome? Semin Immunopathol 2019; 41:461-475. [DOI: 10.1007/s00281-019-00738-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/15/2019] [Indexed: 02/06/2023]
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47
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Dao MC, Sokolovska N, Brazeilles R, Affeldt S, Pelloux V, Prifti E, Chilloux J, Verger EO, Kayser BD, Aron-Wisnewsky J, Ichou F, Pujos-Guillot E, Hoyles L, Juste C, Doré J, Dumas ME, Rizkalla SW, Holmes BA, Zucker JD, Clément K. A Data Integration Multi-Omics Approach to Study Calorie Restriction-Induced Changes in Insulin Sensitivity. Front Physiol 2019; 9:1958. [PMID: 30804813 PMCID: PMC6371001 DOI: 10.3389/fphys.2018.01958] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 12/27/2018] [Indexed: 12/17/2022] Open
Abstract
Background: The mechanisms responsible for calorie restriction (CR)-induced improvement in insulin sensitivity (IS) have not been fully elucidated. Greater insight can be achieved through deep biological phenotyping of subjects undergoing CR, and integration of big data. Materials and Methods: An integrative approach was applied to investigate associations between change in IS and factors from host, microbiota, and lifestyle after a 6-week CR period in 27 overweight or obese adults (ClinicalTrials.gov: NCT01314690). Partial least squares regression was used to determine associations of change (week 6 - baseline) between IS markers and lifestyle factors (diet and physical activity), subcutaneous adipose tissue (sAT) gene expression, metabolomics of serum, urine and feces, and gut microbiota composition. ScaleNet, a network learning approach based on spectral consensus strategy (SCS, developed by us) was used for reconstruction of biological networks. Results: A spectrum of variables from lifestyle factors (10 nutrients), gut microbiota (10 metagenomics species), and host multi-omics (metabolic features: 84 from serum, 73 from urine, and 131 from feces; and 257 sAT gene probes) most associated with IS were identified. Biological network reconstruction using SCS, highlighted links between changes in IS, serum branched chain amino acids, sAT genes involved in endoplasmic reticulum stress and ubiquitination, and gut metagenomic species (MGS). Linear regression analysis to model how changes of select variables over the CR period contribute to changes in IS, showed greatest contributions from gut MGS and fiber intake. Conclusion: This work has enhanced previous knowledge on links between host glucose homeostasis, lifestyle factors and the gut microbiota, and has identified potential biomarkers that may be used in future studies to predict and improve individual response to weight-loss interventions. Furthermore, this is the first study showing integration of the wide range of data presented herein, identifying 115 variables of interest with respect to IS from the initial input, consisting of 9,986 variables. Clinical Trial Registration: clinicaltrials.gov (NCT01314690).
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Affiliation(s)
- Maria Carlota Dao
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Nataliya Sokolovska
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | | | - Séverine Affeldt
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Véronique Pelloux
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Edi Prifti
- Institute of Cardiometabolism and Nutrition, Integromics, ICAN, Paris, France
- Sorbonne University, IRD, UMMISCO, Bondy, France
| | - Julien Chilloux
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Eric O. Verger
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Brandon D. Kayser
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Judith Aron-Wisnewsky
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
| | - Farid Ichou
- Institute of Cardiometabolism and Nutrition, ICANalytics, Paris, France
| | - Estelle Pujos-Guillot
- Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d’Exploration du Métabolisme, MetaboHUB, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Lesley Hoyles
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Bioscience, School of Science and Technology, Nottingham Trent University, Clifton Campus, Nottingham, United Kingdom
| | - Catherine Juste
- National Institute of Agricultural Research, Micalis Institute, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Joël Doré
- National Institute of Agricultural Research, Micalis Institute, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Marc-Emmanuel Dumas
- Section of Biomolecular Medicine, Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Salwa W. Rizkalla
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
| | | | - Jean-Daniel Zucker
- Institute of Cardiometabolism and Nutrition, Integromics, ICAN, Paris, France
- Sorbonne University, IRD, UMMISCO, Bondy, France
| | - Karine Clément
- Sorbonne University, French National Institute for Health and Medical Research, NutriOmics Unit, Institute of Cardiometabolism and Nutrition, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition Department, CRNH Ile-de-France, Pitié-Salpêtrière Hospital, Paris, France
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48
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Le Roy T, Debédat J, Marquet F, Da-Cunha C, Ichou F, Guerre-Millo M, Kapel N, Aron-Wisnewsky J, Clément K. Comparative Evaluation of Microbiota Engraftment Following Fecal Microbiota Transfer in Mice Models: Age, Kinetic and Microbial Status Matter. Front Microbiol 2019; 9:3289. [PMID: 30692975 PMCID: PMC6339881 DOI: 10.3389/fmicb.2018.03289] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022] Open
Abstract
The intestinal microbiota and its functions are intricately interwoven with host physiology. Colonizing rodents with donor microbiota provides insights into host-microbiota interactions characterization and the understanding of disease physiopathology. However, a better assessment of inoculation methods and recipient mouse models is needed. Here, we compare the engraftment at short and long term of genetically obese mice microbiota in germ-free (GF) mice and juvenile and adult specific pathogen free (SPF) mice. We also tested the effects of initial microbiota depletion before microbiota transfer. In the present work, donor microbiota engraftment was better in juvenile SPF mice than in adult SPF mice. In juvenile mice, initial microbiota depletion using laxatives or antibiotics improved donor microbiota engraftment 9 weeks but not 3 weeks after microbiota transfer. Microbiota-depleted juvenile mice performed better than GF mice 3 weeks after the microbiota transfer. However, 9 weeks after transfer, colonized GF mice microbiota had the lowest Unifrac distance to the donor microbiota. Colonized GF mice were also characterized by a chronic alteration in intestinal absorptive function. With these collective results, we show that the use of juvenile mice subjected to initial microbiota depletion constitutes a valid alternative to GF mice in microbiota transfer studies.
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Affiliation(s)
- Tiphaine Le Roy
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France
| | - Jean Debédat
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France
| | - Florian Marquet
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France
| | - Carla Da-Cunha
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France
| | - Farid Ichou
- ICANalytics Facility Core, Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France
| | | | - Nathalie Kapel
- Department of Functional Coprology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Judith Aron-Wisnewsky
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France.,Department of Nutrition, CRNH Ile de France, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Karine Clément
- NutriOmics Team, INSERM, ICAN, Sorbonne Université, Paris, France.,Department of Nutrition, CRNH Ile de France, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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49
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Aron-Wisnewsky J, Prifti E, Belda E, Ichou F, Kayser BD, Dao MC, Verger EO, Hedjazi L, Bouillot JL, Chevallier JM, Pons N, Le Chatelier E, Levenez F, Ehrlich SD, Doré J, Zucker JD, Clément K. Major microbiota dysbiosis in severe obesity: fate after bariatric surgery. Gut 2019; 68:70-82. [PMID: 29899081 PMCID: PMC7143256 DOI: 10.1136/gutjnl-2018-316103] [Citation(s) in RCA: 249] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Decreased gut microbial gene richness (MGR) and compositional changes are associated with adverse metabolism in overweight or moderate obesity, but lack characterisation in severe obesity. Bariatric surgery (BS) improves metabolism and inflammation in severe obesity and is associated with gut microbiota modifications. Here, we characterised severe obesity-associated dysbiosis (ie, MGR, microbiota composition and functional characteristics) and assessed whether BS would rescue these changes. DESIGN Sixty-one severely obese subjects, candidates for adjustable gastric banding (AGB, n=20) or Roux-en-Y-gastric bypass (RYGB, n=41), were enrolled. Twenty-four subjects were followed at 1, 3 and 12 months post-BS. Gut microbiota and serum metabolome were analysed using shotgun metagenomics and liquid chromatography mass spectrometry (LC-MS). Confirmation groups were included. RESULTS Low gene richness (LGC) was present in 75% of patients and correlated with increased trunk-fat mass and comorbidities (type 2 diabetes, hypertension and severity). Seventy-eight metagenomic species were altered with LGC, among which 50% were associated with adverse body composition and metabolic phenotypes. Nine serum metabolites (including glutarate, 3-methoxyphenylacetic acid and L-histidine) and functional modules containing protein families involved in their metabolism were strongly associated with low MGR. BS increased MGR 1 year postsurgery, but most RYGB patients remained with low MGR 1 year post-BS, despite greater metabolic improvement than AGB patients. CONCLUSIONS We identified major gut microbiota alterations in severe obesity, which include decreased MGR and related functional pathways linked with metabolic deteriorations. The lack of full rescue post-BS calls for additional strategies to improve the gut microbiota ecosystem and microbiome-host interactions in severe obesity. TRIAL REGISTRATION NUMBER NCT01454232.
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Affiliation(s)
- Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, NutriOmics team, ICAN, F-75013, Paris, France,Assistance Publique Hôpitaux de Paris, APHP, Nutrition department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Paris France
| | - Edi Prifti
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics and metabolomics platform, Paris, France,IRD, Sorbonne Université, UMMISCO, Unité de modélisation Mathématique et Informatique des Systèmes Complexes, 32 Avenue Henri Varagnat, 93143 Bondy Cedex, France
| | - Eugeni Belda
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics and metabolomics platform, Paris, France
| | - Farid Ichou
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics and metabolomics platform, Paris, France
| | - Brandon D Kayser
- Sorbonne Université, INSERM, NutriOmics team, ICAN, F-75013, Paris, France
| | - Maria Carlota Dao
- Sorbonne Université, INSERM, NutriOmics team, ICAN, F-75013, Paris, France
| | - Eric O Verger
- Sorbonne Université, INSERM, NutriOmics team, ICAN, F-75013, Paris, France
| | - Lyamine Hedjazi
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics and metabolomics platform, Paris, France
| | - Jean-Luc Bouillot
- Assistance Publique Hôpitaux de Paris, APHP, Visceral surgery department of Ambroise Paré, Paris, France
| | - Jean-Marc Chevallier
- Assistance Publique Hôpitaux de Paris, APHP, Visceral surgery department of HEGP; Paris, France
| | - Nicolas Pons
- MGP MetaGénoPolis, INRA, Université Paris-Saclay, 78350 Jouy en Josas, France
| | | | - Florence Levenez
- MGP MetaGénoPolis, INRA, Université Paris-Saclay, 78350 Jouy en Josas, France
| | - Stanislav Dusko Ehrlich
- MGP MetaGénoPolis, INRA, Université Paris-Saclay, 78350 Jouy en Josas, France,AgroParisTech, UMR1319 MICALIS, Jouy-en-Josas, France
| | - Joel Doré
- MGP MetaGénoPolis, INRA, Université Paris-Saclay, 78350 Jouy en Josas, France,AgroParisTech, UMR1319 MICALIS, Jouy-en-Josas, France
| | - Jean-Daniel Zucker
- Institute of Cardiometabolism and Nutrition, ICAN, Integromics and metabolomics platform, Paris, France,IRD, Sorbonne Université, UMMISCO, Unité de modélisation Mathématique et Informatique des Systèmes Complexes, 32 Avenue Henri Varagnat, 93143 Bondy Cedex, France
| | - Karine Clément
- Sorbonne Université, INSERM, NutriOmics team, ICAN, F-75013, Paris, France,Assistance Publique Hôpitaux de Paris, APHP, Nutrition department, CRNH Ile de France, Pitié-Salpêtrière Hospital, Paris France
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50
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Debédat J, Sokolovska N, Coupaye M, Panunzi S, Chakaroun R, Genser L, de Turenne G, Bouillot JL, Poitou C, Oppert JM, Blüher M, Stumvoll M, Mingrone G, Ledoux S, Zucker JD, Clément K, Aron-Wisnewsky J. Long-term Relapse of Type 2 Diabetes After Roux-en-Y Gastric Bypass: Prediction and Clinical Relevance. Diabetes Care 2018; 41:2086-2095. [PMID: 30082327 DOI: 10.2337/dc18-0567] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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] [Received: 03/14/2018] [Accepted: 07/08/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Roux-en-Y gastric bypass (RYGB) induces type 2 diabetes remission (DR) in 60% of patients at 1 year, yet long-term relapse occurs in half of these patients. Scoring methods to predict DR outcomes 1 year after surgery that include only baseline parameters cannot accurately predict 5-year DR (5y-DR). We aimed to develop a new score to better predict 5y-DR. RESEARCH DESIGN AND METHODS We retrospectively included 175 RYGB patients with type 2 diabetes with 5-year follow-up. Using machine learning algorithms, we developed a scoring method, 5-year Advanced-Diabetes Remission (5y-Ad-DiaRem), predicting longer-term DR postsurgery by integrating medical history, bioclinical data, and antidiabetic treatments. The scoring method was based on odds ratios and variables significantly different between groups. This score was further validated in three independent RYGB cohorts from three European countries. RESULTS Compared with 5y-DR patients, patients who had relapsed after 5 years exhibited more severe type 2 diabetes at baseline, lost significantly less weight during the 1st year after RYGB, and regained more weight afterward. The 5y-Ad-DiaRem includes baseline (diabetes duration, number of antidiabetic treatments, and HbA1c) and 1-year follow-up parameters (glycemia, number of antidiabetic treatments, remission status, 1st-year weight loss). The 5y-Ad-DiaRem was accurate (area under the receiver operating characteristic curve [AUROC], 90%; accuracy, 85%) at predicting 5y-DR, performed better than the Diabetes Remission score (DiaRem) and the Advanced-DiaRem (AUROC, 81% and 84%; accuracy, 79% and 78%, respectively), and correctly reclassified 13 of 39 patients misclassified with the DiaRem. The 5y-Ad-DiaRem robustness was confirmed in the independent cohorts. CONCLUSIONS The 5y-Ad-DiaRem accurately predicts 5y-DR and appears relevant to identify patients at risk for relapse. Using this score could help personalize patient care after the 1st year post-RYGB to maximize weight loss, limit weight regains, and prevent relapse.
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Affiliation(s)
- Jean Debédat
- NutriOmics team, Sorbonne Université, INSERM, Paris, France
| | - Nataliya Sokolovska
- NutriOmics team, Sorbonne Université, INSERM, Paris, France.,Integromics team, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France
| | - Muriel Coupaye
- Obesity Reference Center, Explorations Fonctionnelles Department, Louis Mourier Hospital, Assistance Publique Hôpitaux de Paris, Colombes, France
| | - Simona Panunzi
- BioMatLab, Institute for Systems Analysis and Computer Science (IASI), National Council for Research (CNR), Rome, Italy
| | - Rima Chakaroun
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Medical Center, Leipzig, Germany
| | - Laurent Genser
- Visceral Surgery Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Jean-Luc Bouillot
- Visceral Surgery Department, Ambroise Paré Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christine Poitou
- NutriOmics team, Sorbonne Université, INSERM, Paris, France.,Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Jean-Michel Oppert
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Matthias Blüher
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Medical Center, Leipzig, Germany
| | - Michael Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Medical Center, Leipzig, Germany
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy.,Department of Diabetes and Nutritional Sciences, King's College London, London, U.K
| | - Séverine Ledoux
- Obesity Reference Center, Explorations Fonctionnelles Department, Louis Mourier Hospital, Assistance Publique Hôpitaux de Paris, Colombes, France
| | - Jean-Daniel Zucker
- NutriOmics team, Sorbonne Université, INSERM, Paris, France.,Integromics team, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France.,Unité de Modélisation Mathématique et Informatique des Systèmes Complexes (UMMISCO), L'Institut de Recherche pour le Développement (IRD), Sorbonne Université, Bondy, France
| | - Karine Clément
- NutriOmics team, Sorbonne Université, INSERM, Paris, France.,Integromics team, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France.,Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Judith Aron-Wisnewsky
- NutriOmics team, Sorbonne Université, INSERM, Paris, France .,Integromics team, Institute of Cardiometabolism and Nutrition (ICAN), Pitié-Salpêtrière Hospital, Paris, France.,Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
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