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Kalogirou M, Sinakos E. Treating nonalcoholic steatohepatitis with antidiabetic drugs: Will GLP-1 agonists end the struggle? World J Hepatol 2018; 10:790-794. [PMID: 30533179 PMCID: PMC6280165 DOI: 10.4254/wjh.v10.i11.790] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/10/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is highly associated with insulin resistance (IR), type 2 diabetes mellitus and metabolic syndrome, being characterized as the hepatic component of metabolic syndrome. Despite its high prevalence, no pharmacological treatment has been established, as of yet. A growing body of evidence, however, shows that reducing IR can result in improvement of the biochemical and histological features of nonalcoholic steatohepatitis (NASH)-the aggressive form of NAFLD that can lead to cirrhosis and hepatocellular carcinoma. Unfortunately, the several trials that have assessed the effect of various antidiabetic agents to date have failed to establish an effective and safe treatment regimen for patients with NAFLD. Glucagon-like peptide-1 (commonly known as GLP-1) agonists are a novel class of antidiabetic drugs that improve insulin sensitivity and promote weight loss. They also appear to have a direct effect on the lipid metabolism of hepatocytes, reducing hepatic steatosis. Several trials have demonstrated that GLP-1 agonists can reduce aminotransferase levels and improve liver histology in patients with NAFLD, suggesting that these agents could serve as an alternative treatment option for these patients. This manuscript discusses the role and potential mechanisms of GLP-1 agonists in the treatment of NASH.
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Affiliation(s)
- Maria Kalogirou
- 4th Department of Internal Medicine, Hippocrates Hospital, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
| | - Emmanouil Sinakos
- 4th Department of Internal Medicine, Hippocrates Hospital, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
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Rowlands J, Heng J, Newsholme P, Carlessi R. Pleiotropic Effects of GLP-1 and Analogs on Cell Signaling, Metabolism, and Function. Front Endocrinol (Lausanne) 2018; 9:672. [PMID: 30532733 PMCID: PMC6266510 DOI: 10.3389/fendo.2018.00672] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/29/2018] [Indexed: 12/22/2022] Open
Abstract
The incretin hormone Glucagon-Like Peptide-1 (GLP-1) is best known for its "incretin effect" in restoring glucose homeostasis in diabetics, however, it is now apparent that it has a broader range of physiological effects in the body. Both in vitro and in vivo studies have demonstrated that GLP-1 mimetics alleviate endoplasmic reticulum stress, regulate autophagy, promote metabolic reprogramming, stimulate anti-inflammatory signaling, alter gene expression, and influence neuroprotective pathways. A substantial body of evidence has accumulated with respect to how GLP-1 and its analogs act to restore and maintain normal cellular functions. These findings have prompted several clinical trials which have reported GLP-1 analogs improve cardiac function, restore lung function and reduce mortality in patients with obstructive lung disease, influence blood pressure and lipid storage, and even prevent synaptic loss and neurodegeneration. Mechanistically, GLP-1 elicits its effects via acute elevation in cAMP levels, and subsequent protein kinase(s) activation, pathways well-defined in pancreatic β-cells which stimulate insulin secretion in conjunction with elevated Ca2+ and ATP. More recently, new studies have shed light on additional downstream pathways stimulated by chronic GLP-1 exposure, findings which have direct relevance to our understanding of the potential therapeutic effects of longer lasting analogs recently developed for clinical use. In this review, we provide a comprehensive description of the diverse roles for GLP-1 across multiple tissues, describe downstream pathways stimulated by acute and chronic exposure, and discuss novel pleiotropic applications of GLP-1 mimetics in the treatment of human disease.
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Affiliation(s)
| | | | - Philip Newsholme
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Perth, WA, Australia
| | - Rodrigo Carlessi
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Perth, WA, Australia
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Gallego-Colon E, Wojakowski W, Francuz T. Incretin drugs as modulators of atherosclerosis. Atherosclerosis 2018; 278:29-38. [DOI: 10.1016/j.atherosclerosis.2018.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/06/2018] [Accepted: 09/13/2018] [Indexed: 02/06/2023]
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Xourgia E, Papazafiropoulou A, Melidonis A. Effects of antidiabetic drugs on epicardial fat. World J Diabetes 2018; 9:141-148. [PMID: 30254723 PMCID: PMC6153123 DOI: 10.4239/wjd.v9.i9.141] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/19/2018] [Accepted: 06/28/2018] [Indexed: 02/05/2023] Open
Abstract
Epicardial adipose tissue is defined as a deposit of adipocytes with pathophysiological properties similar to those of visceral fat, located in the space between the myocardial muscle and the pericardial sac. When compared with subcutaneous adipose tissue, visceral adipocytes show higher metabolic activity, lipolysis rates, increased insulin resistance along with more steroid hormone receptors. The epicardial adipose tissue interacts with numerous cardiovascular pathways via vasocrine and paracrine signalling comprised of pro- and anti-inflammatory cytokines excretion. Both the physiological differences between the two tissue types, as well as the fact that fat distribution and phenotype, rather than quantity, affect cardiovascular function and metabolic processes, establish epicardial fat as a biomarker for cardiovascular and metabolic syndrome. Numerous studies have underlined an association of altered epicardial fat morphology, type 2 diabetes mellitus (T2DM) and adverse cardiovascular events. In this review, we explore the prospect of using the epicardial adipose tissue as a therapeutic target in T2DM and describe the underlying mechanisms by which the antidiabetic drugs affect the pathophysiological processes induced from adipose tissue accumulation and possibly allow for more favourable cardiovascular outcomes though epicardial fat manipulation.
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Affiliation(s)
- Eleni Xourgia
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Athens 18536, Greece
| | - Athanasia Papazafiropoulou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Athens 18536, Greece
| | - Andreas Melidonis
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Athens 18536, Greece
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Glucagon-like peptide-1 contributes to increases ABCA1 expression by downregulating miR-758 to regulate cholesterol homeostasis. Biochem Biophys Res Commun 2018; 497:652-658. [DOI: 10.1016/j.bbrc.2018.02.126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 02/14/2018] [Indexed: 12/17/2022]
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56
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Oh YS, Jun HS. Effects of Glucagon-Like Peptide-1 on Oxidative Stress and Nrf2 Signaling. Int J Mol Sci 2017; 19:ijms19010026. [PMID: 29271910 PMCID: PMC5795977 DOI: 10.3390/ijms19010026] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 12/16/2022] Open
Abstract
Oxidative cellular damage caused by free radicals is known to contribute to the pathogenesis of various diseases such as cancer, diabetes, and neurodegenerative diseases, as well as to aging. The transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) and Kelch-like ECH-associated protein1 (Keap1) signaling pathways play an important role in preventing stresses including oxidative and inflammatory stresses. Nrf2 is a master regulator of cellular stress responses, induces the expression of antioxidant and detoxification enzymes, and protects against oxidative stress-induced cell damage. Glucagon-like peptide-1 (GLP-1) is an incretin hormone, which was originally found to increase insulin synthesis and secretion. It is now widely accepted that GLP-1 has multiple functions beyond glucose control in various tissues and organs including brain, kidney, and heart. GLP-1 and GLP-1 receptor agonists are known to be effective in many chronic diseases, including diabetes, via antioxidative mechanisms. In this review, we summarize the current knowledge regarding the role of GLP-1 in the protection against oxidative damage and the activation of the Nrf2 signaling pathway.
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Affiliation(s)
- Yoon Sin Oh
- Department of Food and Nutrition, Eulji University, Seongnam 13135, Korea.
| | - Hee-Sook Jun
- College of Pharmacy and Gachon Institute of Pharmaceutical Science, Gachon University, Incheon 21936, Korea.
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea.
- Gachon Medical Research Institute, Gil Hospital, Incheon 21565, Korea.
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Barrea L, Di Somma C, Muscogiuri G, Tarantino G, Tenore GC, Orio F, Colao A, Savastano S. Nutrition, inflammation and liver-spleen axis. Crit Rev Food Sci Nutr 2017; 58:3141-3158. [DOI: 10.1080/10408398.2017.1353479] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Luigi Barrea
- I.O.S. & COLEMAN Srl, Medicina Futura Medical Center, Acerra, Naples, Italy
| | | | | | - Giovanni Tarantino
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples “Federico II”, Via D. Montesano 49, Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, Unit of Endocrinology, “Parthenope” University of Naples, Via Ammiraglio Ferdinando Acton 38, Naples, Italy
- Via Ammiraglio Ferdinando Acton 38, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
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Enteroendocrine L Cells Sense LPS after Gut Barrier Injury to Enhance GLP-1 Secretion. Cell Rep 2017; 21:1160-1168. [DOI: 10.1016/j.celrep.2017.10.008] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/25/2017] [Accepted: 10/02/2017] [Indexed: 12/25/2022] Open
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Kang JY, Kim M, Kang Y, Lee W, Ha TK, Seo JH, Son YG, Ha E. Thyroidectomy stimulates glucagon-like peptide-1 secretion and attenuates hepatic steatosis in high-fat fed rats. Biochem Biophys Res Commun 2017; 493:548-555. [PMID: 28870812 DOI: 10.1016/j.bbrc.2017.08.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/31/2017] [Indexed: 02/07/2023]
Abstract
Thyroid hormones (THs) as a therapeutic intervention to treat obesity has been tried but the effect of THs on body weight and the mechanistic details of which are far from clear. This study was designed to determine and elucidate the mechanistic details of metabolic action of THs in high-fat diet (HFD) fed Sprague Dawley (SD) rats. Rats were made surgically hypothyroid (thyroidectomy, Thx). Body weights and food and water intake profoundly decreased in HFD fed thyroidectomized group (HN Thx). Results showed that delayed insulin response, increased total cholesterol, high-density lipoprotein, and low-density lipoprotein in HN Thx. Unexpectedly, however, Thx reduced serum and hepatic triglyceride concentrations. Further studies revealed that Thx dramatically increased circulating GLP-1 as well as increased expressions of GLP-1 in small intestine. Diminished hepatic expressions of lipogenic genes, were observed in HN Thx group. Beta-catenin and glutamine synthetase, a known target of β-catenin, were up-regulated in the liver of HN Thx group. The expressions of gluconeogenic genes G6P and PCK were reduced in the liver of HN Thx group. The results may suggest that surgery-induced hypothyroidism increases GLP-1, the actions of which may in part be responsible for the reduction in water intake, appetite and hepatic steatosis.
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Affiliation(s)
- Jong Yeon Kang
- Department of Biochemistry, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Mikyung Kim
- Department of Biochemistry, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Yuna Kang
- Department of Pathology, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Wonmok Lee
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Tae Kyung Ha
- Department of Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Ji Hae Seo
- Department of Biochemistry, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Young Gil Son
- Department of Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea.
| | - Eunyoung Ha
- Department of Biochemistry, School of Medicine, Keimyung University, Daegu, Republic of Korea.
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Liraglutide improves liver microvascular dysfunction in cirrhosis: Evidence from translational studies. Sci Rep 2017; 7:3255. [PMID: 28607430 PMCID: PMC5468330 DOI: 10.1038/s41598-017-02866-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023] Open
Abstract
Hepatic stellate cells (HSC) play a key role in the development of chronic liver disease (CLD). Liraglutide, well-established in type 2 diabetes, showed anti-inflammatory and anti-oxidant properties. We evaluated the effects of liraglutide on HSC phenotype and hepatic microvascular function using diverse pre-clinical models of CLD. Human and rat HSC were in vitro treated with liraglutide, or vehicle, and their phenotype, viability and proliferation were evaluated. In addition, liraglutide or vehicle was administered to rats with CLD. Liver microvascular function, fibrosis, HSC phenotype and sinusoidal endothelial phenotype were determined. Additionally, the effects of liraglutide on HSC phenotype were analysed in human precision-cut liver slices. Liraglutide markedly improved HSC phenotype and diminished cell proliferation. Cirrhotic rats receiving liraglutide exhibited significantly improved liver microvascular function, as evidenced by lower portal pressure, improved intrahepatic vascular resistance, and marked ameliorations in fibrosis, HSC phenotype and endothelial function. The anti-fibrotic effects of liraglutide were confirmed in human liver tissue and, although requiring further investigation, its underlying molecular mechanisms suggested a GLP1-R-independent and NF-κB-Sox9-dependent one. This study demonstrates for the first time that liraglutide improves the liver sinusoidal milieu in pre-clinical models of cirrhosis, encouraging its clinical evaluation in the treatment of chronic liver disease.
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Colin IM, Colin H, Dufour I, Gielen CE, Many MC, Saey J, Knoops B, Gérard AC. Extrapancreatic effects of incretin hormones: evidence for weight-independent changes in morphological aspects and oxidative status in insulin-sensitive organs of the obese nondiabetic Zucker rat (ZFR). Physiol Rep 2017; 4:4/15/e12886. [PMID: 27511983 PMCID: PMC4985551 DOI: 10.14814/phy2.12886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 07/18/2016] [Indexed: 12/16/2022] Open
Abstract
Incretin‐based therapies are widely used to treat type 2 diabetes. Although hypoglycemic actions of incretins are mostly due to their insulinotropic/glucagonostatic effects, they may also influence extrapancreatic metabolism. We administered exendin‐4 (Ex‐4), a long‐acting glucagon‐like peptide receptor agonist, at low dose (0.1 nmol/kg/day) for a short period (10 days), in obese nondiabetic fa/fa Zucker rats (ZFRs). Ex‐4‐treated ZFRs were compared to vehicle (saline)‐treated ZFRs and vehicle‐ and Ex‐4‐treated lean rats (LRs). Blood glucose levels were measured at days 0, 9, and 10. Ingested food and animal weight were recorded daily. On the day of sacrifice (d10), blood was sampled along with liver, epididymal, subcutaneous, brown adipose, and skeletal muscle tissues from animals fasted for 24 h. Plasma insulin and blood glucose levels, food intake, and body and epididymal fat weight were unchanged, but gross morphological changes were observed in insulin‐sensitive tissues. The average size of hepatocytes was significantly lower in Ex‐4‐treated ZFRs, associated with decreased number and size of lipid droplets and 4‐hydroxy‐2‐nonenal (HNE) staining, a marker of oxidative stress (OS). Myocytes, which were smaller in ZFRs than in LRs, were significantly enlarged and depleted of lipid droplets in Ex‐4‐treated ZFRs. Weak HNE staining was increased by Ex‐4. A similar observation was made in brown adipose tissue, whereas the elevated HNE staining observed in epididymal adipocytes of ZFRs, suggestive of strong OS, was decreased by Ex‐4. These results suggest that incretins by acting on OS in insulin‐sensitive tissues may contribute to weight‐independent improvement in insulin sensitivity.
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Affiliation(s)
- Ides M Colin
- Endocrino-Diabetology Research Unit, Centre Hospitalier Régional (CHR) Mons-Hainaut, Mons, Belgium
| | - Henri Colin
- Faculté de Médecine, Pôle de Morphologie, Institut de Recherche Expérimentale et Clinique (IREC) Secteur des Sciences de la Santé (SSS) Université catholique de Louvain (UCL), Brussels, Belgium
| | - Ines Dufour
- Faculté de Médecine, Pôle de Morphologie, Institut de Recherche Expérimentale et Clinique (IREC) Secteur des Sciences de la Santé (SSS) Université catholique de Louvain (UCL), Brussels, Belgium
| | - Charles-Edouard Gielen
- Faculté de Médecine, Pôle de Morphologie, Institut de Recherche Expérimentale et Clinique (IREC) Secteur des Sciences de la Santé (SSS) Université catholique de Louvain (UCL), Brussels, Belgium
| | - Marie-Christine Many
- Faculté de Médecine, Pôle de Morphologie, Institut de Recherche Expérimentale et Clinique (IREC) Secteur des Sciences de la Santé (SSS) Université catholique de Louvain (UCL), Brussels, Belgium
| | - Jean Saey
- Endocrino-Diabetology Research Unit, Centre Hospitalier Régional (CHR) Mons-Hainaut, Mons, Belgium
| | - Bernard Knoops
- Group of Animal and Molecular Cell Biology, Institut des Sciences de la Vie, Université catholique de Louvain (UCL), Louvain-La-Neuve, Belgium
| | - Anne-Catherine Gérard
- Endocrino-Diabetology Research Unit, Centre Hospitalier Régional (CHR) Mons-Hainaut, Mons, Belgium Group of Animal and Molecular Cell Biology, Institut des Sciences de la Vie, Université catholique de Louvain (UCL), Louvain-La-Neuve, Belgium
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Muscogiuri G, DeFronzo RA, Gastaldelli A, Holst JJ. Glucagon-like Peptide-1 and the Central/Peripheral Nervous System: Crosstalk in Diabetes. Trends Endocrinol Metab 2017; 28:88-103. [PMID: 27871675 DOI: 10.1016/j.tem.2016.10.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/30/2016] [Accepted: 10/03/2016] [Indexed: 12/17/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) is released in response to meals and exerts important roles in the maintenance of normal glucose homeostasis. GLP-1 is also important in the regulation of neurologic and cognitive functions. These actions are mediated via neurons in the nucleus of the solitary tract that project to multiple regions expressing GLP-1 receptors (GLP-1Rs). Treatment with GLP-1R agonists (GLP-1-RAs) reduces ischemia-induced hyperactivity, oxidative stress, neuronal damage and apoptosis, cerebral infarct volume, and neurologic damage, after cerebral ischemia, in experimental models. Ongoing human trials report a neuroprotective effect of GLP-1-RAs in Alzheimer's and Parkinson's disease. In this review, we discuss the role of GLP-1 and GLP-1-RAs in the nervous system with focus on GLP-1 actions on appetite regulation, glucose homeostasis, and neuroprotection.
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Affiliation(s)
| | - Ralph A DeFronzo
- Diabetes Division, University of Texas Health Science Center, San Antonio, TX, USA
| | - Amalia Gastaldelli
- Diabetes Division, University of Texas Health Science Center, San Antonio, TX, USA; Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy.
| | - Jens J Holst
- NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, Denmark
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Erion DM, Park HJ, Lee HY. The role of lipids in the pathogenesis and treatment of type 2 diabetes and associated co-morbidities. BMB Rep 2017; 49:139-48. [PMID: 26728273 PMCID: PMC4915228 DOI: 10.5483/bmbrep.2016.49.3.268] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Indexed: 12/25/2022] Open
Abstract
In the past decade, the incidence of type 2 diabetes (T2D) has rapidly increased, along with the associated cardiovascular complications. Therefore, understanding the pathophysiology underlying T2D, the associated complications and the impact of therapeutics on the T2D development has critical importance for current and future therapeutics. The prevailing feature of T2D is hyperglycemia due to excessive hepatic glucose production, insulin resistance, and insufficient secretion of insulin by the pancreas. These contribute to increased fatty acid influx into the liver and muscle causing accumulation of lipid metabolites. These lipid metabolites cause dyslipidemia and non-alcoholic fatty liver disease, which ultimately contributes to the increased cardiovascular risk in T2D. Therefore, understanding the mechanisms of hepatic insulin resistance and the specific role of liver lipids is critical in selecting and designing the most effective therapeutics for T2D and the associated co-morbidities, including dyslipidemia and cardiovascular disease. Herein, we review the effects and molecular mechanisms of conventional anti-hyperglycemic and lipid-lowering drugs on glucose and lipid metabolism. [BMB Reports 2016; 49(3): 139-148].
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Affiliation(s)
- Derek M Erion
- Takeda Pharmaceuticals 350 Massachusetts Ave. Cambridge, MA, 02139, USA
| | - Hyun-Jun Park
- Department of Molecular Medicine, Lee Gil Ya Cancer and Diabetes Institute, School of Medicine, Gachon University, Incheon 21999, Korea
| | - Hui-Young Lee
- Department of Molecular Medicine and Korea Mouse Metabolic Phenotyping Center, Lee Gil Ya Cancer and Diabetes Institute, School of Medicine, Gachon University, Incheon 21999, Korea
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65
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Kahnert K, Lucke T, Biertz F, Lechner A, Watz H, Alter P, Bals R, Behr J, Holle R, Huber RM, Karrasch S, Stubbe B, Wacker M, Söhler S, Wouters EFM, Vogelmeier C, Jörres RA. Transfer factor for carbon monoxide in patients with COPD and diabetes: results from the German COSYCONET cohort. Respir Res 2017; 18:14. [PMID: 28086884 PMCID: PMC5237203 DOI: 10.1186/s12931-016-0499-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/30/2016] [Indexed: 03/11/2023] Open
Abstract
Background An impairment of CO diffusing capacity has been shown in diabetic patients without lung disease. We analyzed how diffusing capacity in patients with COPD is affected by the concurrent diagnosis of diabetes. Methods Data from the initial visit of the German COPD cohort COSYCONET were used for analysis. 2575 patients with complete lung function data were included, among them 358 defined as diabetics with a reported physician diagnosis of diabetes and/or specific medication. Pairwise comparisons between groups and multivariate regression models were used to identify variables predicting the CO transfer factor (TLCO%pred) and the transfer coefficient (KCO%pred). Results COPD patients with diabetes differed from those without diabetes regarding lung function, anthropometric, clinical and laboratory parameters. Moreover, gender was an important covariate. After correction for lung function, gender and body mass index (BMI), TLCO%pred did not significantly differ between patients with and without diabetes. The results for the transfer coefficient KCO were similar, demonstrating an important role of the confounding factors RV%pred, TLC%pred, ITGV%pred, FEV1%pred, FEV1/FVC, age, packyears, creatinine and BMI. There was not even a tendency towards lower values in diabetes. Conclusion The analysis of data from a COPD cohort showed no significant differences of CO transport parameters between COPD patients with and without diabetes, if BMI, gender and the reduction in lung volumes were taken into account. This result is in contrast to observations in lung-healthy subjects with diabetes and raises the question which factors, among them potential anti-inflammatory effects of anti-diabetes medication are responsible for this finding.
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Affiliation(s)
- Kathrin Kahnert
- Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research, Ziemssenstr. 1, 80336, Munich, Germany.
| | - Tanja Lucke
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, Munich, Germany
| | - Frank Biertz
- Institute for Biostatistics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andreas Lechner
- Department of Internal Medicine IV, University of Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Henrik Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Woehrendamm 80, 22927, Grosshansdorf, Germany
| | - Peter Alter
- Department of Respiratory Medicine, University of Marburg, University Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research, Baldingerstraße, 35043, Marburg, Germany
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - Jürgen Behr
- Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research, Ziemssenstr. 1, 80336, Munich, Germany
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH) - German Research Center for Environmental Health, Member of the German Center for Lung Research, Comprehensive Pneumology Center Munich (CPC-M), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - Rudolf M Huber
- Department of Internal Medicine V, University of Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research, Ziemssenstr. 1, 80336, Munich, Germany
| | - Stefan Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, Munich, Germany.,Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - Beate Stubbe
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, Scientific Division of Pneumology and Pneumological Epidemiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Margarethe Wacker
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH) - German Research Center for Environmental Health, Member of the German Center for Lung Research, Comprehensive Pneumology Center Munich (CPC-M), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - Sandra Söhler
- ASCONET Study Coordination Office, University of Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands
| | - Claus Vogelmeier
- Department of Respiratory Medicine, University of Marburg, University Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research, Baldingerstraße, 35043, Marburg, Germany
| | - Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, Munich, Germany
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Charytoniuk T, Drygalski K, Konstantynowicz-Nowicka K, Berk K, Chabowski A. Alternative treatment methods attenuate the development of NAFLD: A review of resveratrol molecular mechanisms and clinical trials. Nutrition 2016; 34:108-117. [PMID: 28063505 DOI: 10.1016/j.nut.2016.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/06/2016] [Accepted: 09/12/2016] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is considered to be one of the most common liver pathologies that occur widely among societies with a predominance of the Western dietary pattern. NAFLD may progress from hepatic steatosis to nonalcoholic steatohepatitis (NASH), subsequently leading to cirrhosis and becoming a major cause of hepatocellular carcinoma. Thus its prevention and therapy play an important role in hepatology. To our knowledge, there is no effective treatment for patients with NAFLD. The aim of this review was to summarize the results of recent alternative treatment studies conducted both on cell cultures and in vivo that concern molecular effects of resveratrol (3,5,4'-trihydroxystilbene) in the treatment of NAFLD. The precise metabolism, pharmacology, and clinical trials with different concentrations of resveratrol were described. The review also presents a brief summary of other alternative treatment methods of NAFLD and their mechanisms compared with current clinical understanding.
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Affiliation(s)
- Tomasz Charytoniuk
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Drygalski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland.
| | | | - Klaudia Berk
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
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Betrapally NS, Gillevet PM, Bajaj JS. Changes in the Intestinal Microbiome and Alcoholic and Nonalcoholic Liver Diseases: Causes or Effects? Gastroenterology 2016; 150:1745-1755.e3. [PMID: 26948887 PMCID: PMC5026236 DOI: 10.1053/j.gastro.2016.02.073] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 02/07/2023]
Abstract
The prevalence of fatty liver diseases is increasing rapidly worldwide; after treatment of hepatitis C virus infection becomes more widespread, fatty liver diseases are likely to become the most prevalent liver disorders. Although fatty liver diseases are associated with alcohol, obesity, and the metabolic syndrome, their mechanisms of pathogenesis are not clear. The development and progression of fatty liver, alcoholic, and nonalcoholic liver disease (NAFLD) all appear to be influenced by the composition of the microbiota. The intestinal microbiota have been shown to affect precirrhotic and cirrhotic stages of liver diseases, which could lead to new strategies for their diagnosis, treatment, and study. We review differences and similarities in the cirrhotic and precirrhotic stages of NAFLD and alcoholic liver disease. Differences have been observed in these stages of alcohol-associated disease in patients who continue to drink compared with those who stop, with respect to the composition and function of the intestinal microbiota and intestinal integrity. NAFLD and the intestinal microbiota also differ between patients with and without diabetes. We also discuss the potential of microbial therapy for patients with NAFLD and ALD.
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Affiliation(s)
- Naga S Betrapally
- Microbiome Analysis Center, George Mason University, Manassas, Virginia
| | | | - Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia.
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Ali ES, Hua J, Wilson CH, Tallis GA, Zhou FH, Rychkov GY, Barritt GJ. The glucagon-like peptide-1 analogue exendin-4 reverses impaired intracellular Ca(2+) signalling in steatotic hepatocytes. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2016; 1863:2135-46. [PMID: 27178543 DOI: 10.1016/j.bbamcr.2016.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/20/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023]
Abstract
The release of Ca(2+) from the endoplasmic reticulum (ER) and subsequent replenishment of ER Ca(2+) by Ca(2+) entry through store-operated Ca(2+) channels (SOCE) play critical roles in the regulation of liver metabolism by adrenaline, glucagon and other hormones. Both ER Ca(2+) release and Ca(2+) entry are severely inhibited in steatotic hepatocytes. Exendin-4, a slowly-metabolised glucagon-like peptide-1 (GLP-1) analogue, is known to reduce liver glucose output and liver lipid, but the mechanisms involved are not well understood. The aim of this study was to determine whether exendin-4 alters intracellular Ca(2+) homeostasis in steatotic hepatocytes, and to evaluate the mechanisms involved. Exendin-4 completely reversed lipid-induced inhibition of SOCE in steatotic liver cells, but did not reverse lipid-induced inhibition of ER Ca(2+) release. The action of exendin-4 on Ca(2+) entry was rapid in onset and was mimicked by GLP-1 or dibutyryl cyclic AMP. In steatotic liver cells, exendin-4 caused a rapid decrease in lipid (half time 6.5min), inhibited the accumulation of lipid in liver cells incubated in the presence of palmitate plus the SOCE inhibitor BTP-2, and enhanced the formation of cyclic AMP. Hormone-stimulated accumulation of extracellular glucose in glycogen replete steatotic liver cells was inhibited compared to that in non-steatotic cells, and this effect of lipid was reversed by exendin-4. It is concluded that, in steatotic hepatocytes, exendin-4 reverses the lipid-induced inhibition of SOCE leading to restoration of hormone-regulated cytoplasmic Ca(2+) signalling. The mechanism may involve GLP-1 receptors, cyclic AMP, lipolysis, decreased diacylglycerol and decreased activity of protein kinase C.
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Affiliation(s)
- Eunüs S Ali
- Department of Medical Biochemistry and Centre for Neuroscience, School of Medicine, Flinders University, Adelaide, South Australia 5001, Australia
| | - Jin Hua
- Department of Medical Biochemistry and Centre for Neuroscience, School of Medicine, Flinders University, Adelaide, South Australia 5001, Australia
| | - Claire H Wilson
- Molecular Regulation Laboratory, Centre for Cancer Biology, Division of Health Sciences, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - George A Tallis
- Medical Biochemistry, SA Pathology, Finders Medical Centre, Bedford Park, South Australia 5042, Australia
| | - Fiona H Zhou
- School of Medicine, The University of Adelaide, and South Australian Health and Medical Research Institute, Adelaide, South Australia 5005, Australia
| | - Grigori Y Rychkov
- School of Medicine, The University of Adelaide, and South Australian Health and Medical Research Institute, Adelaide, South Australia 5005, Australia
| | - Greg J Barritt
- Department of Medical Biochemistry and Centre for Neuroscience, School of Medicine, Flinders University, Adelaide, South Australia 5001, Australia.
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Zietek T, Rath E. Inflammation Meets Metabolic Disease: Gut Feeling Mediated by GLP-1. Front Immunol 2016; 7:154. [PMID: 27148273 PMCID: PMC4840214 DOI: 10.3389/fimmu.2016.00154] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/08/2016] [Indexed: 12/14/2022] Open
Abstract
Chronic diseases, such as obesity and diabetes, cardiovascular, and inflammatory bowel diseases (IBD) share common features in their pathology. Metabolic disorders exhibit strong inflammatory underpinnings and vice versa, inflammation is associated with metabolic alterations. Next to cytokines and cellular stress pathways, such as the unfolded protein response (UPR), alterations in the enteroendocrine system are intersections of various pathologies. Enteroendocrine cells (EEC) have been studied extensively for their ability to regulate gastrointestinal motility, secretion, and insulin release by release of peptide hormones. In particular, the L-cell-derived incretin hormone glucagon-like peptide 1 (GLP-1) has gained enormous attention due to its insulinotropic action and relevance in the treatment of type 2 diabetes (T2D). Yet, accumulating data indicate a critical role for EEC and in particular for GLP-1 in metabolic adaptation and in orchestrating immune responses beyond blood glucose control. EEC sense the lamina propria and luminal environment, including the microbiota via receptors and transporters. Subsequently, mediating signals by secreting hormones and cytokines, EEC can be considered as integrators of metabolic and inflammatory signaling. This review focuses on L cell and GLP-1 functions in the context of metabolic and inflammatory diseases. The effects of incretin-based therapies on metabolism and immune system are discussed and the interrelation and common features of metabolic and immune-mediated disorders are highlighted. Moreover, it presents data on the impact of inflammation, in particular of IBD on EEC and discusses the potential role of the microbiota as link between nutrients, metabolism, immunity, and disease.
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Affiliation(s)
- Tamara Zietek
- Department of Nutritional Physiology, Technische Universität München , Freising , Germany
| | - Eva Rath
- Chair of Nutrition and Immunology, Technische Universität München , Freising , Germany
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Abstract
Current literature shows an association of diabetes and secondary complications with chronic inflammation. Evidence of these immunological changes include altered levels of cytokines and chemokines, changes in the numbers and activation states of various leukocyte populations, apoptosis, and fibrosis during diabetes. Therefore, treatment of diabetes and its complications may include pharmacological strategies to reduce inflammation. Apart from anti-inflammatory drugs, various hypoglycemic agents have also been found to reduce inflammation that could contribute to improved outcomes. Extensive studies have been carried out with thiazolidinediones (peroxisome proliferator-activated receptor-γ agonist), dipeptidyl peptidase-4 inhibitors, and metformin (AMP-activated protein kinase activator) with each of these classes of compounds showing moderate-to-strong anti-inflammatory action. Sulfonylureas and alpha glucosidase inhibitors appeared to exert modest effects, while the injectable agents, insulin and glucagon-like peptide-1 receptor agonists, may improve secondary complications due to their anti-inflammatory potential. Currently, there is a lack of clinical data on anti-inflammatory effects of sodium–glucose cotransporter type 2 inhibitors. Nevertheless, for all these glucose-lowering agents, it is essential to distinguish between anti-inflammatory effects resulting from better glucose control and effects related to intrinsic anti-inflammatory actions of the pharmacological class of compounds.
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Affiliation(s)
- Vishal Kothari
- Department of Nutrition and Dietetics, Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA
| | - John A Galdo
- Department of Pharmacy Practice, Samford University, Birmingham, AL, USA
| | - Suresh T Mathews
- Department of Nutrition and Dietetics, Samford University, Birmingham, AL, USA
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Ao N, Yang J, Wang X, Du J. Glucagon-like peptide-1 preserves non-alcoholic fatty liver disease through inhibition of the endoplasmic reticulum stress-associated pathway. Hepatol Res 2016; 46:343-53. [PMID: 26147696 DOI: 10.1111/hepr.12551] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 12/18/2022]
Abstract
AIM Glucagon-like peptide-1 (GLP-1) has been increasingly recognized for treating diabetes mellitus, and for its potential to effectively treat non-alcoholic fatty liver disease (NAFLD). However, the mechanisms of GLP-1 induction in NAFLD are not completely known. We investigated whether GLP-1 can protect against NAFLD by alleviating endoplasmic reticulum (ER) stress. METHODS Male Sprague-Dawley rats were fed a high-fat diet and treated with a long-acting GLP-1 receptor agonist, liraglutide. Biochemical, morphological, genetic and protein expression of ER stress were investigated. In vitro, HepG2 cells were exposed to 0.4 mM palmitate fatty acid and treated with different concentrations of GLP-1, and ER protein 46 (ERp46) and ER stress pathways were analyzed. Cellular response to ER stress and apoptosis were determined upon transfection with either ERp46 siRNA or a negative control siRNA. RESULTS In vivo, the treatment of GLP-1 attenuated the hepatic accumulation of lipids, reduced inflammation and improved metabolic parameters. GLP-1 treatment significantly upregulated the expression of ERp46 and downregulated the ER stress marker. Activation of ER pathways was restrained by GLP-1. Similar observations were made in vitro. Furthermore, inhibition of ERp46 expression by siRNA-mediated silencing increased the ER stress response and enhanced cell apoptosis rates. In addition, GLP-1 could not reduce the levels of ER stress and apoptosis in cells transfected with ERp46 siRNA compared with in negative control transfected cells after palmitate treatment. CONCLUSION GLP-1 protected against NAFLD by inactivating the ER stress-associated apoptosis pathway. In addition, the effect was possibly related to the signaling pathway of ERp46.
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Affiliation(s)
- Na Ao
- Department of Endocrinology, the Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Yang
- Department of Endocrinology, the Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaochen Wang
- Department of Endocrinology, the Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jian Du
- Department of Endocrinology, the Fourth Affiliated Hospital of China Medical University, Shenyang, China
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Vanderheiden A, Harrison LB, Warshauer JT, Adams-Huet B, Li X, Yuan Q, Hulsey K, Dimitrov I, Yokoo T, Jaster AW, Pinho DF, Pedrosa I, Lenkinski RE, Pop LM, Lingvay I. Mechanisms of Action of Liraglutide in Patients With Type 2 Diabetes Treated With High-Dose Insulin. J Clin Endocrinol Metab 2016; 101:1798-806. [PMID: 26909799 DOI: 10.1210/jc.2015-3906] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT The mechanisms of action of incretin mimetics in patients with long-standing type 2 diabetes (T2D) and high insulin requirements have not been studied. OBJECTIVE To evaluate changes in β-cell function, glucagon secretion, and fat distribution after addition of liraglutide to high-dose insulin. DESIGN A single-center, randomized, double-blind, placebo-controlled trial. SETTING University of Texas Southwestern and Parkland Memorial Hospital clinics. PATIENTS Seventy-one patients with long-standing (median, 17 years) T2D requiring high-dose insulin treatment (>1.5 U/kg/d; average, 2.2 ± 0.9 U/kg/d). INTERVENTION Patients were randomized to liraglutide 1.8 mg/d or matching placebo for 6 months. MAIN OUTCOME MEASURES We measured changes in insulin and glucagon secretion using a 4-hour mixed-meal challenge test. Magnetic resonance-based techniques were used to estimate sc and visceral fat in the abdomen and ectopic fat in the liver and pancreas. RESULTS Glycosylated hemoglobin improved significantly with liraglutide treatment, with an end-of-trial estimated treatment difference between groups of −0.9% (95% confidence interval, −1.5, −0.4%) (P = .002). Insulin secretion improved in the liraglutide group vs placebo, as measured by the area under the curve of C-peptide (P = .002) and the area under the curves ratio of C-peptide to glucose (P = .003). Insulin sensitivity (Matsuda index) and glucagon secretion did not change significantly between groups. Liver fat and sc fat decreased in the liraglutide group vs placebo (P = .0006 and P = .01, respectively), whereas neither visceral nor pancreatic fat changed significantly. CONCLUSIONS Treatment with liraglutide significantly improved insulin secretion, even in patients with long-standing T2D requiring high-dose insulin treatment. Liraglutide also decreased liver and sc fat, but it did not alter glucagon secretion.
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Affiliation(s)
- Anna Vanderheiden
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Lindsay B Harrison
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Jeremy T Warshauer
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Beverley Adams-Huet
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Xilong Li
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Qing Yuan
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Keith Hulsey
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Ivan Dimitrov
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Takeshi Yokoo
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Adam W Jaster
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Daniella F Pinho
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Ivan Pedrosa
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Robert E Lenkinski
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Laurentiu M Pop
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Ildiko Lingvay
- Department of Internal Medicine (A.V., L.B.H., J.T.W., B.A.-H., L.M.P., I.L.), Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, Texas 75390; Texas Diabetes & Endocrinology (L.B.H.), Austin, Texas 78749; Departments of Clinical Sciences (B.A.-H., X.L., I.L.) and Radiology (Q.Y., K.H., T.Y., A.W.J., D.F.P., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Philips Medical Systems (I.D.), Cleveland, Ohio 44143; and Advanced Imaging Research Center (T.Y., I.P., R.E.L.), University of Texas Southwestern Medical Center, Dallas, Texas 75390
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Anti-Inflammatory Effects of GLP-1-Based Therapies beyond Glucose Control. Mediators Inflamm 2016; 2016:3094642. [PMID: 27110066 PMCID: PMC4823510 DOI: 10.1155/2016/3094642] [Citation(s) in RCA: 246] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 12/22/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone mainly secreted from intestinal L cells in response to nutrient ingestion. GLP-1 has beneficial effects for glucose homeostasis by stimulating insulin secretion from pancreatic beta-cells, delaying gastric emptying, decreasing plasma glucagon, reducing food intake, and stimulating glucose disposal. Therefore, GLP-1-based therapies such as GLP-1 receptor agonists and inhibitors of dipeptidyl peptidase-4, which is a GLP-1 inactivating enzyme, have been developed for treatment of type 2 diabetes. In addition to glucose-lowering effects, emerging data suggests that GLP-1-based therapies also show anti-inflammatory effects in chronic inflammatory diseases including type 1 and 2 diabetes, atherosclerosis, neurodegenerative disorders, nonalcoholic steatohepatitis, diabetic nephropathy, asthma, and psoriasis. This review outlines the anti-inflammatory actions of GLP-1-based therapies on diseases associated with chronic inflammation in vivo and in vitro, and their molecular mechanisms of anti-inflammatory action.
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Zhou SJ, Yu DM, Yu P. Prevention and treatment of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus. Shijie Huaren Xiaohua Zazhi 2015; 23:5113-5122. [DOI: 10.11569/wcjd.v23.i32.5113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is frequently seen in the type 2 diabetes mellitus (T2DM) population. Insulin resistance is the pathophysiologic bridge which links T2DM and NAFLD. Coexistence of both diseases indicates more severe diseases and higher risk of death. As a result, it is urgent to effectively control NAFLD in patients with T2DM. The advent of glucagon like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors brings new hope for effectively managing NAFLD in T2DM patients. Bariatric surgery provides obese T2DM patients with a powerful means to treat NAFLD. The discovery of adipokines such as adiponectin and fibroblast growth factor 21 (FGF21) may point to a new research direction for NAFLD. In this paper, we present therapeutic options currently available for NAFLD in T2DM patients as well as the present research progress in NAFLD with T2DM, with regards to epidemiology and pathophysiologic links between them.
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Rizvi AA, Patti AM, Giglio RV, Nikolic D, Amato A, Al-Busaidi N, Al-Rasadi K, Soresi M, Banach M, Montalto G, Rizzo M. Liraglutide improves carotid intima-media thickness in patients with type 2 diabetes and non-alcoholic fatty liver disease: an 8-month prospective pilot study. Expert Opin Biol Ther 2015. [PMID: 26195184 DOI: 10.1517/14712598.2015.1067299] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To explore the effects of the glucagon-like peptide-1 receptor analogue liraglutide on subclinical atherosclerosis in diabetic subjects with non-alcoholic fatty liver disease (NAFLD). RESEARCH DESIGN AND METHODS In this 8-month prospective study, 29 subjects with type 2 diabetes (T2DM) and NAFLD (16 men and 13 women, mean age: 61 ± 10 years) were matched for age and gender with 29 subjects with T2DM without NAFLD (16 men and 13 women, mean age: 61 ± 8 years). Liraglutide 0.6 mg/day for 2 weeks, followed by 1.2 mg/day, was given in addition to metformin. MAIN OUTCOME MEASURES Anthropometric variables, glucometabolic parameters and carotid intima-media thickness (IMT) using B-mode real-time ultrasound were assessed at baseline and 4 and 8 months. RESULTS Glycated hemoglobin reduced significantly in both groups. No significant changes were found in body weight, waist circumference and lipids. Carotid IMT decreased significantly in the T2DM patients with NAFLD (from 0.96 ± 0.27 to 0.82 ± 0.17 to 0.85 ± 0.12 mm, p = 0.0325), but not in the T2DM patients without NAFLD (from 0.91 ± 0.23 to 0.88 ± 0.17 to 0.85 ± 0.15 mm, p = 0.4473). CONCLUSION Eight months of liraglutide use in patients with T2DM and NAFLD significantly reduced carotid IMT, a surrogate marker of atherosclerosis, independently of glucometabolic changes.
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Affiliation(s)
- Ali A Rizvi
- a 1 University of South Carolina School of Medicine, Division of Endocrinology, Diabetes and Metabolism , Columbia, SC, USA
| | - Angelo Maria Patti
- b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
| | - Rosaria Vincenza Giglio
- b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
| | - Dragana Nikolic
- b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
| | - Antonella Amato
- c 3 University of Palermo, Department of Biological, Chemical and Pharmaceutical Sciences and Technologies , Palermo, Italy
| | - Noor Al-Busaidi
- d 4 Sultan Qaboos University Hospital, Department of Clinical Biochemistry , Muscat, Oman
| | - Khalid Al-Rasadi
- d 4 Sultan Qaboos University Hospital, Department of Clinical Biochemistry , Muscat, Oman
| | - Maurizio Soresi
- b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
| | - Maciej Banach
- e 5 University of Lodz, Department of Hypertension, Chair of Nephrology and Hypertension , Lodz, Poland
| | - Giuseppe Montalto
- b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
| | - Manfredi Rizzo
- a 1 University of South Carolina School of Medicine, Division of Endocrinology, Diabetes and Metabolism , Columbia, SC, USA.,b 2 University of Palermo, Biomedical Department of Internal Medicine and Medical Specialties , Via del Vespro, 141, 90127, Palermo, Italy +39 091 6552945 ; +39 091 6552945 ;
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Higuera-de la Tijera F, Servín-Caamaño AI. Pathophysiological mechanisms involved in non-alcoholic steatohepatitis and novel potential therapeutic targets. World J Hepatol 2015; 7:1297-1301. [PMID: 26052375 PMCID: PMC4450193 DOI: 10.4254/wjh.v7.i10.1297] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/21/2015] [Accepted: 03/18/2015] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a major health care problem and represents the hepatic expression of the metabolic syndrome. NAFLD is classified as non-alcoholic fatty liver (NAFL) or simple steatosis, and non-alcoholic steatohepatitis (NASH). NASH is characterized by the presence of steatosis and inflammation with or without fibrosis. The physiopathology of NAFL and NASH and their progression to cirrhosis involve several parallel and interrelated mechanisms, such as, insulin resistance (IR), lipotoxicity, inflammation, oxidative stress, and recently the gut-liver axis interaction has been described. Incretin-based therapies could play a role in the treatment of NAFLD. Glucagon-like peptide-1 (GLP-1) is an intestinal mucosa-derived hormone which is secreted into the bloodstream in response to nutrient ingestion; it favors glucose-stimulated insulin secretion, inhibition of postprandial glucagon secretion and delayed gastric emptying. It also promotes weight loss and is involved in lipid metabolism. Once secreted, GLP-1 is quickly degraded by dipeptidyl peptidase-4 (DPP-4). Therefore, DPP-4 inhibitors are able to extend the activity of GLP-1. Currently, GLP-1 agonists and DPP-4 inhibitors represent attractive options for the treatment of NAFLD and NASH. The modulation of lipid and glucose metabolism through nuclear receptors, such as the farsenoid X receptor, also constitutes an attractive therapeutic target. Obeticholic acid is a potent activator of the farnesoid X nuclear receptor and reduces liver fat content and fibrosis in animal models. Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid with immunomodulatory, anti-inflammatory, antiapoptotic, antioxidant and anti-fibrotic properties. UDCA can improve IR and modulate lipid metabolism through its interaction with nuclear receptors such as, TGR5, farnesoid X receptor-α, or the small heterodimeric partner. Finally, pharmacologic modulation of the gut microbiota could have a role in the therapy of NAFLD and NASH. Probiotics prevent bacterial translocation and epithelial invasion, inhibit mucosal adherence by bacteria, and stimulate host immunity. In animal models, probiotics prevent obesity, decrease transaminase levels, and improve IR and liver histology in NASH.
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Self-reported eating speed in relation to non-alcoholic fatty liver disease in adults. Eur J Nutr 2015; 55:327-33. [PMID: 25648740 DOI: 10.1007/s00394-015-0851-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 01/29/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD), known to be related to insulin resistance, has been the focus of intensive research efforts due to its increasing prevalence and clinical significance. Rapid eating behavior is another emerging health issue associated with insulin resistance. We aimed to clarify the correlation between self-reported eating speed and NAFLD, both known to be related to insulin resistance. METHODS A cross-sectional study was conducted during routine medical checkups on 7,917 consecutively enrolled participants. Anthropometric, biochemical, nutritional, and social parameters were checked. The self-reported eating speed per their usual meal (<5, 5-10, 10-15, and more than 15 min) was recorded by a registered dietitian. RESULTS The faster eating groups had a higher proportion of NAFLD, and the grade of NAFLD was advanced. After controlling for anthropometric, cardiometabolic, social, and nutritional parameters, the fastest eating group (<5 min) showed an increased risk of NAFLD compared with the lowest eating speed group (≥15 min) both in total [odds ratio (OR) 1.81, 95% confidence interval (CI) 1.24-2.63] and the participants with BMI < 25 kg/m(2) (OR 1.79, 95% CI 1.22-2.61). As the self-reported eating speed increased, the risk of NAFLD also increased in total and those with BMI < 25 kg/m(2) (P for trend <0.001). CONCLUSIONS Fast eating is associated with an increased risk of the presence and grade of NAFLD in Korean adults, especially those with BMI < 25 kg/m(2), since presence of overweight or obesity may be overwhelming the effect on NAFLD.
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