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Orry S, Dalstrup Jakobsen D, Kristensen NM, Meldgaard Bruun J. Uric acid and sCD163 as biomarkers for metabolic dysfunction and MAFLD in children and adolescents with overweight and obesity. J Pediatr Endocrinol Metab 2023; 0:jpem-2023-0228. [PMID: 37285233 DOI: 10.1515/jpem-2023-0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The prevalence of childhood obesity increases globally, and noninvasive methods are needed to identify metabolic dysfunction and obesity-related complications such as pediatric metabolic associated fatty liver disease (MAFLD). We investigated whether uric acid (UA) and the macrophage marker soluble form of cysteine scavenger receptor CD163 (sCD163) can be used as biomarkers for deteriorated metabolism or pediatric MAFLD in children with overweight or obesity. METHODS Cross-sectional clinical and biochemical data from 94 children with overweight or obesity was included. Surrogate liver markers were calculated, and correlations were investigated using Pearson's or Spearman's correlation test. RESULTS UA and sCD163 correlated with BMI standard deviation score (r=0.23, p<0.05; r=0.33, p<0.01) and body fat (r=0.24, p<0.05; r=0.27, p=0.01). UA correlated with triglycerides (ρ=0.21, p<0.05), fat free mass (r=0.33, p<0.01), and gamma-glutamyl transferase (r=0.39, p<0.01). sCD163 correlated with the pediatric NAFLD fibrosis score (r=0.28, p<0.01) and alanine aminotransferase (r=0.28, p<0.01). No correlation was found between UA and pediatric MAFLD. CONCLUSIONS UA and sCD163 was identified as markers of a deranged metabolic profile, thus acting as easily accessible biomarkers for obesity and an obesity-related deranged metabolism. Furthermore, increasing levels of sCD163 could be a useful biomarker of pediatric MAFLD. Future prospective studies are warranted.
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Affiliation(s)
- Sofie Orry
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Dorthe Dalstrup Jakobsen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
| | | | - Jens Meldgaard Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
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Laursen TL, Mellemkjær A, Møller HJ, Grønbæk H, Kazankov K. Spotlight on liver macrophages for halting injury and progression in non-alcoholic fatty liver disease. Expert Opin Ther Targets 2022; 26:697-705. [PMID: 36205054 DOI: 10.1080/14728222.2022.2132145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of the metabolic syndrome and is rapidly emerging as the leading cause of liver-related morbidity and mortality. Macrophages play an essential role in the development and progression of NAFLD. AREAS COVERED In this review, we provide an update on recent studies of drugs, which directly or indirectly affect macrophages in NAFLD, and discuss the implication of macrophage biomarkers to monitor the disease stage and progression/regression. EXPERT OPINION There is an unmet need for better understanding of disease pathogenesis from hepatic fat accumulation to disease progression with inflammation and fibrosis. We expect that future research will uncover additional objects/pathways as treatment targets. We speculate that this will involve better characterization of the gut microbiome, damage-associated molecular patterns (DAMPS) or molecules and pathways involved in development of DAMPS, and advanced molecular biology studies including single-cell sequencing of macrophage subpopulations. In addition, we speculate that studies focusing on pharmaceuticals that improve insulin resistance, diminish the metabolic syndrome and reduce fibrosis will prevail.
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Affiliation(s)
- Tea Lund Laursen
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
| | - Anders Mellemkjær
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Henning Grønbæk
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Konstantin Kazankov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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3
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Ponce-de-Leon M, Hannemann A, Linseisen J, Nauck M, Lerch MM, Bülow R, Völzke H, Friedrich N, Kassubek J, Müller HP, Baumeister SE, Meisinger C. Links between ectopic and abdominal fat and systemic inflammation: New insights from the SHIP-Trend study. Dig Liver Dis 2022; 54:1030-1037. [PMID: 35232676 DOI: 10.1016/j.dld.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Excessive fat accumulation in adipose tissue depots and organs such as the pancreas and the liver is associated with systemic low-grade chronic inflammation. AIMS To investigate the association between abdominal, hepatic, and pancreatic fat and the circulating level of inflammatory biomarkers. METHODS We used data from a subsample of the Study of Health in Pomerania (SHIP-Trend, n = 469). The plasma concentration of 37 inflammatory biomarkers was measured using the Bio-Plex-Pro™-Human-Inflammation-Panel-1. Subcutaneous and visceral adipose tissue (SAT and VAT), as well as hepatic and pancreatic fat, were determined by magnetic resonance imaging. We assessed the associations between fat content and inflammatory biomarkers using multiple linear regression. RESULTS Hepatic fat was associated with MMP-2 (β -0.11), PTX3 (β -0.14), and TNFSF12 (β -0.06). Pancreatic fat was associated with sTNFR1 (β 0.15), sTNFR2 (β 0.11), and sCD163 (β 0.13). VAT and SAT were associated with sCD163 (βVAT 0.20, βSAT 0.16), MMP-2 (βVAT -0.12, βSAT -0.10), OSTCN (βVAT -0.16, βSAT -0.10), sTNFR1 (βVAT 0.13, βSAT 0.13), sTNFR2 (βVAT 0.13, βSA 0.12), TNFSF12 (βVAT -0.11, βSAT -0.08), and TNFSF14 (βVAT 0.21, βSAT 0.20). VAT was additionally associated with TNFSF13B (β 0.08) and CHI3L1 (β 0.07). CONCLUSIONS Our findings provide new insights into the involvement of hepatic and pancreatic fat on systemic inflammation.
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Affiliation(s)
- Mariana Ponce-de-Leon
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich 81377, Germany; Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstr. 2, Augsburg 86156, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg D-85764, Germany.
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17489, Germany; DZHK (German Center for Cardiovascular Research), Partner site Greifswald, Greifswald 17475, Germany
| | - Jakob Linseisen
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich 81377, Germany; Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstr. 2, Augsburg 86156, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg D-85764, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17489, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald, Ferdinand Sauerbruch-Straße, Greifswald 17475, Germany
| | - Robin Bülow
- Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17475, Germany
| | - Henry Völzke
- DZHK (German Center for Cardiovascular Research), Partner site Greifswald, Greifswald 17475, Germany; Institute for Community Medicine, University Medicine Greifswald, Greifswald 17475, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald 17489, Germany; DZHK (German Center for Cardiovascular Research), Partner site Greifswald, Greifswald 17475, Germany
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Ulm 89081, Germany
| | | | | | - Christa Meisinger
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstr. 2, Augsburg 86156, Germany; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg D-85764, Germany
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Effects of Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy on Body Composition for Patients with a BMI > 35 kg/m 2 at 1 Year After Surgery. Obes Surg 2022; 32:1658-1666. [PMID: 35294693 DOI: 10.1007/s11695-022-06006-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/26/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Effects of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) on body composition have not been well compared. This meta-analysis aimed to compare changes in fat mass (FM) and lean tissue mass (LTM) for patients with a BMI > 35 kg/m2 at 1 year after RYGB and SG. METHODS PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were searched ending in December 2021 for eligible studies which reported baseline and postsurgical BMI, FM, and LTM. RESULTS Of 17 eligible studies, 831 patients were included, 484 following RYGB and 347 following SG. Weighted mean differences (WMD) and 95% confidence intervals (CI) were from a random-effects model. For patients with a BMI > 35 kg/m2, RYGB resulted in a more substantial reduction of BMI (- 14.13 kg/m2 [95%CI - 14.74, - 13.53] versus - 11.96 kg/m2 [95%CI - 12.81, - 11.11], P < 0.001) and FM (- 26.22 kg [95%CI - 28.31, - 24.12] versus - 21.50 kg [95%CI - 25.52, - 17.48], P = 0.042) than SG, and a relatively weaker impact on LTM (- 8.28 kg [95%CI - 9.33, - 7.22] versus - 10.12 kg [95%CI - 11.55, - 8.68], P = 0.043). CONCLUSION This meta-analysis study indicates that RYGB is superior to SG in reducing excess FM for patients with a BMI > 35 kg/m2 and seems to be more beneficial when LTM preservation is taken into consideration.
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Preservation of Fat-free Mass in the first year after Bariatric Surgery: A systematic review and meta-analysis of 122 studies and 10758 participants. Surg Obes Relat Dis 2022; 18:964-982. [DOI: 10.1016/j.soard.2022.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/07/2022] [Accepted: 02/21/2022] [Indexed: 02/07/2023]
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Nuijten MAH, Eijsvogels TMH, Monpellier VM, Janssen IMC, Hazebroek EJ, Hopman MTE. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev 2022; 23:e13370. [PMID: 34664391 PMCID: PMC9285034 DOI: 10.1111/obr.13370] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 12/14/2022]
Abstract
Postbariatric loss of muscle tissue could negatively affect long-term health due to its role in various bodily processes, such as metabolism and functional capacity. This meta-analysis aimed to unravel time-dependent changes in the magnitude and progress of lean body mass (LBM), fat-free mass (FFM), and skeletal muscle mass (SMM) loss following bariatric surgery. A systematic literature search was conducted in Pubmed, Embase, and Web of Science. Fifty-nine studies assessed LBM (n = 37), FFM (n = 20), or SMM (n = 3) preoperatively and ≥1 time points postsurgery. Random-effects meta-analyses were performed to determine pooled loss per outcome parameter and follow-up time point. At 12-month postsurgery, pooled LBM loss was -8.13 kg [95%CI -9.01; -7.26]. FFM loss and SMM loss were -8.23 kg [95%CI -10.74; -5.73] and -3.18 kg [95%CI -5.64; -0.71], respectively. About 55% of 12-month LBM loss occurred within 3-month postsurgery, followed by a more gradual decrease up to 12 months. Similar patterns were seen for FFM and SMM. In conclusion, >8 kg of LBM and FFM loss was observed within 1-year postsurgery. LBM, FFM, and SMM were predominantly lost within 3-month postsurgery, highlighting that interventions to mitigate such losses should be implemented perioperatively.
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Affiliation(s)
- Malou A H Nuijten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Eric J Hazebroek
- Departement of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Kazankov K, Bojsen‐Møller KN, Møller HJ, Madsbad S, Grønbæk H. Macrophage activation marker sCD163 is associated with liver injury and hepatic insulin resistance in obese patients before and after Roux-en-Y gastric bypass. Physiol Rep 2022; 10:e15157. [PMID: 35040267 PMCID: PMC8764469 DOI: 10.14814/phy2.15157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Macrophages are associated with metabolic complications to obesity including fatty liver disease and impaired hepatic and muscle insulin sensitivity (IS). Bariatric surgery induces weight loss and improves IS. We investigated associations between the macrophage activation marker soluble (s)CD163, alanine-aminotransferase (ALT), and IS before and after Roux-en-Y Gastric Bypass (RYGB). METHODS We analyzed sCD163 from 10 type 2 diabetes (T2D) and 10 obese patients with normal glucose tolerance (NGT) undergoing RYGB for associations with hepatic, adipose tissue, and muscle IS and ALT after 1-week, 3, and 12 months postoperatively. IS was evaluated by hyperinsulinemic-euglycemic clamp in combination with glucose tracer technique. RESULTS Preoperative sCD163 correlated with ALT (r = 0.58, p = 0.007) and tended to associate inversely with hepatic (r = -0.39, p = 0.1) and adipose tissue (r = -0.39, p = 0.09), but not muscle IS. Following RYGB, sCD163 decreased significantly in all patients. The decrease in sCD163 during the first 3 months correlated inversely with the improvement of hepatic IS (r = -0.65, p = 0.01) and tended to be associated with changes in muscle IS (r = -0.45, p = 0.09). After 3 months sCD163 remained associated with ALT (r = 0.75, p < 0.001) and inversely with hepatic IS (r = -0.39, p = 0.1), but not muscle or adipose tissue IS. One year after RYGB, sCD163 correlated with ALT (r = 0.61, p = 0.007), but not with hepatic, adipose tissue, or muscle IS. CONCLUSION Macrophage activation is associated with liver injury and hepatic IS in obese patients. Improvements in these measures correlate during the first 3 months following RYGB, supporting a link between macrophages and hepatic IS in severe obesity and diabetes.
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Affiliation(s)
- Konstantin Kazankov
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
- Institute for Liver and Digestive HealthUniversity College LondonLondonUnited Kingdom
| | | | - Holger Jon Møller
- Department of Clinical BiochemistryAarhus University HospitalAarhusDenmark
| | - Sten Madsbad
- Department of EndocrinologyCopenhagen University Hospital HvidovreHvidovreDenmark
- Novo Nordisk Foundation Center for Basic Metabolic ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Henning Grønbæk
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
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Insulin resistance is linked to a specific profile of immune activation in human subjects. Sci Rep 2021; 11:12314. [PMID: 34112902 PMCID: PMC8192510 DOI: 10.1038/s41598-021-91758-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/19/2021] [Indexed: 11/08/2022] Open
Abstract
We tested the hypothesis that a particular immune activation profile might be correlated with insulin resistance in a general population. By measuring 43 markers of immune, endothelial, and coagulation activation, we have previously shown that five different immune activation profiles may be distinguished in 150 volunteers. One of these profiles, Profile 2, characterized by CD4+ T cell senescence, inflammation, monocyte, B cell, and endothelial activation, presented elevated insulinemia, glycemia, triglyceridemia, and γ-glutamyl transferase, a marker of liver injury, in comparison with other profiles. Our data are compatible with a model in which a particular immune activation profile might favor the development of insulin resistance and metabolic syndrome. In this hypothesis, identification of this profile, that is feasible with only 3 markers with an error rate of 5%, might allow to personalize the screening and prevention of metabolic syndrome-driven morbidities as liver steatosis.
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Haghighat N, Ashtari-Larky D, Aghakhani L, Asbaghi O, Hoseinpour H, Hosseini B, Shahabinezhad A, Pourmohammad A, Hosseini SV, Amini M, Clark CCT, Bananzadeh A. How Does Fat Mass Change in the First Year After Bariatric Surgery? A Systemic Review and Meta-Analysis. Obes Surg 2021; 31:3799-3821. [PMID: 34089442 DOI: 10.1007/s11695-021-05512-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/29/2022]
Abstract
This systematic review and meta-analysis investigated the time-course effect of different type of bariatric surgeries (BS) up to 1 year post-surgery on fat mass (FM) and body fat percentage (BFP) in patients with morbid obesity. We searched PubMed, Scopus, EMBASE, ISI web of science, and Cochrane databases from October 2002 until May 2020 with no restriction in the English language, to find studies examining the effect of BS on FM (kg) and BFP (%) in morbid obese patients. Meta-analysis of 103 studies carried out on data of 18,166 and 14,575 morbid obese patients following BS, showed that BS was associated with a substantial decrease in FM and BFP, respectively, in 1 month (- 8.17 kg [95% CI - 9.07, - 7.27] and - 1.51% [95% CI - 2.56, - 0.46]), 3 months (- 15.75 [95% CI - 17.49, - 14.0] and - 4.90 [95% CI - 5.97, - 3.83]), 6 months (- 22.51 [95% CI - 23.93, - 21.09] and - 8.56% [95% CI - 9.63, - 7.49]), and 12 months (- 29.69 [95% CI - 31.3, - 28.09] and - 13.49% [95% CI - 14.52, - 12.40]) after the surgery. In conclusion, BS was associated with sustained declines in FM and BFP, from 1 to 12 months, with no indication of plateau phase post-surgery post-operatively. The present study emphasizes that post-bariatric care should have more focus on FM loss during 1-year post-surgery to identify the patients at risk for fat loss plateau.
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Affiliation(s)
- Neda Haghighat
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damoon Ashtari-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ladan Aghakhani
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tehran, Iran
| | - Hamidreza Hoseinpour
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Hosseini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Shahabinezhad
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Pourmohammad
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Vahid Hosseini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Amini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Cain C T Clark
- Center for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Alimohammad Bananzadeh
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gehrke N, Schattenberg JM. Metabolic Inflammation-A Role for Hepatic Inflammatory Pathways as Drivers of Comorbidities in Nonalcoholic Fatty Liver Disease? Gastroenterology 2020; 158:1929-1947.e6. [PMID: 32068022 DOI: 10.1053/j.gastro.2020.02.020] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a global and growing health concern. Emerging evidence points toward metabolic inflammation as a key process in the fatty liver that contributes to multiorgan morbidity. Key extrahepatic comorbidities that are influenced by NAFLD are type 2 diabetes, cardiovascular disease, and impaired neurocognitive function. Importantly, the presence of nonalcoholic steatohepatitis and advanced hepatic fibrosis increase the risk for systemic comorbidity in NAFLD. Although the precise nature of the crosstalk between the liver and other organs has not yet been fully elucidated, there is emerging evidence that metabolic inflammation-in part, emanating from the fatty liver-is the engine that drives cellular dysfunction, cell death, and deleterious remodeling within various body tissues. This review describes several inflammatory pathways and mediators that have been implicated as links between NAFLD and type 2 diabetes, cardiovascular disease, and neurocognitive decline.
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Affiliation(s)
- Nadine Gehrke
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center, Mainz, Germany.
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center, Mainz, Germany
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11
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Rosso C, Kazankov K, Younes R, Esmaili S, Marietti M, Sacco M, Carli F, Gaggini M, Salomone F, Møller HJ, Abate ML, Vilstrup H, Gastaldelli A, George J, Grønbæk H, Bugianesi E. Crosstalk between adipose tissue insulin resistance and liver macrophages in non-alcoholic fatty liver disease. J Hepatol 2019; 71:1012-1021. [PMID: 31301321 DOI: 10.1016/j.jhep.2019.06.031] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/29/2019] [Accepted: 06/27/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS The pathogenesis of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) is likely due to the interaction between a deranged metabolic milieu and local mediators of hepatic inflammation and fibrosis. We undertook this study to elucidate the interplay between macrophage activation, insulin resistance (IR) in target organs/tissues and hepatic damage. METHODS In 40 non-diabetic patients with biopsy-proven NAFLD we assessed: i) endogenous glucose production (EGP), glucose clearance and indexes of IR in the adipose tissue (Adipo-IR and Lipo-IR) and in the liver (Hep-IR) by tracer infusion ([6,6-2H2]glucose and [2H5]glycerol); ii) macrophage activity (by soluble sCD163) and iii) hepatic expression of CD163 (hCD163). RESULTS We found that sCD163 levels paralleled both the plasma free fatty acid (FFA) levels and lipolysis from adipose tissue. Consistently, sCD163 significantly correlated with adipose tissue IR (Adipo-IR: r = 0.32, p = 0.042; Lipo-IR: r = 0.39, p = 0.012). At multiple regression analysis, sCD163 levels were associated with FFA levels (rp = 0.35, p = 0.026). In vitro exposure of human monocyte-derived macrophages to palmitate enhanced sCD163 secretion. Conversely, sCD163 did not correlate with EGP or with Hep-IR. In the liver, hCD163 positively correlated with sCD163 (r = 0.58, p = 0.007) and the degree of steatosis (r = 0.34, p = 0.048), but not with EGP or Hep-IR (r = -0.27 and r = 0.11, respectively, p >0.10, both). CONCLUSIONS Our findings suggest a link between deranged metabolism in the adipose tissue and activation of hepatic macrophages in patients with NAFLD, possibly in response to FFA overflow and independent of obesity and diabetes. Conversely, our findings do not support a link between activated hepatic macrophages and glucose metabolism (EGP or Hep-IR). The relationship between adipose tissue IR and hepatic macrophages should be considered to define therapeutic targets for NAFLD. LAY SUMMARY The pathogenesis of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) is likely due to the interaction between a deranged metabolic milieu and local mediators of hepatic inflammation and fibrosis in the insulin resistant state. This study provides in vivo support for a possible link between deranged metabolism in the adipose tissue and activation of hepatic macrophages in patients with NAFLD, most likely in response to free fatty acid overflow and independent of obesity and diabetes.
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Affiliation(s)
- Chiara Rosso
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Konstantin Kazankov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Ramy Younes
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Saeed Esmaili
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Milena Marietti
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marco Sacco
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fabrizia Carli
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Melania Gaggini
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Federico Salomone
- Division of Gastroenterology, Ospedale di Acireale, Azienda Sanitaria Provinciale di Catania, Catania, Italy
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Lorena Abate
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Hendrik Vilstrup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Amalia Gastaldelli
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Henning Grønbæk
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Elisabetta Bugianesi
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy.
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12
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Svart M, Rittig N, Møller N, Møller HJ, Gronbaek H. Soluble CD163 correlates with lipid metabolic adaptations in type 1 diabetes patients during ketoacidosis. J Diabetes Investig 2019; 10:67-72. [PMID: 29802679 PMCID: PMC6319477 DOI: 10.1111/jdi.12869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/08/2018] [Accepted: 05/18/2018] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Diabetic ketoacidosis (DKA) is associated with inflammation and increased lipolysis. The macrophage activation marker, soluble CD163 (sCD163), is associated with obesity, non-alcoholic fatty liver disease and type 2 diabetes. We aimed to investigate whether sCD163 correlates with key elements of lipolysis in type 1 diabetes patients during mild DKA. MATERIALS AND METHODS We investigated nine patients with type 1 diabetes twice during: (i) euglycemic control conditions and a bolus of saline; and (ii) hyperglycemic ketotic conditions induced by lipopolysaccharide administration combined with insulin deprivation. Blood samples, indirect calorimetry, palmitate tracer and adipose tissue biopsies were used to investigate lipid metabolism. RESULTS We observed a significant increase in plasma sCD163 levels after lipopolysaccharide exposure (P < 0.001). Concentrations of sCD163 were positively correlated with plasma concentrations of free fatty acids, palmitate rate of appearance and lipid oxidation rates, and negatively correlated to the expression of G0/G1 switch 2 gene messenger ribonucleic acid content in adipose tissue (P < 0.01 for all). Furthermore, sCD163 levels correlated positively with plasma peak concentrations of cortisol, glucagon, tumor necrosis factor-α, interleukin-6 and interleukin-10 (P < 0.01 for all). Data on lipolysis and inflammation have previously been published. CONCLUSIONS Macrophage activation assessed by sCD163 might play an important role in DKA, as it correlates strongly with important components of lipid metabolism including free fatty acids, palmitate, lipid oxidation, G0/G1 switch 2 gene and pro-inflammatory cytokines during initial steps of DKA. These results are novel and add important knowledge to the field of DKA.
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Affiliation(s)
- Mads Svart
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University HospitalAarhus CDenmark
| | - Nikolaj Rittig
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University HospitalAarhus CDenmark
| | - Niels Møller
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University HospitalAarhus CDenmark
| | - Holger J Møller
- Department of Clinical BiochemistryAarhus University HospitalAarhus NDenmark
| | - Henning Gronbaek
- Department of Hepatology and GastroenterologyAarhus UniversityAarhus CDenmark
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13
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Macrophage Markers Are Poorly Associated With Liver Histology in Children With Nonalcoholic Fatty Liver Disease. J Pediatr Gastroenterol Nutr 2018; 67:635-642. [PMID: 30074574 DOI: 10.1097/mpg.0000000000002111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We have previously demonstrated associations between the macrophage activation marker soluble (s)CD163 and histology of nonalcoholic fatty liver disease (NAFLD) in adults, and elevated sCD163 levels in children with obesity with NAFLD. Macrophage activation has, however, not been investigated in children with biopsy-proven NAFLD, which was the objective of the present study. METHODS We used in-house enzyme-linked immunosorbent assays to measure sCD163 and the novel macrophage marker soluble mannose receptor (sMR) in a cross-sectional (n = 155) pediatric NAFLD cohort, and a cohort of NAFLD children (n = 36) undergoing a randomized trial by the probiotic VSL#3. We included 56 healthy nonobese children for comparison. RESULTS Levels of sCD163 and sMR were higher in both of the NAFLD cohorts compared with controls (P < 0.001). In the cross-sectional cohort, sCD163 only showed trends toward association with ballooning (rho = 0.14, P = 0.08) and portal inflammation (rho = 0.17, P = 0.08). sMR showed similar associations with liver histology. In the VSL#3 cohort, sCD163 correlated inversely with steatosis (rho = -0.35, P = 0.04), and lobular (rho = -0.57, P < 0.001) and portal inflammation (rho = -0.38, P = 0.02); sMR was not associated with any histological scores. Neither sCD163 nor sMR changed significantly during intervention, and without association with NAFLD resolution. CONCLUSIONS The macrophage activation markers sCD163 and sMR showed poor associations with liver histology in 2 different cohorts of children with biopsy-proven NAFLD, and none of the markers decreased during successful intervention. These results are in contrast with studies of adult NAFLD and may suggest a possibility of different roles for macrophages in the pathogenesis of adult and pediatric NAFLD.
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14
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Rittig N, Svart M, Jessen N, Møller N, Møller HJ, Grønbæk H. Macrophage activation marker sCD163 correlates with accelerated lipolysis following LPS exposure: a human-randomised clinical trial. Endocr Connect 2018; 7:107-114. [PMID: 29295869 PMCID: PMC5754508 DOI: 10.1530/ec-17-0296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Macrophage activation determined by levels of soluble sCD163 is associated with obesity, insulin resistance, diabetes mellitus type 2 (DM2) and non-alcoholic fatty liver disease (NAFLD). This suggests that macrophage activation is involved in the pathogenesis of conditions is characterised by adaptions in the lipid metabolism. Since sCD163 is shed to serum by inflammatory signals including lipopolysaccharides (LPS, endotoxin), we investigated sCD163 and correlations with lipid metabolism following LPS exposure. METHODS Eight healthy male subjects were investigated on two separate occasions: (i) following an LPS exposure and (ii) following saline exposure. Each study day consisted of a four-hour non-insulin-stimulated period followed by a two-hour hyperinsulinemic euglycemic clamp period. A 3H-palmitate tracer was used to calculate the rate of appearance (Rapalmitate). Blood samples were consecutively obtained throughout each study day. Abdominal subcutaneous adipose tissue was obtained for western blotting. RESULTS We observed a significant two-fold increase in plasma sCD163 levels following LPS exposure (P < 0.001), and sCD163 concentrations correlated positively with the plasma concentration of free fatty acids, Rapalmitate, lipid oxidation rates and phosphorylation of the hormone-sensitive lipase at serine 660 in adipose tissue (P < 0.05, all). Furthermore, sCD163 concentrations correlated positively with plasma concentrations of cortisol, glucagon, tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 (P < 0.05, all). CONCLUSION We observed a strong correlation between sCD163 and stimulation of lipolysis and fat oxidation following LPS exposure. These findings support preexisting theory that inflammation and macrophage activation play a significant role in lipid metabolic adaptions under conditions such as obesity, DM2 and NAFLD.
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Affiliation(s)
- Nikolaj Rittig
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University Hospital, Aarhus C, Denmark
| | - Mads Svart
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University Hospital, Aarhus C, Denmark
| | - Niels Jessen
- Research Laboratory for Biochemical PathologyInstitute for Clinical Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - Niels Møller
- Department of Internal Medicine and Endocrinology (MEA) and Medical Research LaboratoryAarhus University Hospital, Aarhus C, Denmark
| | - Holger J Møller
- Department of Clinical Biochemistry Aarhus University HospitalAarhus C, Denmark
| | - Henning Grønbæk
- Department of Hepatology and GastroenterologyAarhus University Hospital, Aarhus C, Denmark
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15
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Rødgaard-Hansen S, St. George A, Kazankov K, Bauman A, George J, Grønbæk H, Jon Møller H. Effects of lifestyle intervention on soluble CD163, a macrophage activation marker, in patients with non-alcoholic fatty liver disease. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:498-504. [DOI: 10.1080/00365513.2017.1346823] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
| | - Alexis St. George
- Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Australia
| | - Konstantin Kazankov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Adrian Bauman
- Centre for Physical Activity and Health, School of Public Health, Sydney University, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Australia
| | - Henning Grønbæk
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
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16
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Fjeldborg K, Pedersen SB, Møller HJ, Richelsen B. Reduction in serum fibroblast growth factor-21 after gastric bypass is related to changes in hepatic fat content. Surg Obes Relat Dis 2017; 13:1515-1523. [PMID: 28552744 DOI: 10.1016/j.soard.2017.03.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 02/27/2017] [Accepted: 03/25/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Fibroblast growth factor 21 (FGF21) is elevated in obesity. OBJECTIVES We investigated the circulating level of FGF21 and the expression of FGF21, beta-klotho (KLB), and FGF receptor 1 (FGFR1) in adipose tissue in relation to weight, fat distribution, and Roux-en-Y gastric bypass (RYGB)-induced weight loss. SETTING The Department of Endocrinology at Aarhus University Hospital. METHODS Thirty-one obese patients were enrolled. Visceral adipose tissue volume measured by magnetic resonance imaging, hepatic fat content measured by magnetic resonance spectroscopy, and body composition measured by dual-energy x-ray absorbtiometry were determined at baseline and 12 months after RYGB. Fasting blood samples and subcutaneous and visceral adipose tissue samples were obtained. Moreover, 25 lean controls were enrolled. RESULTS FGF21 was significantly elevated in obese patients compared with lean patients (281±151 pg/mL versus 149±99 pg/mL, P<.05). RYGB-induced weight loss resulted in a smaller reduction in FGF21 (P = .08). However, a significant reduction was seen in obese patients with initially high FGF21 levels (42% reduction, P<.001). A significant association was found between FGF21 and hepatic fat content at baseline (r = 0.40, P<.05). Moreover, ΔFGF21 was significantly associated with Δhepatic fat content after RYGB (r = 0.39, P<.05). FGF21 mRNA was not detectable in AT from either lean or obese patients. KLB and FGFR1 were upregulated in AT in relation to obesity, and both were further increased 12 months after RYGB. CONCLUSIONS FGF21 is reduced in relation to weight loss in patients with initial high levels of FGF21 and this reduction is significantly associated with a reduction in hepatic fat content. Thus, changes in FGF21 after RYGB-induced weight loss are closely related to changes in liver fat content.
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Affiliation(s)
- Karen Fjeldborg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Steen B Pedersen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Holger J Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Bjørn Richelsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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17
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Kazankov K, Barrera F, Møller HJ, Rosso C, Bugianesi E, David E, Younes R, Esmaili S, Eslam M, McLeod D, Bibby BM, Vilstrup H, George J, Grønbaek H. The macrophage activation marker sCD163 is associated with morphological disease stages in patients with non-alcoholic fatty liver disease. Liver Int 2016; 36:1549-57. [PMID: 27102725 DOI: 10.1111/liv.13150] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 04/18/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Macrophage activation plays a key pathogenic role in experimental non-alcoholic fatty liver disease (NAFLD) and contributes to the progression of steatohepatitis (NASH) and fibrosis. We studied macrophage activation in human NAFLD by measuring soluble (s)CD163, a specific macrophage activation marker, hypothesizing that sCD163 would be associated with the patients' morphological disease grade. Furthermore, we investigated an association between sCD163 and the apoptosis marker cytokeratin-18 (CK-18) to explore a link between macrophage activation and apoptosis. METHODS sCD163 associations with biochemical and histological measures of NAFLD were investigated in two independent cohorts of 157 Australian and 174 Italian NAFLD patients, with liver biopsies graded for NAFLD severity, steatosis and fibrosis. sCD163 and CK-18 were measured by enzyme-linked immunosorbent assay. RESULTS In both cohorts sCD163 increased in parallel with the patients' morphological disease grading, being independently associated with the Kleiner fibrosis score (P < 0.001). A high sCD163 predicted advanced fibrosis {F ≥ 3; Australian cohort: area under receiver-operating characteristics curve 0.77 [95% confidence interval (CI): 0.76-0.87], Italian cohort: 0.80 (95% CI: 0.72-0.88)}. In both groups, sCD163 was independently associated with CK-18 (P < 0.001). CONCLUSION Soluble CD163 reflecting macrophage activation is associated with morphological features of NAFLD suggesting their involvement in the pathogenesis of NAFLD, NASH and particularly fibrosis. An independent association between sCD163 and cytokeratin-18 suggests that apoptosis may contribute to macrophage activation in NAFLD/NASH.
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Affiliation(s)
- Konstantin Kazankov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Francisco Barrera
- The Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, NSW, Australia.,Department of Gastroenterology, Pontificia Universidad Católica, Santiago, Chile
| | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Chiara Rosso
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Elisabetta Bugianesi
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Ezio David
- Division of Pathology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Ramy Younes
- Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Saeed Esmaili
- The Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, NSW, Australia
| | - Mohammed Eslam
- The Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, NSW, Australia
| | - Duncan McLeod
- Department of Anatomical Pathology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Westmead, NSW, Australia
| | - Bo Martin Bibby
- Department of Biostatistics, Aarhus University, Aarhus, Denmark
| | - Hendrik Vilstrup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob George
- The Storr Liver Centre, Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, NSW, Australia
| | - Henning Grønbaek
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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18
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Mitra S, Fernandez-Del-Valle M, Hill JE. The role of MRI in understanding the underlying mechanisms in obesity associated diseases. Biochim Biophys Acta Mol Basis Dis 2016; 1863:1115-1131. [PMID: 27639834 DOI: 10.1016/j.bbadis.2016.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
Obesity and its possible association with diseases including diabetes and cardiovascular diseases have been studied for decades for its impact on healthcare. Recent studies clearly indicate the need for developing accurate and reproducible methodologies for assessing body fat content and distribution. Body fat distribution plays a significant role in developing an insight in the underlying mechanisms in which adipose tissue is linked with various diseases. Among imaging technologies including computerized axial tomography (CAT or CT), magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS), MRI and MRS seem to be the best emerging techniques and together are being considered as the gold standard for body fat content and distribution. This paper reviews studies up to the present time involving different methodologies of these two emerging technologies and presents the basic concepts of MRI and MRS with required novel image analysis techniques in accurate, quantitative, and direct assessment of body fat content and distribution. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes/Obesity and Critical Illness Spectrum of Diseases - edited by P. Hemachandra Reddy.
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Affiliation(s)
| | | | - Jason E Hill
- Texas Tech University, Lubbock, TX, United States
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19
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Jager J, Aparicio-Vergara M, Aouadi M. Liver innate immune cells and insulin resistance: the multiple facets of Kupffer cells. J Intern Med 2016; 280:209-20. [PMID: 26864622 DOI: 10.1111/joim.12483] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Obesity, which affects 600 million adults worldwide, is a major risk factor for type 2 diabetes (T2D) and insulin resistance. Current therapies for these metabolic disorders include weight management by lifestyle intervention or bariatric surgery and pharmacological treatment with the aim of regulating blood glucose. Probably because of their short-term effectiveness, these therapies have not been able to stop the rapidly rising prevalence of T2D over the past decades, highlighting an urgent need to develop new therapeutic strategies. The role of immune cells, such as macrophages, in insulin resistance has been extensively studied. Major advances have been made to elucidate the role of adipose tissue macrophages in these pathogeneses. Recently, anti-inflammatory drugs have been suggested as an alternative treatment for T2D, and clinical trials of these agents are currently ongoing. In addition, results of previous clinical trials using antibodies against inflammatory cytokines, which showed modest effects, are now being rigorously re-evaluated. However, it is still unclear how liver macrophages [termed Kupffer cells (KCs)], which constitute the major source of macrophages in the body, contribute to the development of insulin resistance. In this review, we will discuss the present understanding of the role of liver immune cells in the development of insulin resistance. We will particularly focus on KCs, which could represent an attractive target for the treatment of metabolic diseases.
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Affiliation(s)
- J Jager
- Department of Medicine, KI/AZ Integrated CardioMetabolic Center, Karolinska Institutet at Karolinska University Hospital Huddinge, C2-84, S-141 86, Stockholm, Sweden
| | - M Aparicio-Vergara
- Department of Medicine, KI/AZ Integrated CardioMetabolic Center, Karolinska Institutet at Karolinska University Hospital Huddinge, C2-84, S-141 86, Stockholm, Sweden
| | - M Aouadi
- Department of Medicine, KI/AZ Integrated CardioMetabolic Center, Karolinska Institutet at Karolinska University Hospital Huddinge, C2-84, S-141 86, Stockholm, Sweden
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Fernández-Ruiz VE, Armero-Barranco D, Xandri-Graupera JM, Paniagua-Urbano JA, Solé-Agustí M, Mulero J. Bariatric and Cardiovascular Efficacy of Long-Limb Roux-en-Y Gastric Bypass: Overcoming the Limitations Inherent in Individuals. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2015.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | | | - José A. Paniagua-Urbano
- Department of Food Technology and Nutrition, Catholic University of San Antonio, Murcia, Spain
| | | | - Juana Mulero
- Department of Food Technology and Nutrition, Catholic University of San Antonio, Murcia, Spain
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