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Henderson GC. Plasma Free Fatty Acid Concentration as a Modifiable Risk Factor for Metabolic Disease. Nutrients 2021; 13:nu13082590. [PMID: 34444750 PMCID: PMC8402049 DOI: 10.3390/nu13082590] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/18/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
Plasma free fatty acid (FFA) concentration is elevated in obesity, insulin resistance (IR), non-alcoholic fatty liver disease (NAFLD), type 2 diabetes (T2D), and related comorbidities such as cardiovascular disease (CVD). Furthermore, experimentally manipulating plasma FFA in the laboratory setting modulates metabolic markers of these disease processes. In this article, evidence is presented indicating that plasma FFA is a disease risk factor. Elevations of plasma FFA can promote ectopic lipid deposition, IR, as well as vascular and cardiac dysfunction. Typically, elevated plasma FFA results from accelerated adipose tissue lipolysis, caused by a high adipose tissue mass, adrenal hormones, or other physiological stressors. Reducing an individual’s postabsorptive and postprandial plasma FFA concentration is expected to improve health. Lifestyle change could provide a significant opportunity for plasma FFA reduction. Various factors can impact plasma FFA concentration, such as chronic restriction of dietary energy intake and weight loss, as well as exercise, sleep quality and quantity, and cigarette smoking. In this review, consideration is given to multiple factors which lead to plasma FFA elevation and subsequent disruption of metabolic health. From considering a variety of medical conditions and lifestyle factors, it becomes clear that plasma FFA concentration is a modifiable risk factor for metabolic disease.
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Affiliation(s)
- Gregory C Henderson
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
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Zhao L, Zhu L, Su Z, Li W, Li P, Liu Y, Liu S, Zhu S. The role of visceral adipose tissue on improvement in insulin sensitivity following Roux-en-Y gastric bypass: a study in Chinese diabetic patients with mild and central obesity. Gastroenterol Rep (Oxf) 2018; 6:298-303. [PMID: 30430019 PMCID: PMC6225828 DOI: 10.1093/gastro/goy024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/09/2018] [Accepted: 05/27/2018] [Indexed: 11/13/2022] Open
Abstract
Background Most Chinese patients with type 2 diabetes mellitus (T2DM) have mild obesity and central obesity. Central obesity is combined with insulin resistance. The aim of this study was to assess the effect of abdominal adipose tissue on insulin-sensitivity improvement after Roux-en-Y gastric bypass (RYGB) in Chinese diabetic patients with mild and central obesity. Methods Seventeen T2DM patients with a mean body mass index of 30.3 kg/m2 were scheduled for laparoscopic RYGB. A hyperinsulinemic-euglycemic clamp and dual-energy X-ray absorptiometry were performed prior to surgery and 3 months after RYGB. The primary end points were the correlations between insulin sensitivity and abdominal adipose tissue, including visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), before and 3 months after RYGB. Results Indices of peripheral insulin sensitivity, including glucose-disposal rate (M value) and glucose infusion rate, were significantly increased after RYGB. Body-fat mass, VAT and SAT were significantly reduced after RYGB. The pre-operative M value was significantly correlated with VAT mass (r = –0.57, P = 0.02), but not correlated with SAT mass. M value changes after RYGB were highly correlated with changes in VAT mass (r = –0.59, P = 0.01), percentage of VAT mass (r = –0.66, P < 0.01), VAT area (r = –0.56, P = 0.02) and percentage of VAT area (r = –0.57, P = 0.02). Conclusions A significant correlation was observed between increased peripheral insulin sensitivity and decreased VAT following RYGB in Chinese patients with mild and central obesity. VAT and SAT were significantly decreased with improved insulin sensitivity after RYGB. VAT mass may be considered as an indication for gastric bypass during patient selection.
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Affiliation(s)
- Lei Zhao
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China.,Department of Gastrointestinal Surgery, First Affiliated Hospital, University of South China, No 69 Chuanshan Road, Hengyang, Hunan, China
| | - Liyong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Zhihong Su
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Weizheng Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Pengzhou Li
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Yong Liu
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Shengping Liu
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
| | - Shaihong Zhu
- Department of General Surgery, Third Xiangya Hospital, Central South University, No 138 Tongzipo Road, Changsha, Hunan, China
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Zhao L, Ni Y, Yu H, Zhang P, Zhao A, Bao Y, Liu J, Chen T, Xie G, Panee J, Chen W, Rajani C, Wei R, Su M, Jia W, Jia W. Serum stearic acid/palmitic acid ratio as a potential predictor of diabetes remission after Roux-en-Y gastric bypass in obesity. FASEB J 2016; 31:1449-1460. [PMID: 28007782 DOI: 10.1096/fj.201600927r] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022]
Abstract
Endogenous fatty acid metabolism that results in elongation and desaturation lipid products is thought to play a role in the development of type 2 diabetes mellitus (T2DM). In this study, we evaluated the potential of estimated elongase and desaturase activities for use as predictive markers for T2DM remission after Roux-en-Y gastric bypass (RYGB). The results of a targeted metabolomics approach from 2 independent studies were used to calculate 24 serum FA concentration ratios (product/precursor). Gene expression data from an open public data set was also analyzed. In a longitudinal study of 38 obese diabetic patients with RYGB, we found higher baseline stearic acid/palmitic acid (S/P) ratio. This ratio reflects an elovl6-encoded elongase enzyme activity that has been found to be associated with greater possibility for diabetes remission after RYGB [odds ratio, 2.16 (95% CI 1.10-4.26)], after adjustment for age, gender, body mass index, diabetes duration, glycosylated hemoglobin A1c, and fasting C-peptide. Our results were validated by examination of postsurgical elovl6 gene expression in morbidly obese patients. The association of S/P with the metabolic status of obese individuals was further validated in a cross-sectional cohort of 381 participants. In summary, higher baseline S/P was associated with greater probability of diabetes remission after RYGB and may serve as a diagnostic marker in preoperative patient assessment. - Zhao, L., Ni, Y., Yu, H., Zhang, P., Zhao, A., Bao, Y., Liu, J., Chen, T., Xie, G., Panee, J., Chen, W., Rajani, C., Wei, R., Su, M., Jia, W., Jia, W. Serum stearic acid/palmitic acid ratio as a potential predictor of diabetes remission after Roux-en-Y gastric bypass in obesity.
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Affiliation(s)
- Linjing Zhao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,College of Chemistry and Chemical Engineering, Shanghai University of Engineering Science, Shanghai, China
| | - Yan Ni
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Haoyong Yu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Pin Zhang
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; and
| | - Aihua Zhao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuqian Bao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiajian Liu
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Tianlu Chen
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Guoxiang Xie
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Jun Panee
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, Manoa, Hawaii, USA
| | - Wenlian Chen
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Cynthia Rajani
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Runmin Wei
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Mingming Su
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Weiping Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; .,Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; .,University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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Knopp KB, Sloan Stakleff KD, Daigle CR, Chlysta WJ. Gender-Specific Weight and Body Composition Changes Following Roux-en-Y Gastric Bypass. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Kim B. Knopp
- The Bariatric Center, Cleveland Clinic Akron General, Akron, Ohio
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