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Gautier-Stein A, Vily-Petit J, Rajas F, Mithieux G. Intestinal gluconeogenesis: A translator of nutritional information needed for glycemic and emotional balance. Biochimie 2024; 223:206-214. [PMID: 38040189 DOI: 10.1016/j.biochi.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
At the interface between the outside world and the self, the intestine is the first organ receiving nutritional information. One intestinal function, gluconeogenesis, is activated by various nutrients, particularly diets enriched in fiber or protein, and thus results in glucose production in the portal vein in the post-absorptive period. The detection of portal glucose induces a nervous signal controlling the activity of the central nuclei involved in the regulation of metabolism and emotional behavior. Induction of intestinal gluconeogenesis is necessary for the beneficial effects of fiber or protein-enriched diets on metabolism and emotional behavior. Through its ability to translate nutritional information from the diet to the brain's regulatory centers, intestinal gluconeogenesis plays an essential role in maintaining physiological balance.
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Affiliation(s)
- Amandine Gautier-Stein
- Universite Claude Bernard Lyon 1, NUDICE, UMR_S 1213, Villeurbanne, 69100, France; Institut National de la Sante et de la Recherche Medicale, NUDICE, UMR_S 1213, Lyon, 69372, France.
| | - Justine Vily-Petit
- Universite Claude Bernard Lyon 1, NUDICE, UMR_S 1213, Villeurbanne, 69100, France; Institut National de la Sante et de la Recherche Medicale, NUDICE, UMR_S 1213, Lyon, 69372, France
| | - Fabienne Rajas
- Universite Claude Bernard Lyon 1, NUDICE, UMR_S 1213, Villeurbanne, 69100, France; Institut National de la Sante et de la Recherche Medicale, NUDICE, UMR_S 1213, Lyon, 69372, France
| | - Gilles Mithieux
- Universite Claude Bernard Lyon 1, NUDICE, UMR_S 1213, Villeurbanne, 69100, France; Institut National de la Sante et de la Recherche Medicale, NUDICE, UMR_S 1213, Lyon, 69372, France
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Intestinal gluconeogenesis: metabolic benefits make sense in the light of evolution. Nat Rev Gastroenterol Hepatol 2023; 20:183-194. [PMID: 36470967 DOI: 10.1038/s41575-022-00707-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 03/02/2023]
Abstract
The intestine, like the liver and kidney, in various vertebrates and humans is able to carry out gluconeogenesis and release glucose into the blood. In the fed post-absorptive state, intestinal glucose is sensed by the gastrointestinal nervous system. The latter initiates a signal to the brain regions controlling energy homeostasis and stress-related behaviour. Intestinal gluconeogenesis (IGN) is activated by several complementary mechanisms, in particular nutritional situations (for example, when food is enriched in protein or fermentable fibre and after gastric bypass surgery in obesity). In these situations, IGN has several metabolic and behavioural benefits. As IGN is activated by nutrients capable of fuelling systemic gluconeogenesis, IGN could be a signal to the brain that food previously ingested is suitable for maintaining plasma glucose for a while. This process might account for the benefits observed. Finally, in this Perspective, we discuss how the benefits of IGN in fasting and fed states could explain why IGN emerged and was maintained in vertebrates by natural selection.
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Intestinal gluconeogenesis shapes gut microbiota, fecal and urine metabolome in mice with gastric bypass surgery. Sci Rep 2022; 12:1415. [PMID: 35082330 PMCID: PMC8791999 DOI: 10.1038/s41598-022-04902-y] [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: 09/10/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Intestinal gluconeogenesis (IGN), gastric bypass (GBP) and gut microbiota positively regulate glucose homeostasis and diet-induced dysmetabolism. GBP modulates gut microbiota, whether IGN could shape it has not been investigated. We studied gut microbiota and microbiome in wild type and IGN-deficient mice, undergoing GBP or not, and fed on either a normal chow (NC) or a high-fat/high-sucrose (HFHS) diet. We also studied fecal and urine metabolome in NC-fed mice. IGN and GBP had a different effect on the gut microbiota of mice fed with NC and HFHS diet. IGN inactivation increased abundance of Deltaproteobacteria on NC and of Proteobacteria such as Helicobacter on HFHS diet. GBP increased abundance of Firmicutes and Proteobacteria on NC-fed WT mice and of Firmicutes, Bacteroidetes and Proteobacteria on HFHS-fed WT mice. The combined effect of IGN inactivation and GBP increased abundance of Actinobacteria on NC and the abundance of Enterococcaceae and Enterobacteriaceae on HFHS diet. A reduction was observed in the amounf of short-chain fatty acids in fecal (by GBP) and in both fecal and urine (by IGN inactivation) metabolome. IGN and GBP, separately or combined, shape gut microbiota and microbiome on NC- and HFHS-fed mice, and modify fecal and urine metabolome.
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Vily-Petit J, Soty-Roca M, Silva M, Raffin M, Gautier-Stein A, Rajas F, Mithieux G. Intestinal gluconeogenesis prevents obesity-linked liver steatosis and non-alcoholic fatty liver disease. Gut 2020; 69:2193-2202. [PMID: 32205419 DOI: 10.1136/gutjnl-2019-319745] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/14/2020] [Accepted: 02/28/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Hepatic steatosis accompanying obesity is a major health concern, since it may initiate non-alcoholic fatty liver disease (NAFLD) and associated complications like cirrhosis or cancer. Intestinal gluconeogenesis (IGN) is a recently described function that contributes to the metabolic benefits of specific macronutrients as protein or soluble fibre, via the initiation of a gut-brain nervous signal triggering brain-dependent regulations of peripheral metabolism. Here, we investigate the effects of IGN on liver metabolism, independently of its induction by the aforementioned macronutrients. DESIGN To study the specific effects of IGN on hepatic metabolism, we used two transgenic mouse lines: one is knocked down for and the other overexpresses glucose-6-phosphatase, the key enzyme of endogenous glucose production, specifically in the intestine. RESULTS We report that mice with a genetic overexpression of IGN are notably protected from the development of hepatic steatosis and the initiation of NAFLD on a hypercaloric diet. The protection relates to a diminution of de novo lipogenesis and lipid import, associated with benefits at the level of inflammation and fibrosis and linked to autonomous nervous system. Conversely, mice with genetic suppression of IGN spontaneously exhibit increased hepatic triglyceride storage associated with activated lipogenesis pathway, in the context of standard starch-enriched diet. The latter is corrected by portal glucose infusion mimicking IGN. CONCLUSION We conclude that IGN per se has the capacity of preventing hepatic steatosis and its eventual evolution toward NAFLD.
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Affiliation(s)
- Justine Vily-Petit
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Maud Soty-Roca
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Marine Silva
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Margaux Raffin
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Amandine Gautier-Stein
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Fabienne Rajas
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France.,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Gilles Mithieux
- U1213 Nutrition, Diabetes and the Brain, Institut national de la santé et de la recherche médicale, Lyon, France .,U1213 Nutrition, Diabetes and the Brain, Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
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Abstract
High-protein meals and foods are promoted for their beneficial effects on satiety, weight loss and glucose homeostasis. However, the mechanisms involved and the long-term benefits of such diets are still debated. We here review how the characterisation of intestinal gluconeogenesis (IGN) sheds new light on the mechanisms by which protein diets exert their beneficial effects on health. The small intestine is the third organ (in addition to the liver and kidney) contributing to endogenous glucose production via gluconeogenesis. The particularity of glucose produced by the intestine is that it is detected in the portal vein and initiates a nervous signal to the hypothalamic nuclei regulating energy homeostasis. In this context, we demonstrated that protein diets initiate their satiety effects indirectly via IGN and portal glucose sensing. This induction results in the activation of brain areas involved in the regulation of food intake. The μ-opioid-antagonistic properties of protein digests, exerted in the portal vein, are a key link between IGN induction and protein-enriched diet in the control of satiety. From our results, IGN can be proposed as a mandatory link between nutrient sensing and the regulation of whole-body homeostasis. The use of specific mouse models targeting IGN should allow us to identify several metabolic functions that could be controlled by protein diets. This will lead to the characterisation of the mechanisms by which protein diets improve whole-body homeostasis. These data could be the basis of novel nutritional strategies targeting the serious metabolic consequences of both obesity and diabetes.
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Barataud A, Vily-Petit J, Goncalves D, Zitoun C, Duchampt A, Philippe E, Gautier-Stein A, Mithieux G. Metabolic benefits of gastric bypass surgery in the mouse: The role of fecal losses. Mol Metab 2019; 31:14-23. [PMID: 31918916 PMCID: PMC6880100 DOI: 10.1016/j.molmet.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 12/27/2022] Open
Abstract
Objective Roux-en-Y gastric surgery (RYGB) promotes a rapid and sustained weight loss and amelioration of glucose control in obese patients. A high number of molecular hypotheses were previously tested using duodenal-jejunal bypass (DJB) performed in various genetic models of mice with knockouts for various hormones or receptors. The data were globally negative or inconsistent. Therefore, the mechanisms remained elusive. Intestinal gluconeogenesis is a gut function that has been suggested to contribute to the metabolic benefits of RYGB in obese patients. Methods We studied the effects of DJB on body weight and glucose control in obese mice fed a high fat-high sucrose diet. Wild type mice and mice with a genetic suppression of intestinal gluconeogenesis were studied in parallel using glucose- and insulin-tolerance tests. Fecal losses, including excretion of lipids, were studied from the feces recovered in metabolic cages. Results DJB induced a dramatic decrease in body weight and improvement in glucose control (glucose- and insulin-tolerance) in obese wild type mice fed a high calorie diet, for 25 days after the surgery. The DJB-induced decrease in food intake was transient and resumed to normal in 7–8 days, suggesting that decreased food intake could not account for the benefits. Total fecal losses were about 5 times and lipid losses 7 times higher in DJB-mice than in control (sham-operated and pair-fed) mice, and could account for the weight loss of mice. The results were comparable in mice with suppression of intestinal gluconeogenesis. There was no effect of DJB on food intake, body weight or fecal loss in lean mice fed a normal chow diet. Conclusions DJB in obese mice fed a high calorie diet promotes dramatic fecal loss, which could account for the dramatic weight loss and metabolic benefits observed. This could dominate the effects of the mouse genotype/phenotype. Thus, fecal energy loss should be considered as an essential process contributing to the metabolic benefits of DJB in obese mice. Duodenal-jejunal bypass (DJB) promotes weight loss in mice fed a high calorie diet. DJB induces dramatic fecal energy losses in mice fed a high calorie diet. DJB has no effect in mice fed a control (starch-based) diet. There is no fecal losses in DJB-mice fed a control diet. Fecal energy loss is a cause of body weight loss in DJB-mice fed high calorie diet.
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Affiliation(s)
- Aude Barataud
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Justine Vily-Petit
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Daisy Goncalves
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Carine Zitoun
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Adeline Duchampt
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Erwann Philippe
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Amandine Gautier-Stein
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France
| | - Gilles Mithieux
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon, F-69008, France; Université de Lyon, Lyon, F-69008, France; Université Lyon 1, Villeurbanne, F-69622, France.
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Pal A, Rhoads DB, Tavakkoli A. Portal milieu and the interplay of multiple antidiabetic effects after gastric bypass surgery. Am J Physiol Gastrointest Liver Physiol 2019; 316:G668-G678. [PMID: 30896970 PMCID: PMC6580237 DOI: 10.1152/ajpgi.00389.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Diabetes is a worldwide health problem. Roux-en-Y gastric bypass (RYGB) leads to rapid resolution of type 2 diabetes (T2D). Decreased hepatic insulin resistance is key, but underlying mechanisms are poorly understood. We hypothesized that changes in intestinal function and subsequent changes in portal venous milieu drive some of these postoperative benefits. We therefore aimed to evaluate postoperative changes in portal milieu. Two rat strains, healthy [Sprague-Dawley (SD)] and obese diabetic [Zucker diabetic fatty (ZDF)] rats, underwent RYGB or control surgery. After 4 wk, portal and systemic blood was sampled before and during an intestinal glucose bolus to investigate changes in intestinal glucose absorption (Gabsorp) and utilization (Gutil), and intestinal secretion of incretins and glucagon-like peptide-2 (GLP-2). Hepatic activity of dipeptidyl peptidase-4 (DPP4), which degrades incretins, was also measured. RYGB decreased Gabsorp in both rat strains. Gutil increased in SD rats and decreased in ZDF rats. In both strains, there was increased expression of intestinal hexokinase and gluconeogenesis enzymes. Systemic incretin and GLP-2 levels also increased after RYGB. This occurred without an increase in secretion. Hepatic DPP4 activity and expression were unchanged. RYGB perturbs multiple intestinal pathways, leading to decreased intestinal glucose absorption and increased incretin levels in both healthy and diabetic animals. In diabetic rats, intestinal glucose balance shifts toward glucose release. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to rapid changes in hepatic glucose and hormone handling. This fresh insight into the surgical physiology of RYGB raises the hope of less invasive alternatives. NEW & NOTEWORTHY Portal milieu after gastric bypass surgery is an underinvestigated area. Roux-en-Y gastric bypass perturbs multiple intestinal pathways, reducing intestinal glucose absorption and increasing incretin levels. In diabetic rats, the intestine becomes a net releaser of glucose, increasing portal glucose levels. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to changes in hepatic glucose handling. This fresh insight raises the hope of less invasive alternatives.
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Affiliation(s)
- Atanu Pal
- 1Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts,2Harvard Medical School, Boston, Massachusetts
| | - David B. Rhoads
- 2Harvard Medical School, Boston, Massachusetts,3Pediatric Endocrinology, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Ali Tavakkoli
- 1Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts,2Harvard Medical School, Boston, Massachusetts,4Center for Weight Management and Metabolic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
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Abstract
Intestinal gluconeogenesis is a recently identified function influencing energy homeostasis. Intestinal gluconeogenesis induced by specific nutrients releases glucose, which is sensed by the nervous system surrounding the portal vein. This initiates a signal positively influencing parameters involved in glucose control and energy management controlled by the brain. This knowledge has extended our vision of the gut-brain axis, classically ascribed to gastrointestinal hormones. Our work raises several questions relating to the conditions under which intestinal gluconeogenesis proceeds and may provide its metabolic benefits. It also leads to questions on the advantage conferred by its conservation through a process of natural selection.
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Affiliation(s)
- Maud Soty
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon I, Villeurbanne 69622, France
| | - Amandine Gautier-Stein
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon I, Villeurbanne 69622, France
| | - Fabienne Rajas
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon I, Villeurbanne 69622, France
| | - Gilles Mithieux
- Institut National de la Santé et de la Recherche Médicale, U1213, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon I, Villeurbanne 69622, France.
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Abstract
OBJECTIVE To evaluate the role of bile routing modification on the beneficial effects of gastric bypass surgery on glucose and energy metabolism. BACKGROUND Gastric bypass surgery (GBP) promotes early improvements in glucose and energy homeostasis in obese diabetic patients. A suggested mechanism associates a decrease in hepatic glucose production to an enhanced intestinal gluconeogenesis. Moreover, plasma bile acids are elevated after GBP and bile acids are inhibitors of gluconeogenesis. METHODS In male Sprague-Dawley rats, we performed bile diversions from the bile duct to the midjejunum or the mid-ileum to match the modified bile delivery in the gut occurring in GBP. Body weight, food intake, glucose tolerance, insulin sensitivity, and food preference were analyzed. The expression of gluconeogenesis genes was evaluated in both the liver and the intestine. RESULTS Bile diversions mimicking GBP promote an increase in plasma bile acids and a marked improvement in glucose control. Bile bioavailability modification is causal because a bile acid sequestrant suppresses the beneficial effects of bile diversions on glucose control. In agreement with the inhibitory role of bile acids on gluconeogenesis, bile diversions promote a blunting in hepatic glucose production, whereas intestinal gluconeogenesis is increased in the gut segments devoid of bile. In rats fed a high-fat-high-sucrose diet, bile diversions improve glucose control and dramatically decrease food intake because of an acquired disinterest in fatty food. CONCLUSIONS This study shows that bile routing modification is a key mechanistic feature in the beneficial outcomes of GBP.
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Mäkinen J, Hannukainen JC, Karmi A, Immonen HM, Soinio M, Nelimarkka L, Savisto N, Helmiö M, Ovaska J, Salminen P, Iozzo P, Nuutila P. Obesity-associated intestinal insulin resistance is ameliorated after bariatric surgery. Diabetologia 2015; 58:1055-62. [PMID: 25631620 PMCID: PMC4392118 DOI: 10.1007/s00125-015-3501-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/12/2014] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS The intestine is the main site for glucose absorption and it has been suggested that it exhibits insulin resistance. Bariatric surgery has been shown to reverse insulin resistance and type 2 diabetes, but its effects on human intestinal metabolism are unknown. Our aim was to evaluate the effects of insulin on intestinal glucose metabolism before and after bariatric surgery. METHODS Twenty-one morbidly obese individuals undergoing bariatric surgery and ten age-matched healthy individuals were recruited and intestinal and skeletal muscle glucose uptake (GU) was measured using [(18)F]fluoro-2-deoxyglucose and positron emission tomography at fast and during hyperinsulinaemia. MRI was used as anatomical reference. Obese participants were studied again 6 months postoperatively. RESULTS In contrast to healthy individuals, insulin had no effect on intestinal GU in obese participants with or without diabetes, suggesting that intestinal insulin resistance is present early in morbid obesity. Postoperatively, jejunal GU increased in line with whole-body and muscle GU. Postoperative GU values in the intestine correlated with whole-body insulin sensitivity, indicating that the intestinal mucosa may reflect the overall glycaemic state and potentially mediate obesity-associated insulin resistance. CONCLUSIONS/INTERPRETATION This study shows that insulin is a potent stimulator of GU in the healthy intestine and that intestinal insulin resistance is ameliorated after bariatric surgery. In our study, obese individuals had intestinal insulin resistance regardless of their glycaemic status. Persistent changes in intestinal glucose metabolism are likely to influence both local processes in the gut and systemic glucose homeostasis.
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Affiliation(s)
- Jaakko Mäkinen
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
| | | | - Anna Karmi
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
| | - Heidi M. Immonen
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Minna Soinio
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Lassi Nelimarkka
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Nina Savisto
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
| | - Mika Helmiö
- Department of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | - Jari Ovaska
- Department of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | - Paulina Salminen
- Department of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | - Patricia Iozzo
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
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Soty M, Penhoat A, Amigo-Correig M, Vinera J, Sardella A, Vullin-Bouilloux F, Zitoun C, Houberdon I, Mithieux G. A gut-brain neural circuit controlled by intestinal gluconeogenesis is crucial in metabolic health. Mol Metab 2014; 4:106-17. [PMID: 25685698 PMCID: PMC4314540 DOI: 10.1016/j.molmet.2014.12.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 12/19/2022] Open
Abstract
Objectives Certain nutrients positively regulate energy homeostasis via intestinal gluconeogenesis (IGN). The objective of this study was to evaluate the impact of a deficient IGN in glucose control independently of nutritional environment. Methods We used mice deficient in the intestine glucose-6 phosphatase catalytic unit, the key enzyme of IGN (I-G6pc−/− mice). We evaluated a number of parameters involved in energy homeostasis, including insulin sensitivity (hyperinsulinemic euglycaemic clamp), the pancreatic function (insulin secretion in vivo and in isolated islets) and the hypothalamic homeostatic function (leptin sensitivity). Results Intestinal-G6pc−/− mice exhibit slight fasting hyperglycaemia and hyperinsulinemia, glucose intolerance, insulin resistance and a deteriorated pancreatic function, despite normal diet with no change in body weight. These defects evoking type 2 diabetes (T2D) derive from the basal activation of the sympathetic nervous system (SNS). They are corrected by treatment with an inhibitor of α-2 adrenergic receptors. Deregulation in a key target of IGN, the homeostatic hypothalamic function (highlighted here through leptin resistance) is a mechanistic link. Hence the leptin resistance and metabolic disorders in I-G6pc−/− mice are corrected by rescuing IGN by portal glucose infusion. Finally, I-G6pc−/− mice develop the hyperglycaemia characteristic of T2D more rapidly under high fat/high sucrose diet. Conclusions Intestinal gluconeogenesis is a mandatory function for the healthy neural control of glucose homeostasis.
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Affiliation(s)
- Maud Soty
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Armelle Penhoat
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Marta Amigo-Correig
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Jennifer Vinera
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Anne Sardella
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Fanny Vullin-Bouilloux
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Carine Zitoun
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Isabelle Houberdon
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
| | - Gilles Mithieux
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon, F-69008, France
- Université de Lyon, Lyon, F-69008, France
- Université Lyon1, Villeurbanne, F-69622, France
- Corresponding author. Inserm U855, Faculté de Médecine Laennec, 7 rue Guillaume Paradin, 69372, Lyon cedex 08, France. Tel.: +33 478 77 10 28; fax: +33 478 77 87 62.
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Mithieux G. Crosstalk between gastrointestinal neurons and the brain in the control of food intake. Best Pract Res Clin Endocrinol Metab 2014; 28:739-44. [PMID: 25256768 DOI: 10.1016/j.beem.2014.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent data have emphasized that the gastrointestinal nervous system is preponderant in the sensing of nutrients and hormones and its translation in terms of control of food intake by the central nervous system. More specifically, the gastrointestinal neural system participates in the control of hunger via the sensing of at least two major macronutrients, e.g. glucose and protein, which may control hunger sensations from the portal vein. Protein are first sensed by mu-opioid receptors present in the portal vein walls to induce intestinal gluconeogenesis-via a reflex arc and next portal glucose sensing. The gastrointestinal nervous system may also account for the rapid benefits of gastric bypass surgeries on energy homeostasis (hunger and body weight) and glucose homeostasis (insulin sensitivity). This knowledge provides novel mechanisms of control of body weight, which might be useful to envision future approaches of prevention or treatment of obesity.
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Affiliation(s)
- Gilles Mithieux
- Inserm U855, Faculté de Médecine Lyon-Est « Laennec », 69372 Lyon Cedex 08, France; Université Lyon 1, 69622 Villeurbanne, France; Université de Lyon, 69008 Lyon, France.
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Mithieux G, Gautier-Stein A. Intestinal glucose metabolism revisited. Diabetes Res Clin Pract 2014; 105:295-301. [PMID: 24969963 DOI: 10.1016/j.diabres.2014.04.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 04/16/2014] [Indexed: 02/02/2023]
Abstract
It is long known that the gut can contribute to the control of glucose homeostasis via its high glucose utilization capacity. Recently, a novel function in intestinal glucose metabolism (gluconeogenesis) was described. The intestine notably contributes to about 20-25% of total endogenous glucose production during fasting. More importantly, intestinal gluconeogenesis is capable of regulating energy homeostasis through a communication with the brain. The periportal neural system senses glucose (produced by intestinal gluconeogenesis) in the portal vein walls, which sends a signal to the brain to modulate hunger sensations and whole body glucose homeostasis. Relating to the mechanism of glucose sensing, the role of the glucose receptor SGLT3 has been strongly suggested. Moreover, dietary proteins mobilize intestinal gluconeogenesis as a mandatory link between their detection in the portal vein and their effect of satiety. In the same manner, dietary soluble fibers exert their anti-obesity and anti-diabetic effects via the induction of intestinal gluconeogenesis. FFAR3 is a key neural receptor involved in the specific sensing of propionate to activate a gut-brain reflex arc triggering the induction of the gut gluconeogenic function. Lastly, intestinal gluconeogenesis might also be involved in the rapid metabolic improvements induced by gastric bypass surgeries of obesity.
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Affiliation(s)
- Gilles Mithieux
- Inserm U855, Faculté de Médecine Lyon-Est "Laennec", 69372 Lyon Cedex 08, France; Université Lyon 1, 69622 Villeurbanne, France; Université de Lyon, 69008 Lyon, France.
| | - Amandine Gautier-Stein
- Inserm U855, Faculté de Médecine Lyon-Est "Laennec", 69372 Lyon Cedex 08, France; Université Lyon 1, 69622 Villeurbanne, France; Université de Lyon, 69008 Lyon, France
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De Vadder F, Mithieux G. Les fibres alimentaires induisent des bénéfices métaboliques via l’activation de la néoglucogenèse intestinale. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s11690-014-0451-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Vadder F, Kovatcheva-Datchary P, Goncalves D, Vinera J, Zitoun C, Duchampt A, Bäckhed F, Mithieux G. Microbiota-generated metabolites promote metabolic benefits via gut-brain neural circuits. Cell 2014; 156:84-96. [PMID: 24412651 DOI: 10.1016/j.cell.2013.12.016] [Citation(s) in RCA: 1471] [Impact Index Per Article: 147.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/15/2013] [Accepted: 12/11/2013] [Indexed: 12/22/2022]
Abstract
Soluble dietary fibers promote metabolic benefits on body weight and glucose control, but underlying mechanisms are poorly understood. Recent evidence indicates that intestinal gluconeogenesis (IGN) has beneficial effects on glucose and energy homeostasis. Here, we show that the short-chain fatty acids (SCFAs) propionate and butyrate, which are generated by fermentation of soluble fiber by the gut microbiota, activate IGN via complementary mechanisms. Butyrate activates IGN gene expression through a cAMP-dependent mechanism, while propionate, itself a substrate of IGN, activates IGN gene expression via a gut-brain neural circuit involving the fatty acid receptor FFAR3. The metabolic benefits on body weight and glucose control induced by SCFAs or dietary fiber in normal mice are absent in mice deficient for IGN, despite similar modifications in gut microbiota composition. Thus, the regulation of IGN is necessary for the metabolic benefits associated with SCFAs and soluble fiber.
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Affiliation(s)
- Filipe De Vadder
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France
| | - Petia Kovatcheva-Datchary
- Wallenberg Laboratory and Department of Molecular and Clinical Medicine, University of Gothenburg 41345, Sweden
| | - Daisy Goncalves
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France
| | - Jennifer Vinera
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France
| | - Carine Zitoun
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France
| | - Adeline Duchampt
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France
| | - Fredrik Bäckhed
- Wallenberg Laboratory and Department of Molecular and Clinical Medicine, University of Gothenburg 41345, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Gilles Mithieux
- Institut de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; Université de Lyon, Lyon 69008, France; Université Lyon 1, Villeurbanne 69622, France.
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Mithieux G. Nutrient control of energy homeostasis via gut-brain neural circuits. Neuroendocrinology 2014; 100:89-94. [PMID: 25342450 DOI: 10.1159/000369070] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/10/2014] [Indexed: 11/19/2022]
Abstract
Intestinal gluconeogenesis is a recently described function in intestinal glucose metabolism. In particular, the intestine contributes around 20-25% of total endogenous glucose production during fasting. Intestinal gluconeogenesis appears to regulate energy homeostasis via a neurally mediated mechanism linking the enterohepatic portal system with the brain. The periportal neural system is able to sense glucose produced by intestinal gluconeogenesis in the portal vein walls, which sends a signal to the brain to modulate energy and glucose homeostasis. Dietary proteins mobilize intestinal gluconeogenesis as a mandatory link between the sensing of these proteins in the portal vein and their well-known effect of satiety. Comparably, dietary soluble fibers exert their antiobesity and antidiabetic effects via the induction of intestinal gluconeogenesis. Finally, intestinal gluconeogenesis might be involved in the rapid metabolic improvements in energy homeostasis induced by gastric bypass surgeries of obesity.
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Affiliation(s)
- Gilles Mithieux
- Inserm U-855, Faculté de Médecine Lyon-Est 'Laennec', and Université de Lyon, Lyon, France
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Penhoat A, Fayard L, Stefanutti A, Mithieux G, Rajas F. Intestinal gluconeogenesis is crucial to maintain a physiological fasting glycemia in the absence of hepatic glucose production in mice. Metabolism 2014; 63:104-11. [PMID: 24135501 DOI: 10.1016/j.metabol.2013.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/08/2013] [Accepted: 09/09/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Similar to the liver and kidneys, the intestine has been strongly suggested to be a gluconeogenic organ. However, the precise contribution of the intestine to endogenous glucose production (EGP) remains to be determined. To define the quantitative role of intestinal gluconeogenesis during long-term fasting, we compared changes in blood glucose during prolonged fasting in mice with a liver-deletion of the glucose-6 phosphatase catalytic (G6PC) subunit (LKO) and in mice with a combined deletion of G6PC in both the liver and the intestine (ILKO). MATERIALS/METHODS The LKO and ILKO mice were studied after 6h and 40 h of fasting by measuring metabolic and hormonal plasmatic parameters, as well as the expression of gluconeogenic enzymes in the liver, kidneys and intestine. RESULTS After a transient hypoglycemic episode (approximately 60 mg/dL) because of their incapacity to mobilize liver glycogen, the LKO mice progressively re-increased their plasma glucose to reach a glycemia comparable to that of wild-type mice (90 mg/dL) from 30 h of fasting. This increase was associated with a rapid induction of renal and intestinal gluconeogenic gene expression, driven by glucagon, glucocorticoids and acidosis. The ILKO mice exhibited a similar induction of renal gluconeogenesis. However, these mice failed to re-increase their glycemia and maintained a plasma glucose level of only 60 mg/dL throughout the 48 h-fasting period. CONCLUSIONS These data indicate that intestinal glucose production is essential to maintain glucose homeostasis in the absence of hepatic glucose production during fasting. These data provide a definitive quantitative estimate of the capacity of intestinal gluconeogenesis to sustain EGP during long-term fasting.
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Affiliation(s)
- Armelle Penhoat
- Institut National de la Santé et de la Recherche Médicale, U855, Lyon 69372, France; University of Lyon, Lyon 69008, France; University Lyon 1, Villeurbanne 69622, France
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De Vadder F, Gautier-Stein A, Mithieux G. Satiety and the role of μ-opioid receptors in the portal vein. Curr Opin Pharmacol 2013; 13:959-63. [PMID: 24095601 DOI: 10.1016/j.coph.2013.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/20/2013] [Accepted: 09/04/2013] [Indexed: 01/03/2023]
Abstract
Mu-opioid receptors (MORs) are known to influence food intake at the brain level, through their involvement in the food reward system. MOR agonists stimulate food intake. On the other hand, MOR antagonists suppress food intake. MORs are also active in peripheral organs, especially in the small intestine where they control the gut motility. Recently, an indirect role in the control of food intake was ascribed to MORs in the extrinsic gastrointestinal neural system. MORs present in the neurons of the portal vein walls sense blood peptides released from the digestion of dietary protein. These peptides behave as MOR antagonists. Their MOR antagonist action initiates a gut-brain circuitry resulting in the induction of intestinal gluconeogenesis, a function controlling food intake. Thus, periportal MORs are a key mechanistic link in the satiety effect of protein-enriched diets.
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Affiliation(s)
- Filipe De Vadder
- Inserm U855, Lyon, France; Université Lyon 1, Villeurbanne, France; Université de Lyon, Lyon, France
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Mithieux G. Nutrient control of hunger by extrinsic gastrointestinal neurons. Trends Endocrinol Metab 2013; 24:378-84. [PMID: 23714040 DOI: 10.1016/j.tem.2013.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/19/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
Abstract
The neural sensing of nutrients during food digestion plays a key role in the regulation of hunger. Recent data have emphasized that the extrinsic gastrointestinal nervous system is preponderant in this phenomenon and in its translation to the control of food intake by the central nervous system (CNS). Nutrient sensing by the extrinsic gastrointestinal nervous system may account for the satiation induced by food lipids, the satiety initiated by food protein, and for the rapid benefits of gastric bypass surgeries on both glucose and energy homeostasis. Thus, this recent knowledge provides novel examples of the mechanisms that control food intake and body weight, and this might pave the way for future approaches to the prevention and/or treatment of obesity.
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Affiliation(s)
- Gilles Mithieux
- Institut National de la Santé et de la Recherche Médicale Unité 855, Faculté de Médecine Lyon-Est 'Laennec', 69372 Lyon CEDEX 08, France.
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