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Schürfeld R, Baratashvili E, Würfel M, Blüher M, Stumvoll M, Tönjes A, Ebert T. Circulating acyl-CoA-binding protein/diazepam-binding inhibitor in gestational diabetes mellitus. Reprod Biol Endocrinol 2023; 21:96. [PMID: 37872629 PMCID: PMC10591366 DOI: 10.1186/s12958-023-01152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Acyl-CoA-binding protein (ACBP)/diazepam-binding inhibitor has recently been characterized as an endocrine factor affecting energy balance and lipid metabolism. However, regulation of ACBP in women with gestational diabetes mellitus (GDM) during pregnancy, as well as postpartum, has not been investigated, so far. METHODS ACBP was quantified in 74 women with GDM and 74 healthy, gestational age-matched, pregnant controls using an enzyme-linked immunosorbent assay. Furthermore, ACBP was quantified post-partum in 82 women (i.e. 41 women with previous GDM vs. 41 previous control women). ACBP was related to measures of obesity, hypertension, glucose and lipid metabolism, renal function, and inflammation during pregnancy and postpartum. RESULTS During pregnancy, median [interquartile range] ACBP levels were not significantly different in women with GDM (40.9 [40.0] µg/l) compared to healthy, pregnant controls (29.1 [32.3] µg/l) (p = 0.215). ACBP serum concentrations increased from 30.3 [40.5] µg/l during pregnancy to 59.7 [33.2] µg/l after pregnancy in the entire cohort (p < 0.001). This observed elevation was consistent across both subgroups of women, those with prior GDM and those without. Multivariate analysis revealed that homeostasis model assessment of beta cell function (HOMA2-B) and creatinine positively and independently correlated with serum ACBP after pregnancy, while multivariate analysis during pregnancy showed no significant correlations. CONCLUSIONS Circulating ACBP is not a marker of GDM status, but ACBP is decreased during pregnancy, irrespective of GDM status. Furthermore, ACBP is related to beta cell function and renal markers in women after pregnancy.
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Affiliation(s)
- Robin Schürfeld
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany.
| | - Ekaterine Baratashvili
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany
| | - Marleen Würfel
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany
| | - Matthias Blüher
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG, Helmholtz Zentrum München at the University of Leipzig and University Hospital, Leipzig, Germany
| | - Michael Stumvoll
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany
| | - Anke Tönjes
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany
| | - Thomas Ebert
- Medical Department III - Endocrinology, University Hospital Leipzig, 04103, Nephrology, Rheumatology, Leipzig, Germany
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Morse JD, Cortinez LI, Anderson BJ. Considerations for Intravenous Anesthesia Dose in Obese Children: Understanding PKPD. J Clin Med 2023; 12:1642. [PMID: 36836174 PMCID: PMC9960599 DOI: 10.3390/jcm12041642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The intravenous induction or loading dose in children is commonly prescribed per kilogram. That dose recognizes the linear relationship between volume of distribution and total body weight. Total body weight comprises both fat and fat-free mass. Fat mass influences the volume of distribution and the use of total body weight fails to recognize the impact of fat mass on pharmacokinetics in children. Size metrics alternative to total body mass (e.g., fat-free and normal fat mass, ideal body weight and lean body weight) have been proposed to scale pharmacokinetic parameters (clearance, volume of distribution) for size. Clearance is the key parameter used to calculate infusion rates or maintenance dosing at steady state. Dosing schedules recognize the curvilinear relationship, described using allometric theory, between clearance and size. Fat mass also has an indirect influence on clearance through both metabolic and renal function that is independent of its effects due to increased body mass. Fat-free mass, lean body mass and ideal body mass are not drug specific and fail to recognize the variable impact of fat mass contributing to body composition in children, both lean and obese. Normal fat mass, used in conjunction with allometry, may prove a useful size metric but computation by clinicians for the individual child is not facile. Dosing is further complicated by the need for multicompartment models to describe intravenous drug pharmacokinetics and the concentration effect relationship, both beneficial and adverse, is often poorly understood. Obesity is also associated with other morbidity that may also influence pharmacokinetics. Dose is best determined using pharmacokinetic-pharmacodynamic (PKPD) models that account for these varied factors. These models, along with covariates (age, weight, body composition), can be incorporated into programmable target-controlled infusion pumps. The use of target-controlled infusion pumps, assuming practitioners have a sound understanding of the PKPD within programs, provide the best available guide to intravenous dose in obese children.
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Affiliation(s)
- James Denzil Morse
- Department of Anaesthesiology, University of Auckland, Park Road, Auckland 1023, New Zealand
| | - Luis Ignacio Cortinez
- División Anestesiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Brian Joseph Anderson
- Department of Anaesthesiology, University of Auckland, Park Road, Auckland 1023, New Zealand
- Department of Anaesthesia, Auckland Children’s Hospital, Park Road, Private Bag 92024, Auckland 1023, New Zealand
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Alquier T, Christian-Hinman CA, Alfonso J, Færgeman NJ. From benzodiazepines to fatty acids and beyond: revisiting the role of ACBP/DBI. Trends Endocrinol Metab 2021; 32:890-903. [PMID: 34565656 PMCID: PMC8785413 DOI: 10.1016/j.tem.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023]
Abstract
Four decades ago Costa and colleagues identified a small, secreted polypeptide in the brain that can displace the benzodiazepine diazepam from the GABAA receptor, and was thus termed diazepam binding inhibitor (DBI). Shortly after, an identical polypeptide was identified in liver by its ability to induce termination of fatty acid synthesis, and was named acyl-CoA binding protein (ACBP). Since then, ACBP/DBI has been studied in parallel without a clear and integrated understanding of its dual roles. The first genetic loss-of-function models have revived the field, allowing targeted approaches to better understand the physiological roles of ACBP/DBI in vivo. We discuss the roles of ACBP/DBI in central and tissue-specific functions in mammals, with an emphasis on metabolism and mechanisms of action.
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Affiliation(s)
- Thierry Alquier
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal Diabetes Research Center, and Departments of Medicine, Pharmacology and Physiology, Biochemistry, and Neurosciences, Université de Montréal, Montreal, QC, Canada.
| | - Catherine A Christian-Hinman
- Department of Molecular and Integrative Physiology, Neuroscience Program, Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Julieta Alfonso
- Department of Clinical Neurobiology, University Hospital Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Nils J Færgeman
- Department of Biochemistry and Molecular Biology, Villum Center for Bioanalytical Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark.
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Díaz M, Blasco-Roset A, Villarroya J, López-Bermejo A, de Zegher F, Villarroya F, Ibáñez L. Circulating diazepam-binding inhibitor in infancy: Relation to markers of adiposity and metabolic health. Pediatr Obes 2021; 16:e12802. [PMID: 34014038 DOI: 10.1111/ijpo.12802] [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: 12/08/2020] [Revised: 04/11/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diazepam-binding inhibitor (DBI) controls feeding behaviour and glucose homeostasis. Individuals born small-for-gestational-age (SGA) with excessive postnatal catch-up in weight are at risk for obesity and type 2 diabetes. OBJECTIVE To assess serum concentrations of DBI (0-2 years) in appropriate-for-gestational-age (AGA, n = 70) vs SGA infants (n = 33) with spontaneous catch-up and their relationship with endocrine-metabolic and adiposity markers. METHODS Longitudinal assessments included auxology, fasting glucose, insulin, insulin-like growth factor, high-molecular-weight adiponectin, DBI and body composition (absorptiometry). DBI was measured cross-sectionally in pregnant and non-pregnant women and in 2-day-old newborns. DBI mRNA expression levels were assessed in adult and neonatal tissues. RESULTS Cord blood DBI concentrations were similar in AGA and SGA newborns and about fivefold higher than those in women. Serum DBI levels decreased by age 2 days, were higher in SGA vs AGA infants at age 2 years and associated negatively with markers of adiposity and insulin resistance and positively with high-molecular-weight adiponectin. DBI mRNA expression was lower in placenta than in other tissues. CONCLUSION The increased DBI concentrations at birth are unrelated to prenatal growth. The higher DBI levels in SGA subjects at age 2 years may be related to catch-up growth or represent an adaptive mechanism to promote lipogenesis.
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Affiliation(s)
- Marta Díaz
- Endocrinology Department, Pediatric Research Institute Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Albert Blasco-Roset
- Biochemistry and Molecular Biomedicine, Institute of Biomedicine, University of Barcelona & Pediatric Research Institute Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - Joan Villarroya
- Biochemistry and Molecular Biomedicine, Institute of Biomedicine, University of Barcelona & Pediatric Research Institute Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI) and Dr. Josep Trueta Hospital, Girona, Spain
| | - Francis de Zegher
- Department of Development & Regeneration, University of Leuven, Leuven, Belgium
| | - Francesc Villarroya
- Biochemistry and Molecular Biomedicine, Institute of Biomedicine, University of Barcelona & Pediatric Research Institute Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - Lourdes Ibáñez
- Endocrinology Department, Pediatric Research Institute Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
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Lebrun B, Barbot M, Tonon MC, Prévot V, Leprince J, Troadec JD. Glial endozepines and energy balance: Old peptides with new tricks. Glia 2020; 69:1079-1093. [PMID: 33105065 DOI: 10.1002/glia.23927] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
The contribution of neuroglial interactions to the regulation of energy balance has gained increasing acceptance in recent years. In this context, endozepines, endogenous analogs of benzodiazepine derived from diazepam-binding inhibitor, are now emerging as major players. Produced by glial cells (astrocytes and tanycytes), endozepines have been known for two decades to exert potent anorexigenic effects by acting at the hypothalamic level. However, it is only recently that their modes of action, including the mechanisms by which they modulate energy metabolism, have begun to be elucidated. The data available today are abundant, significant, and sometimes contradictory, revealing a much more complex regulation than initially expected. Several mechanisms of action of endozepines seem to coexist at the central level, particularly in the hypothalamus. The brainstem has also recently emerged as a potential site of action for endozepines. In addition to their central anorexigenic effects, endozepines may also display peripheral effects promoting orexigenic actions, adding to their complexity and raising yet more questions. In this review, we attempt to provide an overview of our current knowledge in this rapidly evolving field and to pinpoint questions that remain unanswered.
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Affiliation(s)
- Bruno Lebrun
- CNRS 7291, Laboratoire de Neurosciences Cognitives, Aix Marseille University, Marseille, France
| | - Manon Barbot
- CNRS 7291, Laboratoire de Neurosciences Cognitives, Aix Marseille University, Marseille, France
| | - Marie-Christine Tonon
- INSERM U1239, Laboratoire de Différenciation et Communication Neuronale et Neuroendocrine, Normandie Université, Rouen, France
| | - Vincent Prévot
- University of Lille, INSERM, CHU Lille, Development and Plasticity of the Neuroendocrine Brain, Lille Neuroscience and Cognition, UMR-S 1172, European Genomic Institute of Diabetes (EGID), Lille, France
| | - Jérôme Leprince
- INSERM U1239, Laboratoire de Différenciation et Communication Neuronale et Neuroendocrine, Normandie Université, Rouen, France
| | - Jean-Denis Troadec
- CNRS 7291, Laboratoire de Neurosciences Cognitives, Aix Marseille University, Marseille, France
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Tonon MC, Vaudry H, Chuquet J, Guillebaud F, Fan J, Masmoudi-Kouki O, Vaudry D, Lanfray D, Morin F, Prevot V, Papadopoulos V, Troadec JD, Leprince J. Endozepines and their receptors: Structure, functions and pathophysiological significance. Pharmacol Ther 2020; 208:107386. [DOI: 10.1016/j.pharmthera.2019.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/20/2019] [Indexed: 02/06/2023]
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Anderson BJ, Holford NH. What is the best size predictor for dose in the obese child? Paediatr Anaesth 2017; 27:1176-1184. [PMID: 29076211 DOI: 10.1111/pan.13272] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 01/05/2023]
Abstract
Lean body mass is commonly proposed for anesthesia maintenance drug dosing calculations. However, total body mass used with allometric scaling has been shown to be better for propofol in obese adults and children. Fat-free mass has also been used instead of lean body mass. Fat-free mass is essentially the same as lean body mass but excludes a small percentage of mass of lipids in cell membranes, CNS, and bone marrow. Normal fat mass is a size descriptor that partitions total body mass into fat-free mass and fat mass calculated from total body mass minus fat-free mass. The relative influence of fat mass compared with fat-free mass is described by the fraction of fat mass that makes fat equivalent to fat-free mass in terms of allometric size. This fraction (Ffat) will differ for each drug and each parameter affected by body size (eg, clearance and volume of distribution). This fraction is based on the concept of theory-based allometric size. The normal fat mass based on allometric theory and partition of body mass into fat and fat-free components provides a principle-based approach explaining size and body composition effects on pharmacokinetics of all drugs in children and in adults.
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Affiliation(s)
- Brian J Anderson
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Nick Hg Holford
- Department of Pharmacology & Clinical Pharmacology, University of Auckland, Auckland, New Zealand
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Holford NH, Anderson BJ. Allometric size: The scientific theory and extension to normal fat mass. Eur J Pharm Sci 2017; 109S:S59-S64. [DOI: 10.1016/j.ejps.2017.05.056] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
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