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Gilles M. [Nutrient sensing by the gastro-intestinal nervous system and control of energy homeostasis]. Biol Aujourdhui 2016; 209:325-330. [PMID: 27021051 DOI: 10.1051/jbio/2016001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Indexed: 06/05/2023]
Abstract
The gastrointestinal nerves are crucial in the sensing of nutrients and hormones and its translation in terms of control of food intake. Major macronutrients like glucose and proteins are sensed by the extrinsic nerves located around the portal vein walls, which signal to the brain and account for the satiety phenomenon they promote. Glucose is sensed in the portal vein by neurons expressing the glucose receptor SGLT3, which activates the main regions of the brain involved in the control of food intake. Proteins indirectly act on food intake by inducing intestinal gluconeogenesis and its sensing by the portal glucose sensor. The mechanism involves a prior antagonism by peptides of the μ-opioid receptors present in the portal vein nervous system and a reflex arc with the brain inducing intestinal gluconeogenesis. In a comparable manner, short chain fatty acids produced from soluble fibers act via intestinal gluconeogenesis to exert anti-obesity and anti-diabetic effects. In the case of propionate, the mechanism involves a prior activation of the free fatty acid receptor FFAR3 present in the portal nerves and a reflex arc initiating intestinal gluconeogenesis.
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Affiliation(s)
- Mithieux Gilles
- Inserm U855, Faculté de Médecine Laennec Lyon-Est, 69372 Lyon Cedex 08, France - Université Lyon 1, 69622 Villeurbanne, France - Université de Lyon, 69008 Lyon, France
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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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Joly-Amado A, Cansell C, Denis RGP, Delbes AS, Castel J, Martinez S, Luquet S. The hypothalamic arcuate nucleus and the control of peripheral substrates. Best Pract Res Clin Endocrinol Metab 2014; 28:725-37. [PMID: 25256767 DOI: 10.1016/j.beem.2014.03.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The arcuate nucleus (ARC) of the hypothalamus is particularly regarded as a critical platform that integrates circulating signals of hunger and satiety reflecting energy stores and nutrient availability. Among ARC neurons, pro-opiomelanocortin (POMC) and agouti-related protein and neuropeptide Y (NPY/AgRP neurons) are considered as two opposing branches of the melanocortin signaling pathway. Integration of circulating signals of hunger and satiety results in the release of the melanocortin receptor ligand α-melanocyte-stimulating hormone (αMSH) by the POMC neurons system and decreases feeding and increases energy expenditure. The orexigenic/anabolic action of NPY/AgRP neurons is believed to rely essentially on their inhibitory input onto POMC neurons and second-orders targets. Recent updates in the field have casted a new light on the role of the ARC neurons in the coordinated regulation of peripheral organs involved in the control of nutrient storage, transformation and substrate utilization independent of food intake.
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Affiliation(s)
- Aurélie Joly-Amado
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Céline Cansell
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Raphaël G P Denis
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Anne-Sophie Delbes
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Julien Castel
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Sarah Martinez
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, France
| | - Serge Luquet
- Univ Paris Diderot, Sorbonne Paris Cité, Unité de Biologie Fonctionnelle et Adaptative (BFA) UMR 8251 CNRS, F-75205 Paris, 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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Mithieux G. Metabolic effects of portal vein sensing. Diabetes Obes Metab 2014; 16 Suppl 1:56-60. [PMID: 25200297 DOI: 10.1111/dom.12338] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/22/2014] [Indexed: 12/28/2022]
Abstract
The extrinsic gastrointestinal nerves are crucial in the sensing of nutrients and hormones and its translation in terms of control of food intake. Major macronutrients like glucose and protein are sensed by the extrinsic nerves located in the portal vein walls, which signal to the brain and account for the satiety phenomenon they promote. Glucose is sensed in the portal vein by neurons expressing the glucose receptor SGLT3, which activate the main regions of the brain involved in the control of food intake. Proteins indirectly act on food intake by inducing intestinal gluconeogenesis and its sensing by the portal glucose sensor. The mechanism involves a prior antagonism by peptides of the μ-opioid receptors present in the portal vein nervous system and a reflex arc with the brain inducing intestinal gluconeogenesis. In a comparable manner, short-chain fatty acids produced from soluble fibre act via intestinal gluconeogenesis to exert anti-obesity and anti-diabetic effects. In the case of propionate, the mechanism involves a prior activation of the free fatty acid receptor FFAR3 present in the portal nerves and a reflex arc initiating intestinal gluconeogenesis.
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Affiliation(s)
- G Mithieux
- Inserm U855, Faculté de Médecine Lyon-Est Laennec, Lyon, France; Faculté de Médecine Lyon-Est Laennec, Université Lyon 1, Villeurbanne, France; Faculté de Médecine Lyon-Est Laennec, Université de Lyon, Lyon, France
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Roberts LD, Koulman A, Griffin JL. Towards metabolic biomarkers of insulin resistance and type 2 diabetes: progress from the metabolome. Lancet Diabetes Endocrinol 2014; 2:65-75. [PMID: 24622670 DOI: 10.1016/s2213-8587(13)70143-8] [Citation(s) in RCA: 192] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The complex aetiology of type 2 diabetes makes effective screening, diagnosis and prognosis a substantial challenge for the physician. The rapidly developing area of metabolomics, which uses analytical techniques such as mass spectrometry and nuclear magnetic resonance, has emerged as a promising approach to identify biomarkers of diabetes and the insulin-resistant state that precedes overt pathology. Initial successes with metabolomic studies have indicated potential biomarkers for insulin resistance and for identifying people at risk of developing diabetes, with particular focus on aminoacids and lipid metabolism. These biomarkers will help to improve research and management of diabetes. In particular, several biomarkers identified could be used for early identification of diabetes risk. Furthermore, changes in selected biomarkers can indicate effectiveness of therapeutic interventions for type 2 diabetes and the metabolic syndrome. Indeed, there is much promise that branched-chain aminoacids might provide a screening biomarker for type 2 diabetes risk, allowing early dietary and exercise interventions to treat or even prevent the disease.
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Affiliation(s)
- Lee D Roberts
- Medical Research Council (MRC) Human Nutrition Research (HNR), Cambridge CB1 9NL, UK; Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA, UK.
| | - Albert Koulman
- Medical Research Council (MRC) Human Nutrition Research (HNR), Cambridge CB1 9NL, UK; Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA, UK
| | - Julian L Griffin
- Medical Research Council (MRC) Human Nutrition Research (HNR), Cambridge CB1 9NL, UK; Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA, UK.
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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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Mithieux G. A synergy between incretin effect and intestinal gluconeogenesis accounting for the rapid metabolic benefits of gastric bypass surgery. Curr Diab Rep 2012; 12:167-71. [PMID: 22311610 DOI: 10.1007/s11892-012-0257-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The early improvement of glucose control taking place shortly after gastric bypass surgery in obese diabetic patients has long been mysterious. A recent study in mice has highlighted some specific mechanisms underlying this phenomenon. The specificity of gastric bypass in obese diabetic mice relates to major changes in the sensations of hunger and to rapid improvement of glucose parameters. The induction of intestinal gluconeogenesis plays a major role in diminishing hunger, and in restoring insulin sensitivity of endogenous glucose production. In parallel, the restoration of the secretion of glucagon-like peptide 1 and insulin plays a key additional role, in this context of recovered insulin sensitivity, to improve postprandial glucose tolerance. Therefore, a synergy between an incretin effect and intestinal gluconeogenesis is a key feature accounting for the rapid improvement of glucose control in obese diabetic patients after bypass surgery.
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Penhoat A, Mutel E, Amigo-Correig M, Pillot B, Stefanutti A, Rajas F, Mithieux G. Protein-induced satiety is abolished in the absence of intestinal gluconeogenesis. Physiol Behav 2011; 105:89-93. [DOI: 10.1016/j.physbeh.2011.03.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 02/21/2011] [Accepted: 03/08/2011] [Indexed: 12/26/2022]
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Is Intestinal Gluconeogenesis a Key Factor in the Early Changes in Glucose Homeostasis Following Gastric Bypass? Obes Surg 2011; 21:759-62. [DOI: 10.1007/s11695-011-0380-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mithieux G. Brain, liver, intestine: a triumvirate to coordinate insulin sensitivity of endogenous glucose production. DIABETES & METABOLISM 2010; 36 Suppl 3:S50-3. [DOI: 10.1016/s1262-3636(10)70467-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Delaere F, Magnan C, Mithieux G. Hypothalamic integration of portal glucose signals and control of food intake and insulin sensitivity. DIABETES & METABOLISM 2010; 36:257-62. [PMID: 20561808 DOI: 10.1016/j.diabet.2010.05.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Accepted: 05/05/2010] [Indexed: 11/18/2022]
Abstract
Glycolysis is an essential metabolic function that lies at the core of any cellular life. Glucose homoeostasis is, thus, a crucial physiological function of living organisms. A system of plasma glucose-sensing in the portal vein plays a key role in this homoeostasis. Connected to the hypothalamus via the peripheral nervous system, the system allows the body to adapt its response to any variation of portal glycaemia. The hypothalamus controls food intake (exogenous glucose supply) and hepatic glycogenolysis (endogenous glucose supply). Intestinal gluconeogenesis, via the release of glucose into the portal vein, plays a key role in the control of hunger and satiety, and of endogenous glucose production through the modulation of liver insulin sensitivity. The induction of intestinal gluconeogenesis provides a physiological explanation for the satiety effects induced by protein-enriched diets. In particular, the influence of protein-enriched diets on the hypothalamus is comparable to the activation observed after glucose infusion into the portal vein. The induction of intestinal gluconeogenesis also offers an explanation for the early improvement in glycaemia control observed in obese diabetic patients treated by gastric-bypass surgery. In addition to intestinal gluconeogenesis, a number of gastrointestinal hormones involved in the control of food intake exert their effects, at least in part, via the peripheral afferent nervous system. These data emphasize the importance of the gut-brain axis in the understanding and treatment of obesity and type 2 diabetes.
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Affiliation(s)
- F Delaere
- Inserm U855, Institut national de la santé et de recherche médicale, faculté de médecine Laennec, rue Guillaume-Paradin, 69372 Lyon cedex 08, France
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Mutch DM, Fuhrmann JC, Rein D, Wiemer JC, Bouillot JL, Poitou C, Clément K. Metabolite profiling identifies candidate markers reflecting the clinical adaptations associated with Roux-en-Y gastric bypass surgery. PLoS One 2009; 4:e7905. [PMID: 19936240 PMCID: PMC2775672 DOI: 10.1371/journal.pone.0007905] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 10/19/2009] [Indexed: 12/13/2022] Open
Abstract
Background Roux-en-Y gastric bypass (RYGB) surgery is associated with weight loss, improved insulin sensitivity and glucose homeostasis, and a reduction in co-morbidities such as diabetes and coronary heart disease. To generate further insight into the numerous metabolic adaptations associated with RYGB surgery, we profiled serum metabolites before and after gastric bypass surgery and integrated metabolite changes with clinical data. Methodology and Principal Findings Serum metabolites were detected by gas and liquid chromatography-coupled mass spectrometry before, and 3 and 6 months after RYGB in morbidly obese female subjects (n = 14; BMI = 46.2±1.7). Subjects showed decreases in weight-related parameters and improvements in insulin sensitivity post surgery. The abundance of 48% (83 of 172) of the measured metabolites changed significantly within the first 3 months post RYGB (p<0.05), including sphingosines, unsaturated fatty acids, and branched chain amino acids. Dividing subjects into obese (n = 9) and obese/diabetic (n = 5) groups identified 8 metabolites that differed consistently at all time points and whose serum levels changed following RYGB: asparagine, lysophosphatidylcholine (C18:2), nervonic (C24:1) acid, p-Cresol sulfate, lactate, lycopene, glucose, and mannose. Changes in the aforementioned metabolites were integrated with clinical data for body mass index (BMI) and estimates for insulin resistance (HOMA-IR). Of these, nervonic acid was significantly and negatively correlated with HOMA-IR (p = 0.001, R = −0.55). Conclusions Global metabolite profiling in morbidly obese subjects after RYGB has provided new information regarding the considerable metabolic alterations associated with this surgical procedure. Integrating clinical measurements with metabolomics data is capable of identifying markers that reflect the metabolic adaptations following RYGB.
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Affiliation(s)
- David M. Mutch
- Nutriomique U872 team 7, Institut National de la Santé et de la Recherche Médicale, Paris, France
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, Paris, France
- * E-mail: (DMM); (DR)
| | | | - Dietrich Rein
- metanomics Health GmbH, Berlin, Germany
- * E-mail: (DMM); (DR)
| | | | - Jean-Luc Bouillot
- Hôtel-Dieu Hospital Surgery Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christine Poitou
- Nutriomique U872 team 7, Institut National de la Santé et de la Recherche Médicale, Paris, France
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, Paris, France
- Pitié-Salpêtrière Hospital Nutrition and Endocrinology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Karine Clément
- Nutriomique U872 team 7, Institut National de la Santé et de la Recherche Médicale, Paris, France
- Centre de Recherche des Cordeliers, Université Pierre et Marie Curie – Paris 6, Paris, France
- Pitié-Salpêtrière Hospital Nutrition and Endocrinology Department, Assistance Publique-Hôpitaux de Paris, Paris, France
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Mithieux G. A novel function of intestinal gluconeogenesis: Central signaling in glucose and energy homeostasis. Nutrition 2009; 25:881-4. [DOI: 10.1016/j.nut.2009.06.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 06/17/2009] [Accepted: 06/17/2009] [Indexed: 12/29/2022]
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Mithieux G, Andreelli F, Magnan C. Intestinal gluconeogenesis: key signal of central control of energy and glucose homeostasis. Curr Opin Clin Nutr Metab Care 2009; 12:419-23. [PMID: 19474723 DOI: 10.1097/mco.0b013e32832c4d6a] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW It has been established that the gut is much more than a digestive tract. It has the capacity to participate in the control of energy homeostasis via the secretion of various hormones. It can also contribute to the control of glucose homeostasis via its high glycolytic capacity and a recently described function, gluconeogenesis. RECENT FINDINGS In addition to its quantitative role in endogenous glucose production, qualitative roles (i.e. central signaling) were recently described for intestinal gluconeogenesis. In relation to the control of energy homeostasis, intestinal gluconeogenesis, via its detection by a hepatoportal glucose sensor, is able to generate a central signal of control of food intake, resulting in enhanced satiety. This mechanism has been suggested to account for the well known satiety effect initiated by food protein. In relation to the control of glucose homeostasis, intestinal gluconeogenesis has been suggested to be a key factor of the central enhancement of insulin sensitivity for the whole body. It may especially account for the rapid amelioration of the parameters of insulin resistance occurring after gastric bypass, a specific type of surgery of obesity. SUMMARY These new findings on the role of intestinal gluconeogenesis in the central control of energy and glucose homeostasis should be of interest for nutritionists and diabetologists. They pave the way to envision new strategies of prevention or treatment of obesity and type 2 diabetes in humans.
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Affiliation(s)
- Gilles Mithieux
- Institut National de la Santé et de la Recherche Médicale, U855, Université de Lyon, Lyon, France.
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