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House RRJ, Tovar EA, Redlon LN, Essenburg CJ, Dischinger PS, Ellis AE, Beddows I, Sheldon RD, Lien EC, Graveel CR, Steensma MR. NF1 deficiency drives metabolic reprogramming in ER+ breast cancer. Mol Metab 2024; 80:101876. [PMID: 38216123 PMCID: PMC10844973 DOI: 10.1016/j.molmet.2024.101876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/28/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE NF1 is a tumor suppressor gene and its protein product, neurofibromin, is a negative regulator of the RAS pathway. NF1 is one of the top driver mutations in sporadic breast cancer such that 27 % of breast cancers exhibit damaging NF1 alterations. NF1 loss-of-function is a frequent event in the genomic evolution of estrogen receptor (ER)+ breast cancer metastasis and endocrine resistance. Individuals with Neurofibromatosis type 1 (NF) - a disorder caused by germline NF1 mutations - have an increased risk of dying from breast cancer [1-4]. NF-related breast cancers are associated with decreased overall survival compared to sporadic breast cancer. Despite numerous studies interrogating the role of RAS mutations in tumor metabolism, no study has comprehensively profiled the NF1-deficient breast cancer metabolome to define patterns of energetic and metabolic reprogramming. The goals of this investigation were (1) to define the role of NF1 deficiency in estrogen receptor-positive (ER+) breast cancer metabolic reprogramming and (2) to identify potential targeted pathway and metabolic inhibitor combination therapies for NF1-deficient ER + breast cancer. METHODS We employed two ER+ NF1-deficient breast cancer models: (1) an NF1-deficient MCF7 breast cancer cell line to model sporadic breast cancer, and (2) three distinct, Nf1-deficient rat models to model NF-related breast cancer [1]. IncuCyte proliferation analysis was used to measure the effect of NF1 deficiency on cell proliferation and drug response. Protein quantity was assessed by Western Blot analysis. We then used RNAseq to investigate the transcriptional effect of NF1 deficiency on global and metabolism-related transcription. We measured cellular energetics using Agilent Seahorse XF-96 Glyco Stress Test and Mito Stress Test assays. We performed stable isotope labeling and measured [U-13C]-glucose and [U-13C]-glutamine metabolite incorporation and measured total metabolite pools using mass spectrometry. Lastly, we used a Bliss synergy model to investigate NF1-driven changes in targeted and metabolic inhibitor synergy. RESULTS Our results revealed that NF1 deficiency enhanced cell proliferation, altered neurofibromin expression, and increased RAS and PI3K/AKT pathway signaling while constraining oxidative ATP production and restricting energetic flexibility. Neurofibromin deficiency also increased glutamine influx into TCA intermediates and dramatically increased lipid pools, especially triglycerides (TG). Lastly, NF1 deficiency alters the synergy between metabolic inhibitors and traditional targeted inhibitors. This includes increased synergy with inhibitors targeting glycolysis, glutamine metabolism, mitochondrial fatty acid transport, and TG synthesis. CONCLUSIONS NF1 deficiency drives metabolic reprogramming in ER+ breast cancer. This reprogramming is characterized by oxidative ATP constraints, glutamine TCA influx, and lipid pool expansion, and these metabolic changes introduce novel metabolic-to-targeted inhibitor synergies.
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Affiliation(s)
- Rachel Rae J House
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Elizabeth A Tovar
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Luke N Redlon
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Curt J Essenburg
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | | | - Abigail E Ellis
- Mass Spectrometry Core, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Ian Beddows
- Department of Epigenetics, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Ryan D Sheldon
- Mass Spectrometry Core, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Evan C Lien
- Department of Metabolism and Nutritional Programming, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Carrie R Graveel
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Matthew R Steensma
- Department of Cell Biology, Van Andel Research Institute, Grand Rapids, MI, USA; Helen DeVos Children's Hospital, Spectrum Health System, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
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Yasuda K, Nobeyama Y, Asahina A. Improved renal function in neurofibromatosis type 1 patients. SKIN HEALTH AND DISEASE 2022; 2:e119. [PMID: 35677927 PMCID: PMC9168021 DOI: 10.1002/ski2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 12/04/2022]
Abstract
Neurofibromatosis type 1 (NF1), or von Recklinghausen disease, is an autosomal dominant disease that presents with various symptoms, including café‐au‐lait spots and neurofibromas. NF1 patients occasionally suffer from renal artery vasculopathy, which impairs renal function, while results of a previous report suggested that male NF1 patients have a low creatinine level in peripheral blood. The assessment of renal function in NF1 patients remains inadequate. In this study, renal function in NF1 was assessed. We recruited 308 patients consisting of 149 NF1 patients (77 males and 72 females) and 159 control patients (102 males and 57 females). Creatinine, blood urea nitrogen and haemoglobin A1c in peripheral blood as well as protein, occult blood and sugar in urine were examined. In addition, the estimated glomerular filtration rate was calculated. The mean age and body mass index did not differ significantly between the NF1 patients and controls for both sexes. For both sexes, i) the mean creatinine value was significantly lower in the NF1 patients than in the controls; ii) the mean blood urea nitrogen value did not differ significantly between the NF1 patients and controls; iii) the mean blood urea nitrogen‐to‐creatinine ratio was significantly higher in the NF1 patients than in the controls; iv) the mean estimated glomerular filtration rate was significantly higher in the NF1 patients than in the controls; and v) the mean haemoglobin A1c value was significantly lower in the NF1 patients than in the controls. In conclusion, NF1 patients may have improved renal function. The clinical significances should be further examined.
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Affiliation(s)
- Ken‐ichi Yasuda
- Dermatology Jikei University School of Medicine Minato‐ku Tokyo Japan
| | | | - Akihiko Asahina
- Dermatology Jikei University School of Medicine Minato‐ku Tokyo Japan
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3
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Tritz R, Benson T, Harris V, Hudson FZ, Mintz J, Zhang H, Kennard S, Chen W, Stepp DW, Csanyi G, Belin de Chantemèle EJ, Weintraub NL, Stansfield BK. Nf1 heterozygous mice recapitulate the anthropometric and metabolic features of human neurofibromatosis type 1. Transl Res 2021; 228:52-63. [PMID: 32781282 PMCID: PMC7779711 DOI: 10.1016/j.trsl.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 12/26/2022]
Abstract
Neurofibromatosis type 1 (NF1) is a heritable cancer predisposition syndrome resulting from mutations in the NF1 tumor suppressor gene. Genotype-phenotype correlations for NF1 are rare due to the large number of NF1 mutations and role of modifier genes in manifestations of NF1; however, emerging reports suggest that persons with NF1 display a distinct anthropometric and metabolic phenotype featuring short stature, low body mass index, increased insulin sensitivity, and protection from diabetes. Nf1 heterozygous (Nf1+/-) mice accurately reflect the dominant inheritance of NF1 and are regularly employed as a model of NF1. Here, we sought to identify whether Nf1+/- mice recapitulate the anthropometric and metabolic features identified in persons with NF1. Littermate 16-20 week-old male wildtype (WT) and Nf1+/- C57B/6J mice underwent nuclear magnetic resonance (NMR), indirect calorimetry, and glucose/insulin/pyruvate tolerance testing. In some experiments, tissues were harvested for NMR and histologic characterization. Nf1+/- mice are leaner with significantly reduced visceral and subcutaneous fat mass, which corresponds with an increased density of small adipocytes and reduced leptin levels. Additionally, Nf1+/- mice are highly reliant on carbohydrates as an energy substrate and display increased glucose clearance and insulin sensitivity, but normal response to pyruvate suggesting enhanced glucose utilization and preserved gluconeogenesis. Finally, WT and Nf1+/- mice subjected to high glucose diet were protected from diet-induced obesity and hyperglycemia. Our data suggest that Nf1+/- mice closely recapitulate the anthropometric and metabolic phenotype identified in persons with NF1, which will impact the interpretation of previous and future translational studies of NF1.
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Affiliation(s)
- Rebekah Tritz
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Tyler Benson
- Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Valerie Harris
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Farlyn Z Hudson
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - James Mintz
- Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Hanfang Zhang
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Simone Kennard
- Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Weiqin Chen
- Vascular Biology Center, Augusta University, Augusta, Georgia
| | - David W Stepp
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Gabor Csanyi
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Eric J Belin de Chantemèle
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Neal L Weintraub
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Brian K Stansfield
- Vascular Biology Center, Augusta University, Augusta, Georgia; Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia.
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Riccardi C, Perrone L, Napolitano F, Sampaolo S, Melone MAB. Understanding the Biological Activities of Vitamin D in Type 1 Neurofibromatosis: New Insights into Disease Pathogenesis and Therapeutic Design. Cancers (Basel) 2020; 12:E2965. [PMID: 33066259 PMCID: PMC7602022 DOI: 10.3390/cancers12102965] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D is a fat-soluble steroid hormone playing a pivotal role in calcium and phosphate homeostasis as well as in bone health. Vitamin D levels are not exclusively dependent on food intake. Indeed, the endogenous production-occurring in the skin and dependent on sun exposure-contributes to the majority amount of vitamin D present in the body. Since vitamin D receptors (VDRs) are ubiquitous and drive the expression of hundreds of genes, the interest in vitamin D has tremendously grown and its role in different diseases has been extensively studied. Several investigations indicated that vitamin D action extends far beyond bone health and calcium metabolism, showing broad effects on a variety of critical illnesses, including cancer, infections, cardiovascular and autoimmune diseases. Epidemiological studies indicated that low circulating vitamin D levels inversely correlate with cutaneous manifestations and bone abnormalities, clinical hallmarks of neurofibromatosis type 1 (NF1). NF1 is an autosomal dominant tumour predisposition syndrome causing significant pain and morbidity, for which limited treatment options are available. In this context, vitamin D or its analogues have been used to treat both skin and bone lesions in NF1 patients, alone or combined with other therapeutic agents. Here we provide an overview of vitamin D, its characteristic nutritional properties relevant for health benefits and its role in NF1 disorder. We focus on preclinical and clinical studies that demonstrated the clinical correlation between vitamin D status and NF1 disease, thus providing important insights into disease pathogenesis and new opportunities for targeted therapy.
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Affiliation(s)
- Claudia Riccardi
- Department of Chemical Sciences, University of Naples Federico II, via Cintia 21, I-80126 Naples, Italy;
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Lorena Perrone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Filomena Napolitano
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Simone Sampaolo
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
| | - Mariarosa Anna Beatrice Melone
- Department of Advanced Medical and Surgical Sciences, 2nd Division of Neurology, Center for Rare Diseases and InterUniversity Center for Research in Neurosciences, University of Campania Luigi Vanvitelli, via Sergio Pansini 5, I-80131 Naples, Italy; (L.P.); (F.N.); (S.S.)
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, Temple University, BioLife Building (015-00), 1900 North 12th Street, Philadelphia, PA 19122-6078, USA
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Souza MLRD, Jansen AK, Rodrigues LOC, Vilela DLDS, Kakehasi AM, Martins AS, Souza JFD, Rezende NAD. Reduced bone mineral content and density in neurofibromatosis type 1 and its association with nutrient intake. Rev Assoc Med Bras (1992) 2020; 66:666-672. [PMID: 32638973 DOI: 10.1590/1806-9282.66.5.666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/29/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease characterized by multisystem involvement including low bone mineral density (BMD). OBJECTIVE To assess the bone phenotype of individuals with NF1 and verify its association with nutrient intake. METHODS Twenty-six adults with NF1 underwent bone phenotype assessments using dual-energy X-ray absorptiometry (DXA) and food intake evaluations. They were compared to 26 unaffected matched control patients. Weight, height, and waist circumference (WC) were measured. DXA provided total body, spine, and hip BMDs and bone mineral content (BMC) for all patients. Food intake was evaluated for energy, macro- and micro-nutrients. RESULTS Height (1.68 ± 0.1; 1.61 ± 0.1 cm; P = 0.003) and BMC (2.3 ± 0.4; 2.0 ± 0.5 kg; P = 0.046) were lower in the NF1 group. Individuals with NF1 also presented lower total body and spine BMDs (g/cm2) (1.1 ± 0.1, 1.0 ± 0.1, P = 0.036; 1.0 ± 0.1, 0.9 ± 0.1; P = 0.015, respectively). The frequency of total body bone mass below the expected level for patients' ages was higher in the NF1 group (7.7%; 34.6%, P = 0.016). There were no differences in energy consumption. No correlations between BMC and BMD with nutrient intake were observed in the NF1 group. CONCLUSIONS The NF1 group presented lower BMCs and BMDs. Although a lower consumption of calcium, iron, and vitamin A, and a higher intake of sodium and omega-6 were observed, there was no relationship between bone phenotype and nutrient intake.
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Kallionpää RA, Peltonen S, Leppävirta J, Pöyhönen M, Auranen K, Järveläinen H, Peltonen J. Haploinsufficiency of the NF1 gene is associated with protection against diabetes. J Med Genet 2020; 58:378-384. [PMID: 32571896 PMCID: PMC8142421 DOI: 10.1136/jmedgenet-2020-107062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/15/2022]
Abstract
Background The hereditary predisposition to diabetes is only partially explained by genes identified so far. Neurofibromatosis type 1 (NF1) is a rare monogenic dominant syndrome caused by aberrations of the NF1 gene. Here, we used a cohort of 1410 patients with NF1 to study the association of the NF1 gene with type 1 (T1D) and type 2 diabetes (T2D). Methods A total of 1410 patients were confirmed to fulfil the National Institutes of Health diagnostic criteria for NF1 by individually reviewing their medical records. The patients with NF1 were compared with 14 017 controls matched for age, sex and area of residence as well as 1881 non-NF1 siblings of the patients with NF1. Register-based information on purchases of antidiabetic medication and hospital encounters related to diabetes were retrieved. The Cox proportional hazards model was used to calculate the relative risk for diabetes in NF1. Results Patients with NF1 showed a lower rate of T2D when compared with a 10-fold control cohort (HR 0.27, 95% CI 0.17 to 0.43) or with their siblings without NF1 (HR 0.28, 95% CI 0.16 to 0.47). The estimates remained practically unchanged after adjusting the analyses for history of obesity and dyslipidaemias. The rate of T1D in NF1 was decreased although statistically non-significantly (HR 0.58, 95% CI 0.27 to 1.25). Conclusion Haploinsufficiency of the NF1 gene may protect against T2D and probably T1D. Since NF1 negatively regulates the Ras signalling pathway, the results suggest that the Ras pathway may be involved in the pathogenesis of diabetes.
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Affiliation(s)
| | - Sirkku Peltonen
- Department of Dermatology and Venereology, University of Turku, Turku, Finland.,Department of Dermatology, Turku University Hospital, Turku, Finland
| | - Jussi Leppävirta
- Department of Clinical Genetics, HUSLAB, Helsinki University Hospital (HUS) Diagnostic Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Minna Pöyhönen
- Department of Clinical Genetics, HUSLAB, Helsinki University Hospital (HUS) Diagnostic Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Kari Auranen
- Department of Mathematics and Statistics and Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Hannu Järveläinen
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Internal Medicine, Satakunta Central Hospital, Pori, Finland
| | - Juha Peltonen
- Institute of Biomedicine, University of Turku, Turku, Finland
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Souza MLRD, Jansen AK, Rodrigues LOC, Vilela DLDS, Kakehasi AM, Martins AS, Souza JFD, Rezende NAD. Increased resting metabolism in neurofibromatosis type 1. Clin Nutr ESPEN 2019; 32:44-49. [PMID: 31221289 DOI: 10.1016/j.clnesp.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/10/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease that is characterized by neurocutaneous changes with multisystem involvement. A previous study with adults with NF1 revealed that changes in total energy expenditure were related to food consumption and body composition. Resting energy expenditure (REE), a measure of energy that the body expends to maintain vital functions, has not been assessed in NF1 populations. This study aimed to assess REE in individuals with NF1 using indirect calorimetry (IC) and evaluate its correlation with body composition and muscle strength. METHODS Twenty-six adults with NF1 (14 men) aged 18-45 years underwent IC for assessing REE, respiratory quotient (RQ), and substrate utilization. Body composition was assessed by dual energy X-ray absorptiometry. Weight, height, and waist circumference (WC) were also measured. Maximum muscular strength (Smax) was measured by handgrip test using a dynamometer. Patients in the NF1 group were compared to 26 healthy controls in the control group, who were matched by sex, age, body mass index (BMI), and physical activity level. RESULTS There were no differences in weight, WC, fat mass, and body fat percentage (BFP). Appendicular lean mass (ALM) adjusted by BMI (ALMBMI) (0.828 ± 0.161 versus 0.743 ± 0.190; P = 0.048) and Smax (37.5 ± 10.6 versus 31.1 ± 12.2; P = 0.035) was lower in the NF1 group than in the control group. No differences in body composition, strength, and anthropometric parameters were observed in men, but women with NF1 presented lower body surface area (BSA), lean body mass (LBM), ALM, ALMBMI, and Smax. REE adjusted by weight, LBM, or ALM was higher in the NF1 group than in the control group (medians, 21.9 versus 26.3, P = 0.046; 36.5 versus 41.1, P = 0.012; and 82.3 versus 92.4, P = 0.006, respectively), and these differences were observed only among women. RQ was lower in the NF1 group than in the control group (0.9 ± 0.1 versus 0.8 ± 0.1; P = 0.008), revealing that individuals with NF1 oxidized more lipids and fewer carbohydrates than controls. REE correlated negatively with BFP and positively with weight, height, BMI, WC, BSA, LBM, ALM, ALMBMI, bone mineral content, and Smax. CONCLUSIONS Individuals with NF1, particularly women, presented with increased REE (adjusted by weight, LBM, or ALM) and lower RQ compared to healthy controls. These findings were associated with lower ALMBMI and Smax, possibly indicating premature sarcopenia in this population. Further investigation concerning energy metabolism in NF1 and gender differences may be helpful in explaining underlying mechanisms of these changes.
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Affiliation(s)
| | - Ann Kristine Jansen
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | | | | | - Adriana Maria Kakehasi
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Aline Stangherlin Martins
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Juliana Ferreira de Souza
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
| | - Nilton Alves de Rezende
- Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, MG, CEP 30130-100, Brazil
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Souza M, Jansen A, Martins A, Rodrigues L, Rezende N. Body composition in adults with neurofibromatosis type 1. Rev Assoc Med Bras (1992) 2017; 62:831-836. [PMID: 28001256 DOI: 10.1590/1806-9282.62.09.831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 02/15/2016] [Indexed: 12/30/2022] Open
Abstract
Objective To evaluate the body composition and nutritional status of neurofibromatosis type 1 (NF1) adult patients. Method A cross-sectional study of 60 NF1 patients (29 men, 31 women) aged ≥ 18 years who were evaluated from September 2012 to September 2013 in a Neurofibromatosis Outpatient Reference Center. Patients underwent nutritional assessment including measurements of weight, stature, waist circumference (WC), upper-arm circumference (UAC), and skinfolds (biceps, triceps, subscapular, suprailiac). Body mass index (BMI), upper-arm total area (UATA), upper-arm muscle area (UAMA), upper-arm fat area (UAFA), body fat percentage (BFP), fat mass, fat-free mass, fat mass index, and fat-free mass index were also calculated. Results The mean age of the study population was 34.48±10.33 years. The prevalence of short stature was 28.3%. Low weight was present in 10% of the sample and 31.7% of patients had a BMI ≥ 25 kg/m2. Reduced UAMA (<5th percentile) was present in 43.3% and no difference was found in UAFA between the sexes. The BFP was considered high in 30% and 17 (28.3%) patients had a WC above the World Health Organization cutoffs. Conclusion In this study, NF1 patients had a high prevalence of underweight, short stature, and reduced UAMA, with no difference between the sexes. Reduced UAMA was more prevalent in underweight patients; however, this was also observed in the normal and overweight patients. Further studies should investigate the distribution of body tissues in NF1 patients, including differences between men and women, and the influence of diet and nutrition on clinical features in NF1.
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Affiliation(s)
- Marcio Souza
- Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ann Jansen
- Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Aline Martins
- Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luiz Rodrigues
- Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nilton Rezende
- Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Synergistic Interplay between Curcumin and Polyphenol-Rich Foods in the Mediterranean Diet: Therapeutic Prospects for Neurofibromatosis 1 Patients. Nutrients 2017; 9:nu9070783. [PMID: 28754004 PMCID: PMC5537897 DOI: 10.3390/nu9070783] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 01/07/2023] Open
Abstract
Neurofibromas are the hallmark lesions in Neurofibromatosis 1 (NF1); these tumors are classified as cutaneous, subcutaneous and plexiform. In contrast to cutaneous and subcutaneous neurofibromas, plexiform neurofibromas can grow quickly and progress to malignancy. Curcumin, a turmeric-derived polyphenol, has been shown to interact with several molecular targets implicated in carcinogenesis. Here, we describe the impact of different dietary patterns, namely Mediterranean diet (MedDiet) compared to the Western diet (WesDiet), both with or without curcumin, on NF1 patients’ health. After six months, patients adopting a traditional MedDiet enriched with 1200 mg curcumin per day (MedDietCurcumin) presented a significant reduction in the number and volume of cutaneous neurofibromas; these results were confirmed in subsequent evaluations. Notably, in one patient, a large cranial plexiform neurofibroma exhibited a reduction in volume (28%) confirmed by Magnetic Resonance Imaging. Conversely, neither unenriched MedDiet nor WesDiet enriched with curcumin exhibited any significant positive effect. We hypothesize that the combination of a polyphenol-rich Mediterranean diet and curcumin was responsible for the beneficial effect observed on NF1. This is, to the best of our knowledge, the first experience with curcumin supplementation in NF1 patients. Our report suggests that an integrated nutritional approach may effectively aid in the management of NF1.
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10
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Martins AS, Jansen AK, Rodrigues LOC, Matos CM, Souza MLR, de Souza JF, Diniz MDFHS, Barreto SM, Diniz LM, de Rezende NA, Riccardi VM. Lower fasting blood glucose in neurofibromatosis type 1. Endocr Connect 2016; 5:28-33. [PMID: 26631381 PMCID: PMC4703950 DOI: 10.1530/ec-15-0102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/02/2015] [Indexed: 12/23/2022]
Abstract
Studies indicate a lower occurrence of diabetes mellitus (DM) in patients with neurofibromatosis type 1 (NF1). Fasting blood glucose (FBG) level is the main criterion used to diagnose DM and glucose intolerance. Therefore, this study compared FBG level between adults with NF1 and non-NF1 controls. We selected clinical records of 57 out of 701 individuals attending the Neurofibromatosis Outpatient Reference Center of the Clinics Hospital of the Federal University of Minas Gerais in Brazil. The selected patients with NF1 were matched to non-NF1 controls selected from the Brazilian Longitudinal Study of Adult Health according to sex, age (range, 35-74 years) and BMI at a ratio of 1:3. In both groups, individuals with DM were excluded. Median FBG level in the NF1 group (86 mg/dl (range, 56-127 mg/dl)) was lower than that in the non-NF1 control group (102 mg/dl (range, 85-146 mg/dl)) (P<0.001). Prevalence of FBG level ≥100 mg/dl in the NF1 group (16%) was lower than that in the non-NF1 control group (63%) (P<0.05). The chance of a high FBG level was 89% lower in the NF1 group (odds ratio, 0.112; 95% CI, 0.067-0.188) (P<0.05). In conclusion, adults with NF1 showed a lower FBG level and a lower prevalence of high FBG level compared with non-NF1 controls.
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Affiliation(s)
- Aline Stangherlin Martins
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Ann Kristine Jansen
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Luiz Oswaldo Carneiro Rodrigues
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Camila Maria Matos
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Marcio Leandro Ribeiro Souza
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Juliana Ferreira de Souza
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Maria de Fátima Haueisen Sander Diniz
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Sandhi Maria Barreto
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Leonardo Mauricio Diniz
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Nilton Alves de Rezende
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Vincent Michael Riccardi
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
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Koga M, Yoshida Y, Imafuku S. Nutritional, muscular and metabolic characteristics in patients with neurofibromatosis type 1. J Dermatol 2015; 43:799-803. [PMID: 26705255 DOI: 10.1111/1346-8138.13218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/12/2015] [Indexed: 12/20/2022]
Abstract
Neurofibromatosis type 1 (NF1) has many reported clinical characteristics. We previously found that NF1 patients (especially men) had lower body mass index (BMI) than controls, but the reason has not been elucidated. To address this issue, a retrospectively case-control study was conducted. Anthropometric and serum chemistry data that potentially relate to BMI were collected from medical records of NF1 patients and their age- and sex-matched controls. Enrollment of 98 adult patients who underwent skin surgery with NF1 (41 men, 57 women) and 173 without NF1 (74 men, 99 women) were investigated. The median BMI in male NF1 patients was significantly lower than that of the controls. Triglycerides in male NF1 patients were significantly lower than male controls, creatine kinase and lactate dehydrogenase in NF1 patients were also lower than controls, aspartate aminotransferase and alanine aminotransferase showed a lower tendency in NF1 patients, but were significantly lower in female patients. With correlation analysis, lactate dehydrogenase was moderately correlated with BMI in male NF1 patients. Creatine kinase and creatinine showed no statistical correlation with BMI in either group. Triglycerides and alanine aminotransferase showed a positive correlation with BMI in both male and female controls, but not in NF1 patients. In conclusion, only lactate dehydrogenase was moderately correlated with BMI in male NF1 patients, although results of some nutritional and metabolic parameters suggest a specific metabolism in NF1.
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Affiliation(s)
- Monji Koga
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yuichi Yoshida
- Department of Medicine of Sensory and Motor Organs, Division of Dermatology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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