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Trinh B, Rasmussen Rinnov A, Winning Iepsen U, Winding Munch G, Munch Winding K, Lauridsen C, Gluud LL, van Hall G, Ellingsgaard H. Glucose turnover at whole-body and skeletal muscle level in response to parenteral nutrition in male patients with alcoholic liver cirrhosis. Clin Nutr ESPEN 2024; 60:240-246. [PMID: 38479917 DOI: 10.1016/j.clnesp.2024.02.013] [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: 12/06/2023] [Revised: 01/21/2024] [Accepted: 02/09/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Cirrhosis is associated with insulin resistance and impaired glucose tolerance, which may be caused by impairments at different tissue levels (liver, skeletal muscle, and/or beta cell). METHODS Here, glucose kinetics at whole-body and skeletal muscle level in patients with cirrhosis (Child-Pugh A and B) were studied during parenteral nutrition using the isotope dilution technique and arteriovenous balance approach across the leg. As opposed to the euglycemic hyperinsulinemic clamp or glucose tolerance tests applied in previous studies, this approach provides a nutrient composition more similar to a normal meal while circumventing any possible portal-systemic shunting, impaired hepatic uptake and incretin effect. RESULTS We confirmed the presence of hepatic and peripheral insulin resistance in our patient population. Endogenous glucose production was less suppressed in response to parenteral nutrition. However, glucose uptake in skeletal muscle was increased. CONCLUSION Our results suggests that in our study participants with cirrhosis, the hepatic and peripheral insulin resistance is compensated for by increased insulin secretion and thus, increased glucose uptake in muscle. Hereby, glucose homeostasis is maintained.
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Affiliation(s)
- Beckey Trinh
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark.
| | - Anders Rasmussen Rinnov
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Ulrik Winning Iepsen
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark; Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital - Hvidovre Hospital, Copenhagen, Denmark
| | - Gregers Winding Munch
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Kamilla Munch Winding
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Carsten Lauridsen
- Department of Diagnostic Radiology, Copenhagen University Hospital - Rigshospitalet, Denmark; Department of Technology, Copenhagen University College, Denmark
| | - Lise Lotte Gluud
- Gastrounit, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Gerrit van Hall
- Clinical Metabolomics Core Facility, Clinical Biochemistry, Copenhagen University Hospital, Department of Biomedical Sciences, Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helga Ellingsgaard
- The Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Denmark
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2
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Vorotnikov AV, Popov DV, Makhnovskii PA. Signaling and Gene Expression in Skeletal Muscles in Type 2 Diabetes: Current Results and OMICS Perspectives. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:1021-1034. [PMID: 36180992 DOI: 10.1134/s0006297922090139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/16/2023]
Abstract
Skeletal muscles mainly contribute to the emergence of insulin resistance, impaired glucose tolerance and the development of type 2 diabetes. Molecular mechanisms that regulate glucose uptake are diverse, including the insulin-dependent as most important, and others as also significant. They involve a wide range of proteins that control intracellular traffic and exposure of glucose transporters on the cell surface to create an extensive regulatory network. Here, we highlight advantages of the omics approaches to explore the insulin-regulated proteins and genes in human skeletal muscle with varying degrees of metabolic disorders. We discuss methodological aspects of the assessment of metabolic dysregulation and molecular responses of human skeletal muscle to insulin. The known molecular mechanisms of glucose uptake regulation and the first results of phosphoproteomic and transcriptomic studies are reviewed, which unveiled a large-scale array of insulin targets in muscle cells. They demonstrate that a clear depiction of changes that occur during metabolic dysfunction requires systemic and combined analysis at different levels of regulation, including signaling pathways, transcription factors, and gene expression. Such analysis seems promising to explore yet undescribed regulatory mechanisms of glucose uptake by skeletal muscle and identify the key regulators as potential therapeutic targets.
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Affiliation(s)
- Alexander V Vorotnikov
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, 123007, Russia.
- National Medical Research Center of Cardiology, Ministry of Healthcare of the Russian Federation, Moscow, 121552, Russia
| | - Daniil V Popov
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, 123007, Russia.
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Pavel A Makhnovskii
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, 123007, Russia
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Hall KD, Farooqi IS, Friedman JM, Klein S, Loos RJF, Mangelsdorf DJ, O'Rahilly S, Ravussin E, Redman LM, Ryan DH, Speakman JR, Tobias DK. The energy balance model of obesity: beyond calories in, calories out. Am J Clin Nutr 2022; 115:1243-1254. [PMID: 35134825 PMCID: PMC9071483 DOI: 10.1093/ajcn/nqac031] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/02/2022] [Indexed: 02/06/2023] Open
Abstract
A recent Perspective article described the "carbohydrate-insulin model (CIM)" of obesity, asserting that it "better reflects knowledge on the biology of weight control" as compared with what was described as the "dominant energy balance model (EBM)," which fails to consider "biological mechanisms that promote weight gain." Unfortunately, the Perspective conflated and confused the principle of energy balance, a law of physics that is agnostic as to obesity mechanisms, with the EBM as a theoretical model of obesity that is firmly based on biology. In doing so, the authors presented a false choice between the CIM and a caricature of the EBM that does not reflect modern obesity science. Here, we present a more accurate description of the EBM where the brain is the primary organ responsible for body weight regulation operating mainly below our conscious awareness via complex endocrine, metabolic, and nervous system signals to control food intake in response to the body's dynamic energy needs as well as environmental influences. We also describe the recent history of the CIM and show how the latest "most comprehensive formulation" abandons a formerly central feature that required fat accumulation in adipose tissue to be the primary driver of positive energy balance. As such, the new CIM can be considered a special case of the more comprehensive EBM but with a narrower focus on diets high in glycemic load as the primary factor responsible for common obesity. We review data from a wide variety of studies that address the validity of each model and demonstrate that the EBM is a more robust theory of obesity than the CIM.
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Affiliation(s)
- Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - I Sadaf Farooqi
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge
| | | | - Samuel Klein
- Washington University School of Medicine in St Louis
| | - Ruth J F Loos
- Washington University School of Medicine in St Louis.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen
| | | | - Stephen O'Rahilly
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge
| | | | | | | | - John R Speakman
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzen, China, and the University of Aberdeen, Aberdeen, United Kingdom
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4
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Samsonov MV, Podkuychenko NV, Khapchaev AY, Efremov EE, Yanushevskaya EV, Vlasik TN, Lankin VZ, Stafeev IS, Skulachev MV, Shestakova MV, Vorotnikov AV, Shirinsky VP. AICAR Protects Vascular Endothelial Cells from Oxidative Injury Induced by the Long-Term Palmitate Excess. Int J Mol Sci 2021; 23:ijms23010211. [PMID: 35008640 PMCID: PMC8745318 DOI: 10.3390/ijms23010211] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/14/2022] Open
Abstract
Hyperlipidemia manifested by high blood levels of free fatty acids (FFA) and lipoprotein triglycerides is critical for the progression of type 2 diabetes (T2D) and its cardiovascular complications via vascular endothelial dysfunction. However, attempts to assess high FFA effects in endothelial culture often result in early cell apoptosis that poorly recapitulates a much slower pace of vascular deterioration in vivo and does not provide for the longer-term studies of endothelial lipotoxicity in vitro. Here, we report that palmitate (PA), a typical FFA, does not impair, by itself, endothelial barrier and insulin signaling in human umbilical vein endothelial cells (HUVEC), but increases NO release, reactive oxygen species (ROS) generation, and protein labeling by malondialdehyde (MDA) hallmarking oxidative stress and increased lipid peroxidation. This PA-induced stress eventually resulted in the loss of cell viability coincident with loss of insulin signaling. Supplementation with 5-aminoimidazole-4-carboxamide-riboside (AICAR) increased endothelial AMP-activated protein kinase (AMPK) activity, supported insulin signaling, and prevented the PA-induced increases in NO, ROS, and MDA, thus allowing to maintain HUVEC viability and barrier, and providing the means to study the long-term effects of high FFA levels in endothelial cultures. An upgraded cell-based model reproduces FFA-induced insulin resistance by demonstrating decreased NO production by vascular endothelium.
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Affiliation(s)
- Mikhail V. Samsonov
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Nikita V. Podkuychenko
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Asker Y. Khapchaev
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Eugene E. Efremov
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Elena V. Yanushevskaya
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Tatiana N. Vlasik
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Vadim Z. Lankin
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Iurii S. Stafeev
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
| | - Maxim V. Skulachev
- Belozersky Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, 119234 Moscow, Russia;
| | | | - Alexander V. Vorotnikov
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
- Correspondence: (A.V.V.); (V.P.S.)
| | - Vladimir P. Shirinsky
- National Medical Research Center for Cardiology, 121552 Moscow, Russia; (M.V.S.); (N.V.P.); (A.Y.K.); (E.E.E.); (E.V.Y.); (T.N.V.); (V.Z.L.); (I.S.S.)
- Correspondence: (A.V.V.); (V.P.S.)
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Blocking endogenous IL-6 impairs mobilization of free fatty acids during rest and exercise in lean and obese men. CELL REPORTS MEDICINE 2021; 2:100396. [PMID: 34622233 PMCID: PMC8484687 DOI: 10.1016/j.xcrm.2021.100396] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/03/2021] [Accepted: 08/17/2021] [Indexed: 12/26/2022]
Abstract
Lack of interleukin-6 (IL-6) leads to expansion of adipose tissue mass in rodents and humans. The exact underlying mechanisms have not been identified. In this placebo-controlled, non-randomized, participant-blinded crossover study, we use the IL-6 receptor antibody tocilizumab to investigate the role of endogenous IL-6 in regulating systemic energy metabolism at rest and during exercise and recovery in lean and obese men using tracer dilution methodology. Tocilizumab reduces fatty acid appearance in the circulation under all conditions in lean and obese individuals, whereas lipolysis (the rate of glycerol appearance into the circulation) is mostly unaffected. The fact that fatty acid oxidation is unaffected by IL-6 receptor blockade suggests increased re-esterification of fatty acids. Glucose kinetics are unaffected. We find that blocking endogenous IL-6 signaling with tocilizumab impairs fat mobilization, which may contribute to expansion of adipose tissue mass and, thus, affect the health of individuals undergoing anti-IL-6 therapy (Clinicaltrials.gov: NCT03967691).
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6
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Samms RJ, Coghlan MP, Sloop KW. How May GIP Enhance the Therapeutic Efficacy of GLP-1? Trends Endocrinol Metab 2020; 31:410-421. [PMID: 32396843 DOI: 10.1016/j.tem.2020.02.006] [Citation(s) in RCA: 195] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/30/2020] [Accepted: 02/06/2020] [Indexed: 12/25/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists improve glucose homeostasis, reduce bodyweight, and over time benefit cardiovascular health in type 2 diabetes mellitus (T2DM). However, dose-related gastrointestinal effects limit efficacy, and therefore agents possessing GLP-1 pharmacology that can also target alternative pathways may expand the therapeutic index. One approach is to engineer GLP-1 activity into the sequence of glucose-dependent insulinotropic polypeptide (GIP). Although the therapeutic implications of the lipogenic actions of GIP are debated, its ability to improve lipid and glucose metabolism is especially evident when paired with the anorexigenic mechanism of GLP-1. We review the complexity of GIP in regulating adipose tissue function and energy balance in the context of recent findings in T2DM showing that dual GIP/GLP-1 receptor agonist therapy produces profound weight loss, glycemic control, and lipid lowering.
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Affiliation(s)
- Ricardo J Samms
- Diabetes and Complications, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Matthew P Coghlan
- Diabetes and Complications, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Kyle W Sloop
- Diabetes and Complications, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.
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