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Majumdar SK. Triglyceride Clearance in Hypertriglyceridemic Pancreatitis: Time Course and Its Implications for Management. Endocr Pract 2023; 29:971-979. [PMID: 37714331 DOI: 10.1016/j.eprac.2023.09.002] [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: 07/04/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE To characterize the time course of triglyceride (Tg) lowering in hypertriglyceridemic (HTg) pancreatitis according to the initial Tg values, causes, and interventions. METHODS Patients hospitalized from October 2013 through December of 2018 with a diagnosis of pancreatitis associated with HTg (Tg level, ≥500 mg/dL), in the absence of other causes, were identified by medical record review. Tg lowering was retrospectively assessed for differences in relation to the initial Tg values, use of intravenous insulin, ethanol-associated versus nonethanol-associated causes, and time to Tg values of <500 versus <1000 mg/dL. RESULTS Sixty-six cases were identified, and 45 had multiple measurements for time-course evaluation. Those with initial Tg values of <4000 mg/dL achieved Tg levels of <1000 mg/dL in <3 days, whereas 18.8% with higher values took 5-9 days. Insulin therapy was associated with a longer duration of HTg, whereas ethanol was associated with a shorter duration. Tg clearance in ethanol-associated HTg appeared independent of insulin treatment. Time to Tg levels of <500 mg/dL versus <1000 mg/dL was significantly longer when the initial Tg levels were >2000 mg/dL. CONCLUSION A threshold of 4000 mg/dL for the initial Tg levels in HTg pancreatitis appears to separate patients who are likely to achieve Tg levels of <1000 mg/dL in <3 versus >3 days, independent of cause or treatment. Insulin therapy is appropriate for patients with hyperglycemia but appears unnecessary for those with isolated ethanol-associated HTg. A threshold Tg level of <1000 mg/dL appears more practical than that of <500 mg/dL for resuming nutritional intake.
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Affiliation(s)
- Sachin K Majumdar
- Section of Endocrinology, Yale University School of Medicine, New Haven, Connecticut; Departments of Endocrinology and Internal Medicine, Bridgeport Hospital, Yale New Haven Health System, Bridgeport, Connecticut.
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Gubensek J. The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis-a concise review. BMC Gastroenterol 2023; 23:341. [PMID: 37789261 PMCID: PMC10546782 DOI: 10.1186/s12876-023-02957-3] [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: 06/22/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
Severe hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP) and is involved in its pathogenesis. Chylomicrons increase blood viscosity and induce ischemia, while free fatty acids induce inflammation and distant organ damage. Conservative treatment options include fasting and insulin; limited evidence shows their comparable efficacy. Plasma exchange might provide more rapid lowering of triglycerides and amelioration of systemic effects of severe AP. Available data from controlled studies show only moderately faster lowering of triglycerides with apheresis (about 70% vs. 50% with conservative treatment within 24 h) and limited data from non-randomized studies show no improvement in clinical outcomes. New evidence is expected soon from ongoing large randomized trials. Until then, insulin may be used in mild HTG-AP and plasma exchange should be considered only in severe HTG-AP, especially if the decline of triglycerides with conservative treatment is slow, and in HTG-AP during pregnancy.
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Affiliation(s)
- Jakob Gubensek
- Department of Nephrology, University Medical Center Ljubljana, Zaloska cesta 7, 1000, Ljubljana, Slovenia.
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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Cook JR, Kohan AB, Haeusler RA. An Updated Perspective on the Dual-Track Model of Enterocyte Fat Metabolism. J Lipid Res 2022; 63:100278. [PMID: 36100090 PMCID: PMC9593242 DOI: 10.1016/j.jlr.2022.100278] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/08/2022] [Accepted: 08/31/2022] [Indexed: 02/04/2023] Open
Abstract
The small intestinal epithelium has classically been envisioned as a conduit for nutrient absorption, but appreciation is growing for a larger and more dynamic role for enterocytes in lipid metabolism. Considerable gaps remain in our knowledge of this physiology, but it appears that the enterocyte's structural polarization dictates its behavior in fat partitioning, treating fat differently based on its absorption across the apical versus the basolateral membrane. In this review, we synthesize existing data and thought on this dual-track model of enterocyte fat metabolism through the lens of human integrative physiology. The apical track includes the canonical pathway of dietary lipid absorption across the apical brush-border membrane, leading to packaging and secretion of those lipids as chylomicrons. However, this track also reserves a portion of dietary lipid within cytoplasmic lipid droplets for later uses, including the "second-meal effect," which remains poorly understood. At the same time, the enterocyte takes up circulating fats across the basolateral membrane by mechanisms that may include receptor-mediated import of triglyceride-rich lipoproteins or their remnants, local hydrolysis and internalization of free fatty acids, or enterocyte de novo lipogenesis using basolaterally absorbed substrates. The ultimate destinations of basolateral-track fat may include fatty acid oxidation, structural lipid synthesis, storage in cytoplasmic lipid droplets, or ultimate resecretion, although the regulation and purposes of this basolateral track remain mysterious. We propose that the enterocyte integrates lipid flux along both of these tracks in order to calibrate its overall program of lipid metabolism.
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Affiliation(s)
- Joshua R. Cook
- Naomi Berrie Diabetes Center, Columbia University College of Physicians and Surgeons, New York, NY, USA,Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Alison B. Kohan
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca A. Haeusler
- Naomi Berrie Diabetes Center, Columbia University College of Physicians and Surgeons, New York, NY, USA,Department of Pathology and Cell Biology; Columbia University College of Physicians and Surgeons, New York, NY, USA,For correspondence: Rebecca A. Haeusler
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Stenkula KG, Klemendz LE, Fryklund C, Wierup N, Alsalim W, Landin-Olsson M, Trinh L, Månsson S, Bennet L. Postprandial triglyceride levels rather than fat distribution may reflect early signs of disturbed fat metabolism in Iraqi immigrants. Lipids Health Dis 2022; 21:68. [PMID: 35927727 PMCID: PMC9351238 DOI: 10.1186/s12944-022-01679-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/19/2022] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Previous studies have shown that at a similar body mass index, Middle Eastern immigrants are more insulin resistant and at higher risk for type 2 diabetes (T2D) than native Europeans. Insulin resistance is strongly associated with disturbed fat metabolism and cardiovascular disease (CVD). However, fat metabolism is poorly investigated comparing Middle Eastern and European ethnicities. METHODS This observational study included 26 Iraqi and 16 Swedish-born men without T2D or clinical risk factors for CVD. An oral fat tolerance test (OFTT) was performed, where plasma triglycerides (p-TG) were measured for 6 h. mRNA expression and adipocyte size were measured in subcutaneous adipose tissue biopsies collected prior to OFTT, and magnetic resonance imaging was conducted to assess body fat distribution. RESULTS The median p-TG accumulation was higher and the clearance slower among Iraqis than Swedes. None of the groups reached their fasting p-TG (Iraqis 1.55 mmol/l; Swedes 0.95 mmol/l) after 6 h (Iraqis p-TG 3.10 mmol/l; Swedes p-TG 1.50 mmol/l). Adipocyte size, mRNA expression, and fat accumulation in the liver, muscle and abdomen were similar in both groups. CONCLUSION Postprandial p-TG levels rather than fat distribution may reflect early signs of disturbed fat metabolism in Iraqi immigrants without CVD risk factors.
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Affiliation(s)
- Karin G Stenkula
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden.
| | | | - Claes Fryklund
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden
| | - Wathik Alsalim
- Lund University, Skåne University Hospital Lund, Lund, Sweden
| | | | - Lena Trinh
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Sven Månsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Louise Bennet
- Lund University, Skåne University Hospital Lund, Lund, Sweden
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Saturated Fat and Cardiovascular Health: Phenotype and Dietary Factors Influencing Interindividual Responsiveness. Curr Atheroscler Rep 2022; 24:391-398. [PMID: 35320834 DOI: 10.1007/s11883-022-01014-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Recent inconsistencies in nutrition research studies examining the influence of saturated fat (SFA) on cardiovascular disease (CVD) risk have led to substantial scientific debate and increased public confusion. This review will summarize metabolic characteristics and food-based factors that underlie interindividual responsiveness to SFA consumption. RECENT FINDINGS The magnitude of postprandial blood lipid responses to SFA intake is dependent on a number of individual factors including age, sex, and adiposity status. Further, the metabolic effects of SFA intake are influenced by the specific types of SFAs and the food matrix within which they are contained. Importantly, results from research examining the effects of SFA on CVD risk should be interpreted with consideration of the comparator nutrient (i.e., carbohydrate, monounsaturated fat, polyunsaturated fat). A more nuanced understanding of the multitude of factors mediating the influence of SFA on lipid metabolism and CVD risk might help resolve the current controversy and inform more precise personalized recommendations for future dietary guidelines.
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Lebrun LJ, Moreira S, Tavernier A, Niot I. Postprandial consequences of lipid absorption in the onset of obesity: Role of intestinal CD36. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159154. [DOI: 10.1016/j.bbalip.2022.159154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
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Yin L, Zhang L, Luo L, Liu Y, Wang F, Feng Y, Wang H, Han Y, Yan Y, Huang C, Fan S. Berbamine reduces body weight via suppression of small GTPase Rab8a activity and activation of paraventricular hypothalamic neurons in obese mice. Eur J Pharmacol 2022; 916:174679. [PMID: 34982965 DOI: 10.1016/j.ejphar.2021.174679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/22/2021] [Accepted: 12/02/2021] [Indexed: 11/03/2022]
Abstract
Small GTPase Rab8a is involved in fat-specific protein 27 (Fsp27) mediated lipid droplet accumulation in adipocytes. By screening inhibitors of Rab8a GTPase from a natural compound library, berbamine (BBM), a marketing drug for treatment of leukopenia in China, was identified to inhibit the activity of Rab8a GTPase and block the differentiation of 3T3-L1 adipocytes. Animal study showed that BBM could reduce body weight, improved glucose and lipid metabolic homeostasis in high-fat diet-induced obesity (DIO) C57BL/6 mice and db/db mice. Additional, BBM increased energy expenditure and inhibited food intake in mice but not in lean mice. Moreover, intracerebroventricular injection (i.c.v.) of BBM inhibited feeding behavior and increased c-Fos expression in paraventricular nucleus of the hypothalamus (PVH) of mice. Our data suggest that BBM may improve obesity through the inhibition of Rab8a GTPase activity and the activation of anorexigenic energy-sensing neuron in PVH.
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Affiliation(s)
- Liufang Yin
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China; Department of Pharmacy, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, China
| | - Lijun Zhang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Lingling Luo
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yalei Liu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fei Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yaru Feng
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hongqing Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yongli Han
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yingxuan Yan
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Cheng Huang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Shengjie Fan
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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The effect of berberine supplementation on obesity indices: A dose- response meta-analysis and systematic review of randomized controlled trials. Complement Ther Clin Pract 2020; 39:101113. [PMID: 32379652 DOI: 10.1016/j.ctcp.2020.101113] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND and purpose: Clinical studies investigating the effects of berberine supplementation on anthropometric indices in humans have generated inconsistent results. Thus, the objective of this systematic review and meta-analysis was to clarify the effects of berberine supplementation on obesity indices in human subjects. METHODS Several online medical databases were systematically searched up to February 2019. All clinical trials exploring the effects of berberine supplementation on indices of obesity were included. The combined weighted mean difference (WMD) of eligible studies was assessed using a random-effects model. We evaluated publication bias by using the Egger's test. RESULTS Overall, 10 studies were included. The combined outcomes suggested a significant influence of berberine administration on body mass index (BMI) (WMD: -0.29 kg/m2, 95% CI: -0.51 to -0.08, p = 0.006) and waist circumference (WC) (WMD: -2.75 cm, 95% CI: -4.88 to -0.62, p = 0.01). However, berberine supplementation yielded no significant decline in body weight (BW) (WMD: -0.11 kg, 95% CI: -0.99 to 0.76, p = 0.79). Following the dose-response evaluation, berberine intake was found to significantly reduce BMI (r = -0.02) and WC (r = -0.72) based on treatment duration. CONCLUSION The results of the current study support the use of berberine supplementation for the improvement of obesity indices.
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Stahel P, Xiao C, Nahmias A, Lewis GF. Role of the Gut in Diabetic Dyslipidemia. Front Endocrinol (Lausanne) 2020; 11:116. [PMID: 32231641 PMCID: PMC7083132 DOI: 10.3389/fendo.2020.00116] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes (T2D) is associated with increased risk of cardiovascular disease (CVD). In insulin resistant states such as the metabolic syndrome, overproduction and impaired clearance of liver-derived very-low-density lipoproteins and gut-derived chylomicrons (CMs) contribute to hypertriglyceridemia and elevated atherogenic remnant lipoproteins. Although ingested fat is the major stimulus of CM secretion, intestinal lipid handling and ultimately CM secretory rate is determined by numerous additional regulatory inputs including nutrients, hormones and neural signals that fine tune CM secretion during fasted and fed states. Insulin resistance and T2D represent perturbed metabolic states in which intestinal sensitivity to key regulatory hormones such as insulin, leptin and glucagon-like peptide-1 (GLP-1) may be altered, contributing to increased CM secretion. In this review, we describe the evidence from human and animal models demonstrating increased CM secretion in insulin resistance and T2D and discuss the molecular mechanisms underlying these effects. Several novel compounds are in various stages of preclinical and clinical investigation to modulate intestinal CM synthesis and secretion. Their efficacy, safety and therapeutic utility are discussed. Similarly, the effects of currently approved lipid modulating therapies such as statins, ezetimibe, fibrates, and PCSK9 inhibitors on intestinal CM production are discussed. The intricacies of intestinal CM production are an active area of research that may yield novel therapies to prevent atherosclerotic CVD in insulin resistance and T2D.
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Larsen MA, Isaksen VT, Paulssen EJ, Goll R, Florholmen JR. Postprandial leptin and adiponectin in response to sugar and fat in obese and normal weight individuals. Endocrine 2019; 66:517-525. [PMID: 31605363 DOI: 10.1007/s12020-019-02102-9] [Citation(s) in RCA: 11] [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: 05/15/2019] [Accepted: 09/26/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Adipokines produced by white adipose tissue are central in the development of lifestyle diseases. Individuals in industrialized countries spend a substantial part of life in the non-fasting, postprandial state, which is associated with increased oxidation and inflammation. The aim was to study postprandial adiponectin and leptin levels after an oral fat tolerance test (OFTT) and an oral glucose tolerance test (OGTT) in obese (OB) and healthy, normal weight individuals (NW). METHODS Fifty adults with obesity (BMI ≥ 30) and 17 healthy, NW were included. Postprandial triglyceride (TG), adiponectin, and leptin levels were measured every second hour during an 8 h OFTT, and every half hour during a 2 h OGTT. RESULTS Compared with the basal level, postprandial levels of adiponectin following OFTT showed a slight initial peak, followed by a significant decrease at 8 h, in the NW. In the OB these changes were abolished. Postprandial levels of leptin decreased significantly from basal levels in the OFTT, in the NW, whereas in the OB, leptin was unchanged except for a slight increase from 2 to 8 h. During the OGTT both adiponectin and leptin levels remained unchanged in the NW, but decreased significantly in the OB. In addition, the OB had delayed TG clearance at 6 h. CONCLUSIONS A fatty meal gives postprandial changes in the secretion of adiponectin and leptin in NW, but not in OB. Our observations indicate that a potential postprandial regulatory role of adiponectin and leptin is impaired in OB, and of importance in a more comprehensive understanding of the delayed postprandial TG clearance in obese individuals.
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Affiliation(s)
- M A Larsen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - V T Isaksen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - E J Paulssen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - R Goll
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - J R Florholmen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Larsen MA, Isaksen VT, Moen OS, Wilsgaard L, Remijn M, Paulssen EJ, Florholmen J, Goll R. Leptin to adiponectin ratio - A surrogate biomarker for early detection of metabolic disturbances in obesity. Nutr Metab Cardiovasc Dis 2018; 28:1114-1121. [PMID: 30145019 DOI: 10.1016/j.numecd.2018.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/05/2018] [Accepted: 06/26/2018] [Indexed: 01/11/2023]
Abstract
AIM To study if the leptin to adiponectin (L:A) ratio, can be a potential biomarker for postprandial triglyceride clearance, insulin resistance (IR) or leptin resistance (LR) in apparently healthy obese, and obese individuals with established metabolic disease. METHODS AND RESULTS Fifty adult subjects with obesity (BMI ≥30); of which 36 metabolic healthy obese (MHO), and 14 metabolic dysregulated obese (MDO), with clinical and/or biochemical signs of metabolic disease were included. Seventeen healthy, normal weight subjects represented the control group. Postprandial triglyceride (TG) levels were measured in an 8 h oral fat tolerance test (OFTT). IR by HOMA-IR, L:A ratio and indirect LR were measured. In the MHO group, 71.4%, 69.4% and 86.1%, had delayed TG clearance, IR and LR, respectively; whereas in the MDO group this was detected in 85.7%, 71.4% and 91.7%, respectively. A combination of all three metabolic risk factors was found in 39.8% of the MHO and in 42.9% of the MDO patients. Receiver operating characteristics (ROC) analysis revealed that a cut-off value for the L:A ratio of >1.65 for the control group (PPV 1.0, NPV 0.91) and >3.65 for the obese subjects (PPV 0.86, NPV 0.48) predicted the delayed TG clearance with a good specificity and sensitivity. Detecting a combined risk with at least 2/3 metabolic risk factors, the ROC yielded the most suitable L:A ratio cut-off at >1.88. CONCLUSION L:A ratio was able to detect early metabolic disturbances in obese individuals, and may be a potential useful clinical surrogate biomarker of metabolic disorders.
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Affiliation(s)
- M A Larsen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - V T Isaksen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - O S Moen
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - L Wilsgaard
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - M Remijn
- Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - E J Paulssen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - J Florholmen
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - R Goll
- Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Nephrology and Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Cartier LJ, Collins C, Lagacé M, Douville P. Comparison of fasting and non-fasting lipid profiles in a large cohort of patients presenting at a community hospital. Clin Biochem 2018; 52:61-66. [DOI: 10.1016/j.clinbiochem.2017.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/01/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
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Firouzi S, Malekahmadi M, Ghayour-Mobarhan M, Ferns G, Rahimi HR. Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action. Diabetes Metab Syndr Obes 2018; 11:699-705. [PMID: 30519065 PMCID: PMC6233907 DOI: 10.2147/dmso.s181572] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Obesity is a consequence of an imbalance between energy intake and energy expenditure. It affects people of both genders and all age groups, ethnicity and socioeconomic groups, and in developed and developing countries. Obesity is often accompanied by the metabolic syndrome (MetS). MetS is characterized by a clustering of cardiovascular risk factors, including high blood pressure, adiposity, dyslipidemia and glucose intolerance, which together increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus and other causes of mortality. Nowadays, there is a growing interest in the use of plant-based agents instead of synthetic drugs to manage chronic diseases such as MetS; one such example is Berberis vulgaris. B. vulgaris contains isoquinonline alkaloids such as berberine, berberrubine and berbamine. Recent studies have proved that berberine exhibits pharmacological activities and positive effects on the risk factors of obesity and MetS. We have reviewed original articles related to the possible molecular mechanisms of action of berberine on obesity and MetS. Berberine suppresses adipocyte differentiation and decreases obesity. It also regulates glucose metabolism via decreasing insulin resistance and increasing insulin secretion. Other effects of berberine include antihyperlipidemic and antihypertensive activities and endothelial protection.
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Affiliation(s)
- Safieh Firouzi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, ,
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Malekahmadi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, ,
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, ,
- Department of Modern Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, , ,
| | - Gordon Ferns
- Department of Medical Education, Brighton and Sussex Medical School, University of Brighton Falmer Campus, Brighton, UK
| | - Hamid Reza Rahimi
- Department of Modern Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, , ,
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,
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Recreational football practice attenuates postprandial lipaemia in normal and overweight individuals. Eur J Appl Physiol 2017; 118:261-270. [DOI: 10.1007/s00421-017-3766-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/14/2017] [Indexed: 01/01/2023]
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Higgins V, Adeli K. Postprandial Dyslipidemia: Pathophysiology and Cardiovascular Disease Risk Assessment. EJIFCC 2017; 28:168-184. [PMID: 29075168 PMCID: PMC5655632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although the fed state predominates over the course of a day, the fasting lipid profile has traditionally been used to assess cardiovascular disease (CVD) risk. The nonfasting lipid profile may be more reflective of the daily circulating plasma lipids and simplifies lipid monitoring for patients, laboratories, and clinicians. Nonfasting triglyceride levels are also independently associated with cardiovascular events, leading to several clinical guidelines (e.g. in Denmark, the UK, Europe, and Canada) now recommending nonfasting lipid testing in the primary prevention setting. Obese and insulin resistant states are associated with intestinal chylomicron overproduction and subsequent remnant lipoprotein accumulation, leading to development of postprandial dyslipidemia in the fed state. Postprandial dyslipidemia is thought to be a major contributor of atherogenesis and shown to be an important CVD risk factor. As intestinal peptides (e.g. glucagon-like-peptide 1; GLP-1) have been shown to regulate chylomicron output, alterations in these signaling pathways in insulin resistant states may play a role in the development and/or progression of postprandial dyslipidemia. Although several advances have been made in understanding postprandial dyslipidemia in insulin resistance and its association with CVD, several limitations remain. Although nonfasting lipid measurements (i.e. random blood sampling) are now recommended in some countries, a more functional assessment of postprandial lipemia involves ingestion of a high-fat meal with subsequent blood collection over a specified time period (i.e. oral fat tolerance test). However, oral fat tolerance test methodology remains largely unstandardized and reference values to interpret postprandial values remain to be accurately established. Development of standardized methodologies and biomarker profiles for assessment of postprandial dyslipidemia in clinical practice will enable early and accurate identification of those at risk for CVD.
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Affiliation(s)
- Victoria Higgins
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada, Department of Laboratory Medicine & Pathobiology, University of Toronto, Ontario, Canada
| | - Khosrow Adeli
- CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada, Department of Laboratory Medicine & Pathobiology, University of Toronto, Ontario, Canada,Clinical Biochemistry, DPLM The Hospital for Sick Children 555 University Avenue Toronto, ON, M5G 1X8 Canada
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Buttet M, Poirier H, Traynard V, Gaire K, Tran TTT, Sundaresan S, Besnard P, Abumrad NA, Niot I. Deregulated Lipid Sensing by Intestinal CD36 in Diet-Induced Hyperinsulinemic Obese Mouse Model. PLoS One 2016; 11:e0145626. [PMID: 26727015 PMCID: PMC4703141 DOI: 10.1371/journal.pone.0145626] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/07/2015] [Indexed: 12/28/2022] Open
Abstract
The metabolic syndrome (MetS) greatly increases risk of cardiovascular disease and diabetes and is generally associated with abnormally elevated postprandial triglyceride levels. We evaluated intestinal synthesis of triglyceride-rich lipoproteins (TRL) in a mouse model of the MetS obtained by feeding a palm oil-rich high fat diet (HFD). By contrast to control mice, MetS mice secreted two populations of TRL. If the smaller size population represented 44% of total particles in the beginning of intestinal lipid absorption in MetS mice, it accounted for only 17% after 4 h due to the secretion of larger size TRL. The MetS mice displayed accentuated postprandial hypertriglyceridemia up to 3 h due to a defective TRL clearance. These alterations reflected a delay in lipid induction of genes for key proteins of TRL formation (MTP, L-FABP) and blood clearance (ApoC2). These abnormalities associated with blunted lipid sensing by CD36, which is normally required to optimize jejunal formation of large TRL. In MetS mice CD36 was not downregulated by lipid in contrast to control mice. Treatment of controls with the proteosomal inhibitor MG132, which prevented CD36 downregulation, resulted in blunted lipid-induction of MTP, L-FABP and ApoC2 gene expression, as in MetS mice. Absence of CD36 sensing was due to the hyperinsulinemia in MetS mice. Acute insulin treatment of controls before lipid administration abolished CD36 downregulation, lipid-induction of TRL genes and reduced postprandial triglycerides (TG), while streptozotocin-treatment of MetS mice restored lipid-induced CD36 degradation and TG secretion. In vitro, insulin treatment abolished CD36-mediated up-regulation of MTP in Caco-2 cells. In conclusion, HFD treatment impairs TRL formation in early stage of lipid absorption via insulin-mediated inhibition of CD36 lipid sensing. This impairment results in production of smaller TRL that are cleared slowly from the circulation, which might contribute to the reported association of CD36 variants with MetS risk.
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Affiliation(s)
- Marjorie Buttet
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Hélène Poirier
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Véronique Traynard
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Kévin Gaire
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Thi Thu Trang Tran
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Sinju Sundaresan
- Department of Medicine, Gastroenterology Division, University of Michigan, Ann Arbor, Michigan, 48109, United States of America
| | - Philippe Besnard
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
| | - Nada A. Abumrad
- Department of Medicine, Center for Human Nutrition, and Department of Cell Biology & Physiology, Washington University School of Medicine, St. Louis, Missouri, 63110, United States of America
| | - Isabelle Niot
- Physiologie de la Nutrition et Toxicologie (NUTox), UMR U866 INSERM/Université de Bourgogne/AgroSup Dijon, F-21000, Dijon, France
- * E-mail:
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