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Ullah A, Zhao J, Singla RK, Shen B. Pathophysiological impact of CXC and CX3CL1 chemokines in preeclampsia and gestational diabetes mellitus. Front Cell Dev Biol 2023; 11:1272536. [PMID: 37928902 PMCID: PMC10620730 DOI: 10.3389/fcell.2023.1272536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Diabetes-related pathophysiological alterations and various female reproductive difficulties were common in pregnant women with gestational diabetes mellitus (GDM), who had 21.1 million live births. Preeclampsia (PE), which increases maternal and fetal morbidity and mortality, affects approximately 3%-5% of pregnancies worldwide. Nevertheless, it is unclear what triggers PE and GDM to develop. Therefore, the development of novel moderator therapy approaches is a crucial advancement. Chemokines regulate physiological defenses and maternal-fetal interaction during healthy and disturbed pregnancies. Chemokines regulate immunity, stem cell trafficking, anti-angiogenesis, and cell attraction. CXC chemokines are usually inflammatory and contribute to numerous reproductive disorders. Fractalkine (CX3CL1) may be membrane-bound or soluble. CX3CL1 aids cell survival during homeostasis and inflammation. Evidence reveals that CXC and CX3CL1 chemokines and their receptors have been the focus of therapeutic discoveries for clinical intervention due to their considerable participation in numerous biological processes. This review aims to give an overview of the functions of CXC and CX3CL1 chemokines and their receptors in the pathophysiology of PE and GDM. Finally, we examined stimulus specificity for CXC and CX3CL1 chemokine expression and synthesis in PE and GDM and preclinical and clinical trials of CXC-based PE and GDM therapies.
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Affiliation(s)
- Amin Ullah
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhao
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Rajeev K. Singla
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Bairong Shen
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine, Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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2
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Liu H, Liu A, Kaminga AC, McDonald J, Wen SW, Pan X. Chemokines in Gestational Diabetes Mellitus. Front Immunol 2022; 13:705852. [PMID: 35211112 PMCID: PMC8860907 DOI: 10.3389/fimmu.2022.705852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Studies investigating chemokines in gestational diabetes mellitus (GDM) have yielded mixed results. The purpose of this meta-analysis was to explore whether concentrations of chemokines in patients with GDM differed from that of the controls. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched Web of Science, Embase, Cochrane Library, and PubMed databases for articles, published in any language, on chemokines and GDM through August 1st, 2021. The difference in concentrations of chemokines between patients with GDM and controls was determined by a standardized mean difference (SMD) with a 95% confidence interval (CI), calculated in the meta-analysis of the eligible studies using a random-effects model with restricted maximum-likelihood estimator. Results Seventeen studies met the inclusion criteria for the meta-analysis. Altogether, they included nine different chemokines comparisons involving 5,158 participants (1,934 GDM patients and 3,224 controls). Results showed a significant increase of these chemokines (CCL2, CXCL1, CXCL8, CXCL9, and CXCL12) in the GDM patients compared with the controls. However, there was a significant decrease of the chemokines, CCL4, CCL11 and CXCL10, in the GDM patients compared with the controls. Moreover, subgroup analysis revealed a potential role of chemokines as biomarkers in relation to laboratory detection (different sample type and assay methods) and clinical characteristics of GDM patients (ethnicity and body mass index). Conclusion GDM is associated with several chemokines (CCL2, CCL4, CCL11, CXCL1, CXCL8, CXCL9, CXCL10 and CXCL12). Therefore, consideration of these chemokines as potential targets or biomarkers in the pathophysiology of GDM development is necessary. Notably, the information of subgroup analysis underscores the importance of exploring putative mechanisms underlying this association, in order to develop new individualized clinical and therapeutic strategies.
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Affiliation(s)
- Hongying Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa C Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Judy McDonald
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Shi Wu Wen
- OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Obstetrics and Gynaecology and School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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3
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Tu C, Wang L, Tao H, Gu L, Zhu S, Chen X. Expression of miR-409-5p in gestational diabetes mellitus and its relationship with insulin resistance. Exp Ther Med 2020; 20:3324-3329. [PMID: 32855704 PMCID: PMC7444361 DOI: 10.3892/etm.2020.9049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/19/2020] [Indexed: 12/12/2022] Open
Abstract
Expression of miR-409-5p in gestational diabetes mellitus (GDM) and its relationship with insulin resistance were explore. One hundred and forty-nine pregnant women who underwent antenatal examination in Taizhou First People's Hospital were divided into a GDM group and a control group according to whether they had GDM or not. Serum miR-409-5p expression of the two groups was detected, and the levels of glycosylated hemoglobin (HbAlc) and other GDM-related biochemical indicators were measured. Fasting plasma glucose (FPG) was determined by glucose oxidase method, fasting insulin (FINS) was detected by radioimmunoassay, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The relationship between miR-409-5p and other biochemical indicators and insulin resistance was analyzed, and logistic multivariate regression was employed to analyze the risk factors of GDM. miR-409-5p was highly expressed in the serum of GDM patients. HbAlc, FPG, FINS, and HOMA-IR in pregnant women in the GDM group were markedly higher than those in the control group. The serum miR-409-5p in GDM pregnant women showed a positive correlation with HbAlc, FPG, FINS, and HOMA-IR (P<0.05). The insulin resistance group presented remarkably higher serum miR-409-5p level than the non-insulin resistance group. Moreover, it was found that elevated miR-409-5p, FINS, and HOMA-IR were all independent risk factors for the onset of GDM. miR-409-5p is highly expressed in the serum of patients with GDM, and it is positively correlated with insulin resistance index of GDM patients, which may be a potential target for clinical diagnosis and treatment of GDM.
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Affiliation(s)
- Chuanfa Tu
- Department of Endocrinology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
| | - Lijun Wang
- Department of Endocrinology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
| | - Haiying Tao
- Department of Endocrinology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
| | - Lingjia Gu
- Department of Endocrinology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
| | - Shuang Zhu
- Department of Endocrinology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
| | - Xiaolu Chen
- Department of Obstetrics and Gynecology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, P.R. China
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Campos Lima T, Lemes JBP, Capop TFPA, de Lima LB, Monteiro da Cruz Lotufo C. Altered morphology and function of the peripheral nociceptive system in the offspring of diabetic rats. Int J Dev Neurosci 2020; 80:267-275. [PMID: 32144810 DOI: 10.1002/jdn.10023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to determine whether maternal diabetes induced by alloxan injection in the first gestational day of female Wistar rats interferes with the development of the nociceptive peripheral system of the offspring. Behavioral and histologic analysis was performed using the adult offspring of diabetic and control rats. It was found that the offspring of diabetic rats were more sensitive to thermal stimulation and showed an altered response to carrageenan-induced inflammatory hyperalgesia. The histological analysis showed an increased proportion of nociceptive neurons, while the population of non-nociceptive myelinated neurons was reduced. Therefore, exposition to hyperglycemia and/or hyperinsulinemia in uterus, caused by a diabetic mother, might result in altered nociceptive sensations in the offspring throughout life.
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Affiliation(s)
- Taís Campos Lima
- Área de Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Júlia Borges Paes Lemes
- Área de Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | | | - Lorena Borges de Lima
- Área de Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
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Gan WZ, Ramachandran V, Lim CSY, Koh RY. Omics-based biomarkers in the diagnosis of diabetes. J Basic Clin Physiol Pharmacol 2019; 31:/j/jbcpp.ahead-of-print/jbcpp-2019-0120/jbcpp-2019-0120.xml. [PMID: 31730525 DOI: 10.1515/jbcpp-2019-0120] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus (DM) is a group of metabolic diseases related to the dysfunction of insulin, causing hyperglycaemia and life-threatening complications. Current early screening and diagnostic tests for DM are based on changes in glucose levels and autoantibody detection. This review evaluates recent studies on biomarker candidates in diagnosing type 1, type 2 and gestational DM based on omics classification, whilst highlighting the relationship of these biomarkers with the development of diabetes, diagnostic accuracy, challenges and future prospects. In addition, it also focuses on possible non-invasive biomarker candidates besides common blood biomarkers.
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Affiliation(s)
- Wei Zien Gan
- Division of Applied Biomedical Science and Biotechnology, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Valsala Ramachandran
- Division of Applied Biomedical Science and Biotechnology, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Crystale Siew Ying Lim
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University Kuala Lumpur, 56000 Kuala Lumpur, Malaysia
| | - Rhun Yian Koh
- Division of Applied Biomedical Science and Biotechnology, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia, Phone: +60327317207
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6
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Demi R İ, Guler A, Alarslan P, Isil AM, Ucman O, Aslanipour B, Calan M. Fractalkine: an inflammatory chemokine elevated in subjects with polycystic ovary syndrome. Endocrine 2019; 65:175-183. [PMID: 31154608 DOI: 10.1007/s12020-019-01972-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/25/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Fractalkine (FKN) is an inflammatory chemokine related to reproductive system and glucose metabolism. There is a link between FKN and steroidogenesis as FKN induces progesterone synthesis. Polycystic ovary syndrome (PCOS) is a common reproductive and metabolic disorder associated with low progesterone production and insulin resistance. We aimed to explore whether women with PCOS have any difference in FKN levels compared to women without PCOS. We also focused on determination of any association between FKN levels and hormonal-metabolic parameters in women with PCOS. METHODS The current research was designed as a case-control study. Eighty subjects with PCOS and 80 age- and body mass index (BMI)-matched subjects with normal menstrual cycle were taken into the study. We measured circulating FKN levels via ELISA methods. RESULTS Circulating FKN levels were higher in women with PCOS than controls (1.93 ± 0.61 vs. 1.22 ± 0.33 ng/ml, P< 0.001). FKN levels showed a positive correlation with body mass index (BMI), insulin resistance, inflammatory marker hs-CRP, total testosterone, and free-androgen index (FAI), whereas it showed a negative correlation with sex hormone-binding protein in women with PCOS. Linear regression analyses revealed that the link of FKN with BMI, insulin resistance, hs-CRP, and FAI was independent. Binary logistic regression analysis showed that the risk of having PCOS was associated with high levels of FKN. CONCLUSIONS Increased FKN levels related to insulin resistance, inflammation and androgens in women with PCOS. FKN may have an inter-related role in different pathophysiologic pathways of PCOS.
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Affiliation(s)
- İsmail Demi R
- Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey
| | - Aslı Guler
- Department of Family Physician, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey
| | - Pınar Alarslan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey
| | - Ahmet Murat Isil
- Department of Family Physician, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey
| | - Ozge Ucman
- Department of Family Physician, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey
| | - Behnaz Aslanipour
- Department of Bioengineering, Faculty of Engineering, Ege University, 35100, Bornova, Izmir, Turkey
| | - Mehmet Calan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170, Bozyaka, Izmir, Turkey.
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7
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Anti-inflammatory Action of Metformin with Respect to CX3CL1/CX3CR1 Signaling in Human Placental Circulation in Normal-Glucose Versus High-Glucose Environments. Inflammation 2019; 41:2246-2264. [PMID: 30097812 DOI: 10.1007/s10753-018-0867-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Upregulation of chemokine CX3CL1 and its receptor CX3CR1 occurs in the diabetic human placenta. Metformin, an insulin-sensitizing biguanide, is used in the therapy of diabetic pregnancy. By preventing the activation of NF-κB, metformin exhibits anti-inflammatory properties. We examined the influence of hyperglycemia (25 mmol/L glucose; HG group; N = 36) on metformin-mediated effects on CX3CL1 and TNF-α production by placental lobules perfused extracorporeally. Additionally, CX3CR1 expression and contents of CX3CR1, TNF-α receptor 1 (TNFR1), and NF-κB proteins in the placental tissue were evaluated. Placentae perfused under normoglycemia (5 mmol/L glucose; NG group; N = 36) served as the control. Metformin (2.5 and 5.0 mg/L; subgroups B and C) lowered the production of CX3CL1 and TNF-α in a dose-dependent and time-dependent manner. Hyperglycemia did not weaken the strength of these metformin effects. Moreover, CX3CL1 levels after perfusion with 5.0 mg/L metformin were reduced by 33.28 and 33.83% (at 120 and 150 min, respectively) in the HG-C subgroup versus 24.98 and 23.66% in the NG-C subgroup, which indicated an augmentation of the metformin action over time in hyperglycemia. CX3CR1 expression was significantly higher in the HG-B and HG-C subgroups compared to that in the NG-B and NG-C subgroups. Increased CX3CR1 protein content in the placental lysates was observed in subgroups B and C. The two higher metformin concentrations significantly decreased the levels of NF-κBp65 protein content in both groups. However, the decrease was significantly stronger in hyperglycemia. TNFR1 upregulation in the HG group was not affected by metformin. Further studies on metformin therapy during pregnancy are needed, including safety issues.
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8
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Mizoguchi M, Ishida Y, Nosaka M, Kimura A, Kuninaka Y, Yahata T, Nanjo S, Toujima S, Minami S, Ino K, Mukaida N, Kondo T. Prevention of lipopolysaccharide-induced preterm labor by the lack of CX3CL1-CX3CR1 interaction in mice. PLoS One 2018; 13:e0207085. [PMID: 30399192 PMCID: PMC6219809 DOI: 10.1371/journal.pone.0207085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/24/2018] [Indexed: 01/28/2023] Open
Abstract
Preterm labor (PTL) is the most common cause of neonatal death and long-term adverse outcome. The pharmacological agents for PTL prevention are palliative and frequently fail to prevent PTL and improve neonatal outcome. It is essential to fully understand the molecular mechanisms of PTL in order to develop novel therapeutic methods against PTL. Several lines of evidence indicate some chemokines are expressed in gestational tissues during labor or PTL. To reveal the pathophysiological roles of the CX3CL1-CX3CR1 axis in PTL, we performed present study using LPS-induced PTL mice model in CX3CR1-deficient (Cx3cr1-/-) mice. We indicated that PTL was suppressed in Cx3cr1-/- mice and immunoneutralization of CX3CL1 in WT mice. From immunohistochemical and the gene expression analyses, the CX3CL1-CX3CR1 axis has detrimental roles in PTL through intrauterine recruitment of macrophages and the enhancement of macrophage-derived inflammatory mediators. Thus, the CX3CL1-CX3CR1 axis may be a good molecular target for preventing PTL.
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Affiliation(s)
- Mika Mizoguchi
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Yuko Ishida
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Mizuho Nosaka
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akihiko Kimura
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yumi Kuninaka
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tamaki Yahata
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Sakiko Nanjo
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Saori Toujima
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Sawako Minami
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Kazuhiko Ino
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan
| | - Naofumi Mukaida
- Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, Wakayama, Japan
- * E-mail:
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9
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Riopel M, Seo JB, Bandyopadhyay GK, Li P, Wollam J, Chung H, Jung SR, Murphy A, Wilson M, de Jong R, Patel S, Balakrishna D, Bilakovics J, Fanjul A, Plonowski A, Koh DS, Larson CJ, Olefsky JM, Lee YS. Chronic fractalkine administration improves glucose tolerance and pancreatic endocrine function. J Clin Invest 2018; 128:1458-1470. [PMID: 29504946 DOI: 10.1172/jci94330] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 01/18/2018] [Indexed: 01/09/2023] Open
Abstract
We have previously reported that the fractalkine (FKN)/CX3CR1 system represents a novel regulatory mechanism for insulin secretion and β cell function. Here, we demonstrate that chronic administration of a long-acting form of FKN, FKN-Fc, can exert durable effects to improve glucose tolerance with increased glucose-stimulated insulin secretion and decreased β cell apoptosis in obese rodent models. Unexpectedly, chronic FKN-Fc administration also led to decreased α cell glucagon secretion. In islet cells, FKN inhibited ATP-sensitive potassium channel conductance by an ERK-dependent mechanism, which triggered β cell action potential (AP) firing and decreased α cell AP amplitude. This results in increased glucose-stimulated insulin secretion and decreased glucagon secretion. Beyond its islet effects, FKN-Fc also exerted peripheral effects to enhance hepatic insulin sensitivity due to inhibition of glucagon action. In hepatocytes, FKN treatment reduced glucagon-stimulated cAMP production and CREB phosphorylation in a pertussis toxin-sensitive manner. Together, these results raise the possibility of use of FKN-based therapy to improve type 2 diabetes by increasing both insulin secretion and insulin sensitivity.
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Affiliation(s)
- Matthew Riopel
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA
| | - Jong Bae Seo
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA.,Department of Physiology and Biophysics, University of Washington, Seattle, Washington, USA
| | - Gautam K Bandyopadhyay
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA
| | - Pingping Li
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA.,State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Joshua Wollam
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA
| | - Heekyung Chung
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA
| | - Seung-Ryoung Jung
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington, USA
| | - Anne Murphy
- Department of Pharmacology, UCSD, La Jolla, California, USA
| | - Maria Wilson
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Ron de Jong
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Sanjay Patel
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Deepika Balakrishna
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - James Bilakovics
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Andrea Fanjul
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Artur Plonowski
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA
| | - Duk-Su Koh
- Department of Physiology and Biophysics, University of Washington, Seattle, Washington, USA
| | - Christopher J Larson
- Cardiovascular and Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, California, USA.,Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, USA
| | - Jerrold M Olefsky
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA
| | - Yun Sok Lee
- Department of Medicine, Division of Endocrinology and Metabolism, UCSD, La Jolla, California, USA.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
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10
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Verheggen RJHM, Poelkens F, Roerink SHPP, Ramakers REFS, Catoire M, Hermus ARMM, Thijssen DHJ, Hopman MTE. Exercise Improves Insulin Sensitivity in the Absence of Changes in Cytokines. Med Sci Sports Exerc 2017; 48:2378-2386. [PMID: 27414688 DOI: 10.1249/mss.0000000000001035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The benefits of aerobic exercise training on insulin sensitivity in subjects with metabolic syndrome (MetS) are, at least in part, associated with changes in cytokines. Recent studies identified novel cytokines (e.g., fractalkine, omentin, and osteopontin) that are strongly involved in glucose homeostasis and therefore potentially contribute in the exercise-induced changes in insulin sensitivity. Therefore, we aim to examine changes in skeletal muscle RNA expression and plasma levels of novel cytokines after exercise training and correlate these changes to the exercise-induced changes in insulin sensitivity. METHODS Women with metabolic syndrome (MetS, n = 11) and healthy women (n = 10) participated in a 6-month aerobic exercise training intervention (three times a week, 45 min per session at 65%-85% of individual heart rate reserve). Before and after training, we examined insulin sensitivity (M value during hyperinsulinemic euglycemic clamp) and circulating blood levels of cytokines (venous blood sample; leptin, adiponectin, omentin, fraktalkin, and osteopontin). The skeletal muscle RNA expression of these cytokines (muscle biopsy) was examined in two subgroups (MetS, n = 6; healthy women, n = 6). RESULTS At baseline, plasma levels of omentin (85.8 ± 26.2 ng·mL) and adiponectin (5.0 ± 1.7 μg·mL) levels were significantly higher in controls compared with MetS (51.1 ± 27.1; 3.6 ± 1.1 respectively), and leptin levels were lower in controls (18.7 ± 11.5 vs 53.0 ± 23.5 ng·mL). M value was significantly higher in controls (8.1 ± 1.9 mg·kg·min) than in MetS (4.0 ± 1.7). Exercise training significantly improved M values in both groups (P < 0.01). Exercise training did not alter plasma and skeletal muscle RNA expression levels of cytokines, but no correlation was observed between changes in cytokine level/RNA expression and M values (P > 0.05). CONCLUSION Although exercise training successfully improves insulin sensitivity in MetS and healthy women, we found no change in plasma and mRNA expression levels of novel cytokines.
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Affiliation(s)
- Rebecca J H M Verheggen
- 1Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, THE NETHERLANDS; 2Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, THE NETHERLANDS; and 3Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM
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Kralisch S, Hoffmann A, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M, Ebert T. The brown-fat-secreted adipokine neuregulin 4 is decreased in gestational diabetes mellitus. DIABETES & METABOLISM 2017; 44:150-154. [PMID: 28709749 DOI: 10.1016/j.diabet.2017.06.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 01/20/2023]
Abstract
AIMS Neuregulin 4 has recently been recognized as a novel adipokine secreted by brown adipose tissue (BAT), with beneficial effects on murine insulin resistance and hepatic steatosis. Yet, thus far, neither regulation of neuregulin 4 in gestational diabetes mellitus (GDM) nor its longitudinal changes in the peripartum period have been elucidated. METHODS Circulating neuregulin 4 levels were measured by ELISA in 74 women with GDM and 74 healthy, gestational-age-matched controls. Also, neuregulin 4 was quantified during pregnancy and compared with postpartum levels in a follow-up study of 25 women with previous GDM and 25 healthy control women. RESULTS Women with GDM had lower median serum levels of the novel BAT-secreted adipokine neuregulin 4 (3.0μg/L) compared with healthy (non-GDM) pregnant controls (3.5μg/L; P=0.020), and the area under the glucose curve (AUCGlucose) was an independent and negative predictor of circulating neuregulin 4 (P=0.033). Also, median postpartum serum concentrations of neuregulin 4 (3.2μg/L) were not significantly different from prepartum levels (2.8μg/L; P=0.328). In addition, neuregulin 4 was positively and independently associated with irisin (P=0.009), but not other BAT-secreted adipokines. CONCLUSION/INTERPRETATION Women with GDM have significantly lower circulating neuregulin 4 levels compared with healthy pregnant controls, and the AUCGlucose is negatively and independently associated with neuregulin 4 during pregnancy. Neuregulin 4 is positively correlated with irisin during pregnancy, as well as in a longitudinal fashion. Future studies are now needed to better elucidate the precise pathomechanisms of the regulation of BAT-secreted adipokines during pregnancy.
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Affiliation(s)
- S Kralisch
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany
| | - A Hoffmann
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - J Kratzsch
- Institute of Laboratory Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - M Blüher
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - M Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - M Fasshauer
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany
| | - T Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany.
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Szukiewicz D, Pyzlak M, Szewczyk G, Stangret A, Trojanowski S, Bachanek M, Braksator W, Wejman J. High Glucose Level Disturbs the Resveratrol-Evoked Curtailment of CX3CL1/CX3CR1 Signaling in Human Placental Circulation. Mediators Inflamm 2017; 2017:9853108. [PMID: 28655972 PMCID: PMC5471565 DOI: 10.1155/2017/9853108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/01/2017] [Accepted: 04/26/2017] [Indexed: 12/30/2022] Open
Abstract
Hyperglycemia-induced hyperactivity of chemokine CX3CL1 (fractalkine) occurs in the human placenta. Anti-inflammatory/antioxidant activities of resveratrol (3,5,4'-trihydroxy-trans-stilbene) are related to the modulation of chemokine CX3CL1 and its receptor, CX3CR1, signaling pathways. We examined the influence of high glucose (25 mmol/L glucose; HG group; N = 36) on resveratrol-mediated effects on CX3CL1 and TNF-α production by the placental lobule, CX3CR1 expression and contents of CX3CR1, TNF-α receptor 1 (TNFR1), and NF-κB proteins in placental tissue. The placental lobules perfused under normoglycemic conditions formed the control NG group (N = 36). Resveratrol (50 and 100 μM; subgroups B and C) administered into the perfusion fluid lowered the production of both CX3CL1 and TNF-α. The reductions in CX3CL1 levels were more evident in the NG group. CX3CR1 expression was significantly higher in the NG subgroups B and C compared to the HG subgroups B and C (385.2 and 426.5% versus 199.3 and 282.4%, resp.). An increase in CX3CR1 protein content in placental lysates was observed in the NG subgroups B and C. Also, resveratrol significantly decreased NF-κBp65 protein content only in the NG group, not affecting hyperglycemia-elicited TNFR1 upregulation. In conclusion, euglycemia assures optimal effects of resveratrol pertaining to CX3CL1/CX3CR1 signaling in the placenta. Future studies on resveratrol are needed, especially those including maternal-fetal risk assessments.
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Affiliation(s)
- Dariusz Szukiewicz
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Second Faculty of Medicine, Medical University of Warsaw, ul. Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Michal Pyzlak
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Second Faculty of Medicine, Medical University of Warsaw, ul. Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Grzegorz Szewczyk
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Second Faculty of Medicine, Medical University of Warsaw, ul. Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Aleksandra Stangret
- Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Second Faculty of Medicine, Medical University of Warsaw, ul. Pawinskiego 3C, 02-106 Warsaw, Poland
| | - Seweryn Trojanowski
- Department of Obstetrics & Gynecology, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Michal Bachanek
- Department of Obstetrics & Gynecology, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Wojciech Braksator
- Department of Cardiology, Hypertension, and Internal Medicine, Second Faculty of Medicine, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Jaroslaw Wejman
- Department of Pathology, Professor Witold Orlowski Public Clinical Hospital, Medical Center for Postgraduate Education, ul. Czerniakowska 231, 00-416 Warsaw, Poland
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Kralisch S, Hoffmann A, Lössner U, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M, Ebert T. Regulation of the novel adipokines/ hepatokines fetuin A and fetuin B in gestational diabetes mellitus. Metabolism 2017; 68:88-94. [PMID: 28183456 DOI: 10.1016/j.metabol.2016.11.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Fetuin B has recently been introduced as a novel adipokine/hepatokine which is significantly increased in hepatic steatosis and mediates impaired insulin action, as well as glucose intolerance. However, regulation of fetuin B in gestational diabetes mellitus (GDM), as well as its longitudinal changes in the peripartum period, have not been elucidated, so far. DESIGN AND METHODS Circulating fetuin A and fetuin B were quantified in 74 women with GDM and 74 healthy and gestational age-matched controls by enzyme-linked immunosorbent assay during pregnancy (median gestational age: 201days). Furthermore, fetuin B was quantified during pregnancy as compared to postpartum levels in a follow-up study (median time after delivery: 4years and 115days). RESULTS Median [interquartile range] serum fetuin B levels were significantly higher in women with GDM (4.8 [1.7] mg/l) as compared to non-diabetic pregnant controls (4.3 [1.2] mg/l) (p=0.013) during pregnancy. In multivariate analysis, GDM status, insulin resistance, and fetuin A were independent and positive predictors of circulating fetuin B. Furthermore, fetuin B serum concentrations significantly decreased after delivery from 4.6 [1.7] mg/l (prepartum) to 3.0 [2.2] mg/l (postpartum) in all women (p<0.001). CONCLUSIONS Women with GDM have significantly higher fetuin B levels as compared to healthy pregnant control women and GDM status, insulin resistance, and fetuin A positively predict circulating fetuin B. Postpartum fetuin B is decreased as compared to prepartum values suggesting a placental co-secretion of this novel adipokine/hepatokine. Further studies need to elucidate factors contributing to fetuin B regulation in humans, as well as the pathophysiological significance of fetuin B upregulation in GDM.
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Affiliation(s)
- Susan Kralisch
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - Annett Hoffmann
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - Ulrike Lössner
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - Jürgen Kratzsch
- University of Leipzig, Institute of Laboratory Medicine, 04103 Leipzig, Germany
| | - Matthias Blüher
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - Michael Stumvoll
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - Mathias Fasshauer
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - Thomas Ebert
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany.
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Serum levels of sclerostin in cardiometabolic disorders during pregnancy. Cytokine 2015; 76:591-593. [DOI: 10.1016/j.cyto.2015.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 02/07/2015] [Accepted: 02/11/2015] [Indexed: 01/20/2023]
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Metabolic Effects of CX3CR1 Deficiency in Diet-Induced Obese Mice. PLoS One 2015; 10:e0138317. [PMID: 26393344 PMCID: PMC4579121 DOI: 10.1371/journal.pone.0138317] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/28/2015] [Indexed: 12/20/2022] Open
Abstract
The fractalkine (CX3CL1-CX3CR1) chemokine system is associated with obesity-related inflammation and type 2 diabetes, but data on effects of Cx3cr1 deficiency on metabolic pathways is contradictory. We examined male C57BL/6 Cx3cr1-/- mice on chow and high-fat diet to determine the metabolic effects of Cx3cr1 deficiency. We found no difference in body weight and fat content or feeding and energy expenditure between Cx3cr1-/- and WT mice. Cx3cr1-/- mice had reduced glucose intolerance assessed by intraperitoneal glucose tolerance tests at chow and high-fat fed states, though there was no difference in glucose-stimulated insulin values. Cx3cr1-/- mice also had improved insulin sensitivity at hyperinsulinemic-euglycemic clamp, with higher glucose infusion rate, rate of disposal, and hepatic glucose production suppression compared to WT mice. Enhanced insulin signaling in response to acute intravenous insulin injection was demonstrated in Cx3cr1-/- by increased liver protein levels of phosphorylated AKT and GSK3β proteins. There were no differences in adipose tissue macrophage populations, circulating inflammatory monocytes, adipokines, lipids, or inflammatory markers. In conclusion, we demonstrate a moderate and reproducible protective effect of Cx3cr1 deficiency on glucose intolerance and insulin resistance.
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Ebert T, Kralisch S, Wurst U, Lössner U, Kratzsch J, Blüher M, Stumvoll M, Tönjes A, Fasshauer M. Betatrophin levels are increased in women with gestational diabetes mellitus compared to healthy pregnant controls. Eur J Endocrinol 2015; 173:1-7. [PMID: 25850828 DOI: 10.1530/eje-14-0815] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 04/07/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Betatrophin has recently been introduced as a novel adipokine/hepatokine, which promotes pancreatic β cell proliferation and improves glucose tolerance in several mouse models of insulin resistance. However, regulation of betatrophin in gestational diabetes mellitus (GDM), as well as its association with markers of obesity, such as glucose and lipid metabolism, inflammation, and renal function, have not been elucidated. DESIGN AND METHODS Circulating betatrophin was quantified in 74 women with GDM and 74 healthy and gestational age-matched controls by ELISA. In a subset of the study population comprising of 85 patients (41 previous controls, 44 previous women with GDM), postpartum betatrophin levels were measured in a follow-up study. RESULTS Median (interquartile range) serum betatrophin levels were higher in women with GDM (1.79 (0.53) μg/l) as compared to non-diabetic pregnant controls (1.58 (0.44) μg/l) (P=0.002). In multivariate analysis, GDM status was an independent and positive predictor of circulating betatrophin (P=0.001). Furthermore, betatrophin levels were significantly higher during gestation (1.70 (0.53) μg/l) as compared to postpartum levels (1.55 (0.66) μg/l) (P=0.028). Moreover, postpartum irisin remained a positive and independent predictor of postpartum betatrophin concentrations. CONCLUSIONS Women with GDM have significantly higher betatrophin levels as compared to healthy pregnant controls and GDM status positively predicts circulating betatrophin. Furthermore, postpartum levels are significantly lower as compared to betatrophin concentrations during pregnancy. Moreover, irisin is a significant predictor of postpartum betatrophin levels.
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Affiliation(s)
- Thomas Ebert
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Susan Kralisch
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Ulrike Wurst
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Ulrike Lössner
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Jürgen Kratzsch
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Anke Tönjes
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
| | - Mathias Fasshauer
- Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany Department of Endocrinology and NephrologyUniversity of Leipzig, Liebigstraße 20, 04103 Leipzig, GermanyLeipzig University Medical CenterIFB AdiposityDiseases, Liebigstraße 20, 04103 Leipzig, GermanyInstitute of Laboratory MedicineUniversity of Leipzig, Leipzig, Germany
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