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Sardar MB, Raza M, Fayyaz A, Nadir MA, Nadeem ZA, Babar M. Environmental Heavy Metal Exposure and Associated Cardiovascular Diseases in Light of the Triglyceride Glucose Index. Cardiovasc Toxicol 2024; 24:1301-1309. [PMID: 39212843 DOI: 10.1007/s12012-024-09913-x] [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: 05/20/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
Cardiovascular diseases (CVD), primarily ischemic heart disease and stroke, remain leading global health burdens. Environmental risk factors have a major role in the development of CVD, particularly exposure to heavy metals. The Triglyceride Glucose Index (TyG), a measure of insulin resistance and CVD risk, is the primary focus of this study, which summarizes the most recent findings on the effects of lead (Pb), arsenic (As), and cadmium (Cd) on CVD risk. A higher risk of CVD is correlated with an elevated TyG index, which has been linked to insulin resistance. Exposure to Cd is associated with disturbance of lipid metabolism and oxidative stress, which increases the risk of CVD and TyG. Exposure reduces insulin secretion and signaling, which raises the TyG index and causes dyslipidemia. Pb exposure increases the risk of CVD and TyG index via causing oxidative stress and pancreatic β-cell destruction. These results highlight the need of reducing heavy metal exposure by lifestyle and environmental modifications in order to lower the risk of CVD. To comprehend the mechanisms and create practical management plans for health hazards associated with heavy metals, more study is required.
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Affiliation(s)
- Muhammad Bilal Sardar
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan.
| | - Mohsin Raza
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Ammara Fayyaz
- Department of Medicine, Central Park Medical College, Lahore, Pakistan
| | - Muhammad Asfandyar Nadir
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Zain Ali Nadeem
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Muhammad Babar
- Department of Medicine, Social Security Hospital, Faisalabad, Pakistan
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Schulze MB, Stefan N. Metabolically healthy obesity: from epidemiology and mechanisms to clinical implications. Nat Rev Endocrinol 2024:10.1038/s41574-024-01008-5. [PMID: 38937638 DOI: 10.1038/s41574-024-01008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/29/2024]
Abstract
The concept of metabolic health, particularly in obesity, has attracted a lot of attention in the scientific community, and is being increasingly used to determine the risk of cardiovascular diseases and diabetes mellitus-related complications. This Review assesses the current understanding of metabolically healthy obesity (MHO). First, we present the historical evolution of the concept. Second, we discuss the evidence for and against its existence, the usage of different definitions of MHO over the years and the efforts made to provide novel definitions of MHO. Third, we highlight epidemiological data with regard to cardiovascular risk in MHO, which is estimated to be moderately elevated using widely used definitions of MHO when compared with individuals with metabolically healthy normal weight, but potentially not elevated using a novel definition of MHO. Fourth, we discuss novel findings about the physiological mechanisms involved in MHO and how such knowledge helps to identify and characterize both people with MHO and those with metabolically unhealthy normal weight. Finally, we address how the concept of MHO can be used for risk stratification and treatment in clinical practice.
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Affiliation(s)
- Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
- German Center for Diabetes Research, Neuherberg, Germany.
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
| | - Norbert Stefan
- German Center for Diabetes Research, Neuherberg, Germany
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich, Tübingen, Germany
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Falkenhain K, Daraei A, Little JP. The Effect of Novel Exogenous Ketone Supplements on Blood Beta-Hydroxybutyrate and Glucose. J Diet Suppl 2023; 21:38-52. [PMID: 36847287 DOI: 10.1080/19390211.2023.2179152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Exogenous ketone monoesters can raise blood β-OHB and lower glucose without other nutritional modifications or invasive procedures. However, unpleasant taste and potential gastrointestinal discomfort may make adherence to supplementation challenging. Two novel ketone supplements promise an improved consumer experience but differ in their chemical properties; it is currently unknown how these affect blood β-OHB and blood glucose compared to the ketone monoester. In a double-blind randomized cross-over pilot study, N=12 healthy individuals (29 ± 5 years, BMI = 25 ± 4 kg/m2, 42% female) participated in three experimental trials with a different ketone supplement providing 10 grams of active ingredient in each; (i) the monoester (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, (ii) D-β-hydroxybutyric acid with R-1,3-butanediol, and (iii) R-1,3-butanediol. Blood β-OHB and glucose were measured via finger prick capillary blood samples at baseline and across 240 minutes post-supplementation. Supplement acceptability, hunger, and gastrointestinal distress were assessed via questionnaires. β-OHB was elevated compared to baseline in all conditions. Total and incremental area under the curve (p < 0.05) and peak β-OHB (p < 0.001) differed between conditions with highest values seen in the ketone monoester condition. Blood glucose was reduced after consumption of each supplement, with no differences in total and incremental area under the curve across supplements. Supplement acceptability was greatest for D-β-hydroxybutyric acid with R-1,3-butanediol, with no effect on hunger or evidence of gastrointestinal distress across all supplements. All ketone supplements tested raised β-OHB with highest values seen after ketone monoester ingestion. Blood glucose was lowered similarly across the assessed time frame with all three supplements.
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Affiliation(s)
- Kaja Falkenhain
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Ali Daraei
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
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Falkenhain K, Islam H, Little JP. Exogenous ketone supplementation: an emerging tool for physiologists with potential as a metabolic therapy. Exp Physiol 2023; 108:177-187. [PMID: 36533967 PMCID: PMC10103874 DOI: 10.1113/ep090430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
NEW FINDINGS What is the topic of this review? The integrative physiological response to exogenous ketone supplementation. What advances does it highlight? The physiological effects and therapeutic potential of exogenous ketones on metabolic health, cardiovascular function, cognitive processing, and modulation of inflammatory pathways and immune function. Also highlighted are current challenges and future directions of the field. ABSTRACT Exogenous oral ketone supplements, primarily in form of ketone salts or esters, have emerged as a useful research tool for manipulating metabolism with potential therapeutic application targeting various aspects of several common chronic diseases. Recent literature has investigated the effects of exogenously induced ketosis on metabolic health, cardiovascular function, cognitive processing, and modulation of inflammatory pathways and immune function. This narrative review provides an overview of the integrative physiological effects of exogenous ketone supplementation and highlights current challenges and future research directions. Much of the existing research on therapeutic applications - particularly mechanistic studies - has involved pre-clinical rodent and/or cellular models, requiring further validation in human clinical studies. Existing human studies report that exogenous ketones can lower blood glucose and improve some aspects of cognitive function, highlighting the potential therapeutic application of exogenous ketones for type 2 diabetes and neurological diseases. There is also support for the ability of exogenous ketosis to improve cardiac metabolism in rodent models of heart failure with supporting human studies emerging; long-terms effects of exogenous ketone supplementation on the human cardiovascular system and lipid profiles are needed. An important avenue for future work is provided by research accelerating technologies that enable continuous ketone monitoring and/or the development of more palatable ketone mixtures that optimize plasma ketone kinetics to enable sustained ketosis. Lastly, research exploring the physiological interactions between exogenous ketones and varying metabolic states (e.g., exercise, fasting, metabolic disease) should yield important insights that can be used to maximize the health benefits of exogenous ketosis.
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Affiliation(s)
- Kaja Falkenhain
- School of Health and Exercise SciencesUniversity of British Columbia OkanaganKelownaBritish ColumbiaCanada
| | - Hashim Islam
- School of Health and Exercise SciencesUniversity of British Columbia OkanaganKelownaBritish ColumbiaCanada
| | - Jonathan P. Little
- School of Health and Exercise SciencesUniversity of British Columbia OkanaganKelownaBritish ColumbiaCanada
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Angiotensin II Inhibits Insulin Receptor Signaling in Adipose Cells. Int J Mol Sci 2022; 23:ijms23116048. [PMID: 35682723 PMCID: PMC9181642 DOI: 10.3390/ijms23116048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
Angiotensin II (Ang II) is a critical regulator of insulin signaling in the cardiovascular system and metabolic tissues. However, in adipose cells, the regulatory role of Ang II on insulin actions remains to be elucidated. The effect of Ang II on insulin-induced insulin receptor (IR) phosphorylation, Akt activation, and glucose uptake was examined in 3T3-L1 adipocytes. In these cells, Ang II specifically inhibited insulin-stimulated IR and insulin receptor substrate-1 (IRS-1) tyrosine-phosphorylation, Akt activation, and glucose uptake in a time-dependent manner. These inhibitory actions were associated with increased phosphorylation of the IR at serine residues. Interestingly, Ang II-induced serine-phosphorylation of IRS was not detected, suggesting that Ang II-induced desensitization begins from IR regulation itself. PKC inhibition by BIM I restored the inhibitory effect of Ang II on insulin actions. We also found that Ang II promoted activation of several PKC isoforms, including PKCα/βI/βII/δ, and its association with the IR, particularly PKCβII, showed the highest interaction. Finally, we also found a similar regulatory effect of Ang II in isolated adipocytes, where insulin-induced Akt phosphorylation was inhibited by Ang II, an effect that was prevented by PKC inhibitors. These results suggest that Ang II may lead to insulin resistance through PKC activation in adipocytes.
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Falkenhain K, Daraei A, Forbes SC, Little JP. Effects of Exogenous Ketone Supplementation on Blood Glucose: A Systematic Review and Meta-analysis. Adv Nutr 2022; 13:1697-1714. [PMID: 35380602 PMCID: PMC9526861 DOI: 10.1093/advances/nmac036] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 01/28/2023] Open
Abstract
Recently developed ketone (monoester or salt) supplements acutely elevate blood β-hydroxybutyrate (BHB) exogenously without prolonged periods of fasting or carbohydrate restriction. Previous (small-scale) studies have found a blood glucose-lowering effect of exogenous ketones. This study aimed to systematically review available evidence and conduct meta-analyses of studies reporting on exogenous ketones and blood glucose. We searched 6 electronic databases on 13 December 2021 for randomized and nonrandomized trials of any length that reported on the use of exogenous ketones. We calculated raw mean differences (MDs) in blood BHB and glucose in 2 main analyses: 1) after compared with before acute ingestion of exogenous ketones and 2) following acute ingestion of exogenous ketones compared with a comparator supplement. We pooled effect sizes using random-effects models and performed prespecified subgroup analyses to examine the effect of potential explanatory factors, including study population, exercise, blood BHB, and supplement type, dosing, and timing. Risk of bias was examined using Cochrane's risk-of-bias tools. Studies that could not be meta-analyzed were summarized narratively. Forty-three trials including 586 participants are summarized in this review. Following ingestion, exogenous ketones increased blood BHB (MD = 1.73 mM; 95% CI: 1.26, 2.21 mM; P < 0.001) and decreased mean blood glucose (MD = -0.54 mM; 95% CI: -0.68, -0.40 mM; P < 0.001). Similarly, when compared with placebo, blood BHB increased (MD = 1.98 mM; 95% CI: 1.52, 2.45 mM; P < 0.001) and blood glucose decreased (MD = -0.47 mM; 95% CI: -0.57, -0.36 mM; P < 0.001). Across both analyses, significantly greater effects were seen with ketone monoesters compared with salts (P < 0.001). The available evidence indicates that acute ingestion of exogenous ketones leads to increased blood BHB and decreased blood glucose. Limited evidence on prolonged ketone supplementation was found.
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Affiliation(s)
| | - Ali Daraei
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Scott C Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, Manitoba, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Reed J, Bain S, Kanamarlapudi V. A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments and Future Perspectives. Diabetes Metab Syndr Obes 2021; 14:3567-3602. [PMID: 34413662 PMCID: PMC8369920 DOI: 10.2147/dmso.s319895] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/09/2021] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes (T2D), which has currently become a global pandemic, is a metabolic disease largely characterised by impaired insulin secretion and action. Significant progress has been made in understanding T2D aetiology and pathogenesis, which is discussed in this review. Extrapancreatic pathology is also summarised, which demonstrates the highly multifactorial nature of T2D. Glucagon-like peptide (GLP)-1 is an incretin hormone responsible for augmenting insulin secretion from pancreatic beta-cells during the postprandial period. Given that native GLP-1 has a very short half-life, GLP-1 mimetics with a much longer half-life have been developed, which are currently an effective treatment option for T2D by enhancing insulin secretion in patients. Interestingly, there is continual emerging evidence that these therapies alleviate some of the post-diagnosis complications of T2D. Additionally, these therapies have been shown to induce weight loss in patients, suggesting they could be an alternative to bariatric surgery, a procedure associated with numerous complications. Current GLP-1-based therapies all act as orthosteric agonists for the GLP-1 receptor (GLP-1R). Interestingly, it has emerged that GLP-1R also has allosteric binding sites and agonists have been developed for these sites to test their therapeutic potential. Recent studies have also demonstrated the potential of bi- and tri-agonists, which target multiple hormonal receptors including GLP-1R, to more effectively treat T2D. Improved understanding of T2D aetiology/pathogenesis, coupled with the further elucidation of both GLP-1 activity/targets and GLP-1R mechanisms of activation via different agonists, will likely provide better insight into the therapeutic potential of GLP-1-based therapies to treat T2D.
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Affiliation(s)
- Josh Reed
- Institute of Life Science 1, Medical School, Swansea University, Swansea, SA2 8PP, UK
| | - Stephen Bain
- Institute of Life Science 1, Medical School, Swansea University, Swansea, SA2 8PP, UK
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Genua I, Tuneu L, Ramos A, Stantonyonge N, Caimari F, Balagué C, Fernández-Ananin S, Sánchez-Quesada JL, Pérez A, Miñambres I. Effectiveness of Bariatric Surgery in Patients with the Metabolically Healthy Obese Phenotype. Obes Surg 2021; 31:517-522. [PMID: 32915359 DOI: 10.1007/s11695-020-04967-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the effectiveness and safety of bariatric surgery in metabolically healthy obese (MHO) patients. METHODS In this retrospective, observational study, we reviewed the medical records of patients who underwent bariatric surgery at a tertiary care hospital between January 2007 and March 2015. Patients who underwent revisional surgery and patients with type 1 diabetes were excluded from the analysis. MHO patients were defined as those without a previous diagnosis of diabetes or atherogenic dyslipidemia and absence of hypoglycemic treatment or treatment with fibrates. RESULTS A total of 188 patients were included (mean age 48.97 ± 10.32 years, 68.6% of women). Sleeve gastrectomy was performed in 121 patients (64%) and a gastric bypass in 67 patients (36%). Prior to surgery, 36 patients (19%) were MHO. In the second- and third-year post-surgery, MHO patients presented a higher percentage of total weight loss (%TWL) (35.16% vs. 30.34%; p = 0.02 and 33.97% vs. 27.78%; p = 0.013 respectively). Multiple regression analysis showed that MHO was associated with a higher weight loss irrespective of age, sex, baseline BMI, and type of surgery. We did not detect any differences in acute complications between patients with and without MHO after bariatric surgery. CONCLUSIONS Bariatric surgery in MHO patients in our study was associated with higher weight loss than that in MUHO patients. There were no differences between the two groups in respect to acute complications following surgery.
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Affiliation(s)
- Idoia Genua
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Laura Tuneu
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Analía Ramos
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Nicole Stantonyonge
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Francisca Caimari
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Carmen Balagué
- Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Antonio Pérez
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
| | - Inka Miñambres
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
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Videira-Silva A, Freira S, Fonseca H. Metabolically healthy overweight adolescents: definition and components. Ann Pediatr Endocrinol Metab 2020; 25:256-264. [PMID: 33401882 PMCID: PMC7788346 DOI: 10.6065/apem.2040052.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/29/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE In adolescents, the definition and clinical implications of metabolically healthy overweight (MHO) status have not been established. This study aimed to investigate the prevalence of MHO according to its most widespread definition, which is based on metabolic syndrome (MS), and to explore further metabolic indicators such as Homeostatic Model Assessment of Insulin Resistance, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, and C-reactive protein levels, together with metabolic health predictors in a sample of adolescents attending a pediatric obesity clinic. METHODS Data from 487 adolescents categorized as overweight (52.6% females, 88.1% white), with a mean body mass index (BMI) z-score of 2.74 (±1.07 standard deviation [SD]), and a mean age of 14.4 years (±2.2 SD) were cross-sectionally analyzed. From this original sample, a subsample of 176 adolescents underwent a second assessment at 12 (±6 SD) months for longitudinal analysis. RESULTS From the 487 adolescents originally analyzed, 200 (41.1%) were categorized as MHO, but only 93 (19.1%) had none of the metabolic indicators considered in this study. According to longitudinal analysis, 30 of the 68 adolescents (44%) categorized as MHO at baseline became non-MHO over time. BMI z-score was the best predictor of metabolic health both in cross-sectional and longitudinal analyses. Increased BMI z-score reduced the odds of being categorized as MHO (odds ratio [OR], 0.6; 95% confidence interval [CI], 0.4-0.9; P=.008) and increased the odds of having hypertension (OR 2.1, 95% CI: 1.4-3.3, P=0.001), insulin resistance (OR, 2.4; 95% CI, 1.4-4.1, P=0.001), or a proinflammatory state (OR, 1.2; 95% CI, 1.1-1.3, P=0.002). CONCLUSION Diagnosis of MHO should not be exclusively based on MS parameters, and other metabolic indicators should be considered. Adolescents categorized as overweight should participate in weight-management lifestyle interventions regardless of their metabolic health phenotype.
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Affiliation(s)
- António Videira-Silva
- Pediatric University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal,Address for correspondence: António Videira-Silva, MSc Pediatric University Clinic, Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal Tel: +351969172368 E-mail:
| | - Silvia Freira
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal
| | - Helena Fonseca
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon; Rheumatology Research Unit, Molecular Medicine Institute, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Exploring Therapeutic Targets to Reverse or Prevent the Transition from Metabolically Healthy to Unhealthy Obesity. Cells 2020; 9:cells9071596. [PMID: 32630256 PMCID: PMC7407965 DOI: 10.3390/cells9071596] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of obesity and obesity-related metabolic comorbidities are rapidly increasing worldwide, placing a huge economic burden on health systems. Excessive nutrient supply combined with reduced physical exercise results in positive energy balance that promotes adipose tissue expansion. However, the metabolic response and pattern of fat accumulation is variable, depending on the individual’s genetic and acquired susceptibility factors. Some develop metabolically healthy obesity (MHO) and are resistant to obesity-associated metabolic diseases for some time, whereas others readily develop metabolically unhealthy obesity (MUO). An unhealthy response to excess fat accumulation could be due to susceptibility intrinsic factors (e.g., increased likelihood of dedifferentiation and/or inflammation), or by pathogenic drivers extrinsic to the adipose tissue (e.g., hyperinsulinemia), or a combination of both. This review outlines the major transcriptional factors and genes associated with adipogenesis and regulation of adipose tissue homeostasis and describes which of these are disrupted in MUO compared to MHO individuals. It also examines the potential role of pathogenic insulin hypersecretion as an extrinsic factor capable of driving the changes in adipose tissue which cause transition from MHO to MUO. On this basis, therapeutic approaches currently available and emerging to prevent and reverse the transition from MHO to MUO transition are reviewed.
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Clemente-Postigo M, Tinahones A, El Bekay R, Malagón MM, Tinahones FJ. The Role of Autophagy in White Adipose Tissue Function: Implications for Metabolic Health. Metabolites 2020; 10:metabo10050179. [PMID: 32365782 PMCID: PMC7281383 DOI: 10.3390/metabo10050179] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 02/07/2023] Open
Abstract
White adipose tissue (WAT) is a highly adaptive endocrine organ that continuously remodels in response to nutritional cues. WAT expands to store excess energy by increasing adipocyte number and/or size. Failure in WAT expansion has serious consequences on metabolic health resulting in altered lipid, glucose, and inflammatory profiles. Besides an impaired adipogenesis, fibrosis and low-grade inflammation also characterize dysfunctional WAT. Nevertheless, the precise mechanisms leading to impaired WAT expansibility are yet unresolved. Autophagy is a conserved and essential process for cellular homeostasis, which constitutively allows the recycling of damaged or long-lived proteins and organelles, but is also highly induced under stress conditions to provide nutrients and remove pathogens. By modulating protein and organelle content, autophagy is also essential for cell remodeling, maintenance, and survival. In this line, autophagy has been involved in many processes affected during WAT maladaptation, including adipogenesis, adipocyte, and macrophage function, inflammatory response, and fibrosis. WAT autophagy dysregulation is related to obesity and diabetes. However, it remains unclear whether WAT autophagy alteration in obese and diabetic patients are the cause or the consequence of WAT malfunction. In this review, current data regarding these issues are discussed, focusing on evidence from human studies.
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Affiliation(s)
- Mercedes Clemente-Postigo
- Department of Cell Biology, Physiology and Immunology, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)-Reina Sofia University Hospital, University of Cordoba, Edificio IMIBIC, Av. Menéndez Pidal s/n, 14004 Córdoba, Spain;
- Correspondence: (M.C.-P.); (F.J.T.); Tel.: +34-957213728 (M.C.-P.); +34-951032648 (F.J.T.)
| | - Alberto Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición (Hospital Universitario Virgen de la Victoria), Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Campus Teatinos s/n, 29010 Málaga, Spain;
| | - Rajaa El Bekay
- Unidad de Gestión Clínica de Endocrinología y Nutrición (Hospital Universitario Regional de Málaga), Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Campus Teatinos s/n, 29010 Málaga, Spain;
- Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - María M. Malagón
- Department of Cell Biology, Physiology and Immunology, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)-Reina Sofia University Hospital, University of Cordoba, Edificio IMIBIC, Av. Menéndez Pidal s/n, 14004 Córdoba, Spain;
- Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Francisco J. Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición (Hospital Universitario Virgen de la Victoria), Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Campus Teatinos s/n, 29010 Málaga, Spain;
- Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (M.C.-P.); (F.J.T.); Tel.: +34-957213728 (M.C.-P.); +34-951032648 (F.J.T.)
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Cockcroft EJ, Bond B, Williams CA, Harris S, Jackman SR, Armstrong N, Barker AR. The effects of two weeks high-intensity interval training on fasting glucose, glucose tolerance and insulin resistance in adolescent boys: a pilot study. BMC Sports Sci Med Rehabil 2019; 11:29. [PMID: 31827806 PMCID: PMC6900855 DOI: 10.1186/s13102-019-0141-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/10/2019] [Indexed: 01/27/2023]
Abstract
Background Current evidence of metabolic health benefits of high-intensity interval training (HIIT) are limited to longer training periods or conducted in overweight youth. This study assessed 1) fasting and postprandial insulin and glucose before and after 2 weeks of HIIT in healthy adolescent boys, and 2) the relationship between pre intervention health outcomes and the effects of the HIIT intervention. Methods Seven healthy boys (age:14.3 ± 0.3 y, BMI: 21.6 ± 2.6, 3 participants classified as overweight) completed 6 sessions of HIIT over 2 weeks. Insulin resistance (IR) and blood glucose and insulin responses to a Mixed Meal Tolerance Test (MMTT) were assessed before (PRE), 20 h and 70 h after (POST) the final HIIT session. Results Two weeks of HIIT had no effect on fasting plasma glucose, insulin or IR at 20 h and 70 h POST HIIT, nor insulin and glucose response to MMTT (all P > 0.05). There was a strong negative correlation between PRE training IR and change in IR after HIIT (r = − 0.96, P < 0.05). Conclusion Two weeks of HIIT did not elicit improvements to fasting or postprandial glucose or insulin health outcomes in a group of adolescent boys. However the negative correlation between PRE IR and improvements after HIIT suggest that interventions of this type may be effective in adolescents with raised baseline IR.
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Affiliation(s)
- Emma J Cockcroft
- 1Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK.,2College of Medicine and Health, University of Exeter, Exeter, EX1 2LU UK
| | - Bert Bond
- 1Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
| | - Craig A Williams
- 1Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
| | - Sam Harris
- 3Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
| | - Sarah R Jackman
- 3Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
| | - Neil Armstrong
- 1Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
| | - Alan R Barker
- 1Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU UK
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Hamley S, Kloosterman D, Duthie T, Dalla Man C, Visentin R, Mason SA, Ang T, Selathurai A, Kaur G, Morales-Scholz MG, Howlett KF, Kowalski GM, Shaw CS, Bruce CR. Mechanisms of hyperinsulinaemia in apparently healthy non-obese young adults: role of insulin secretion, clearance and action and associations with plasma amino acids. Diabetologia 2019; 62:2310-2324. [PMID: 31489455 PMCID: PMC6861536 DOI: 10.1007/s00125-019-04990-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/29/2019] [Indexed: 01/07/2023]
Abstract
AIMS/HYPOTHESIS This study aimed to examine the metabolic health of young apparently healthy non-obese adults to better understand mechanisms of hyperinsulinaemia. METHODS Non-obese (BMI < 30 kg/m2) adults aged 18-35 years (N = 254) underwent a stable isotope-labelled OGTT. Insulin sensitivity, glucose effectiveness and beta cell function were determined using oral minimal models. Individuals were stratified into quartiles based on their insulin response during the OGTT, with quartile 1 having the lowest and quartile 4 the highest responses. RESULTS Thirteen per cent of individuals had impaired fasting glucose (IFG; n = 14) or impaired glucose tolerance (IGT; n = 19), allowing comparisons across the continuum of insulin responses within the spectrum of normoglycaemia and prediabetes. BMI (~24 kg/m2) was similar across insulin quartiles and in those with IFG and IGT. Despite similar glycaemic excursions, fasting insulin, triacylglycerols and cholesterol were elevated in quartile 4. Insulin sensitivity was lowest in quartile 4, and accompanied by increased insulin secretion and reduced insulin clearance. Individuals with IFG had similar insulin sensitivity and beta cell function to those in quartiles 2 and 3, but were more insulin sensitive than individuals in quartile 4. While individuals with IGT had a similar degree of insulin resistance to quartile 4, they exhibited a more severe defect in beta cell function. Plasma branched-chain amino acids were not elevated in quartile 4, IFG or IGT. CONCLUSIONS/INTERPRETATION Hyperinsulinaemia within normoglycaemic young, non-obese adults manifests due to increased insulin secretion and reduced insulin clearance. Individual phenotypic characterisation revealed that the most hyperinsulinaemic were more similar to individuals with IGT than IFG, suggesting that hyperinsulinaemic individuals may be on the continuum toward IGT. Furthermore, plasma branched-chain amino acids may not be an effective biomarker in identifying hyperinsulinaemia and insulin resistance in young non-obese adults.
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Affiliation(s)
- Steven Hamley
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Danielle Kloosterman
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Tamara Duthie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Chiara Dalla Man
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Roberto Visentin
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Shaun A Mason
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Teddy Ang
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Ahrathy Selathurai
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Gunveen Kaur
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Maria G Morales-Scholz
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Kirsten F Howlett
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Greg M Kowalski
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Christopher S Shaw
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Clinton R Bruce
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
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Zhang Y, Zheng Y, Fu Y, Wang C. Identification of biomarkers, pathways and potential therapeutic agents for white adipocyte insulin resistance using bioinformatics analysis. Adipocyte 2019; 8:318-329. [PMID: 31407623 PMCID: PMC6768254 DOI: 10.1080/21623945.2019.1649578] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
For the better understanding of insulin resistance (IR), the molecular biomarkers in IR white adipocytes and its potential mechanism, we downloaded two mRNA expression profiles from Gene Expression Omnibus (GEO). The white adipocyte samples in two databases were collected from the human omental adipose tissue of IR obese (IRO) subjects and insulin-sensitive obese (ISO) subjects, respectively. We identified 86 differentially expressed genes (DEGs) between the IRO and ISO subjects using limma package in R software. Gene Set Enrichment Analysis (GSEA) provided evidence that the most gene sets enriched in kidney mesenchyme development in the ISO subjects, as compared with the IRO subjects. The Gene Ontology (GO) analysis indicated that the most significantly enriched in cellular response to interferon-gamma. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that the DEGs were most significantly enriched in cytokine-cytokine receptor interaction. Protein–Protein Interaction (PPI) network was performed with the STRING, and the top 10 hub genes were identified with the Cytohubba. CMap analysis found several small molecular compounds to reverse the altered DEGs, including dropropizine, aceclofenac, melatonin, and so on. Our outputs could empower the novel potential targets to treat omental white adipocyte insulin resistance, diabetes, and diabetes-related diseases.
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Affiliation(s)
- Yemin Zhang
- Department of Pathology and Pathophysiology, Wuhan University School of Basic Medical Sciences, Wuhan, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
| | - Yuyang Zheng
- Department of Pathology and Pathophysiology, Wuhan University School of Basic Medical Sciences, Wuhan, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
| | - Yalin Fu
- Department of Pathology and Pathophysiology, Wuhan University School of Basic Medical Sciences, Wuhan, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
| | - Changhua Wang
- Department of Pathology and Pathophysiology, Wuhan University School of Basic Medical Sciences, Wuhan, China
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
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Jaremka LM, Pacanowski CR. Social anxiety symptoms moderate the link between obesity and metabolic function. Psychoneuroendocrinology 2019; 110:104425. [PMID: 31542635 PMCID: PMC7384604 DOI: 10.1016/j.psyneuen.2019.104425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/09/2019] [Accepted: 08/29/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity is a well-known risk factor for elevated inflammation and insulin resistance. Social anxiety may moderate this relationship, such that individuals who areboth obese and socially anxious may have an even greater risk for elevated inflammation and insulin resistance than those who are obese but not socially anxious; the combination of obesity and social anxiety is markedly stressful. METHODS The current paper reports secondary analyses from the Biomarker wave of the Mid-Life in the United States (MIDUS) study (N = 1255), a publicly available dataset of American adults. Participants completed a standard scale measuring social anxiety symptoms and had their waist circumference, height, and weight measured by a staff member. They also provided a fasting blood sample that was assayed for CRP, IL-6, HOMA-IR, glucose, and insulin. RESULTS The interaction between obesity and social anxiety symptoms was significant. People with a larger waist circumference and more social anxiety symptoms had greater inflammation and insulin resistance relative to those with a larger waist circumference but less social anxiety symptoms. These results were similar for both measures of inflammation and were robust across both the unadjusted and adjusted models. The results were also largely replicated in models using body mass index (BMI) rather than waist circumference as the measure of obesity. CONCLUSIONS The current findings build on existing work about the health risks of obesity, extending it in an important new direction by demonstrating that these health risks are stronger among those who are also socially anxious. In fact, the magnitude of the relationship between obesity and metabolic function is 1.5 times stronger among those with more social anxiety symptoms. Thus, knowing whether a person is obese only provides one piece of the puzzle; knowing information about both obesity and social anxiety symptoms is critical for understanding who is most at risk for obesity-related health problems. Thus, a critical next step is for intervention scientists to examine health programs tailored to people who are both obese and socially anxious.
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Affiliation(s)
- Lisa M. Jaremka
- Department of Psychological and Brain Sciences, University of Delaware,Corresponding Author: Lisa M. Jaremka, Department of Psychological and Brain Sciences, 108 Wolf Hall, University of Delaware, Newark DE 19716,
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Kim SH, Abbasi F. Myths about Insulin Resistance: Tribute to Gerald Reaven. Endocrinol Metab (Seoul) 2019; 34:47-52. [PMID: 30912338 PMCID: PMC6435844 DOI: 10.3803/enm.2019.34.1.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 12/12/2022] Open
Abstract
Gerald Reaven was often called the "father of insulin resistance." On the 1-year anniversary of his death in 2018, we challenge three myths associated with insulin resistance: metformin improves insulin resistance; measurement of waist circumference predicts insulin resistance better than body mass index; and insulin resistance causes weight gain. In this review, we highlight Reaven's relevant research that helped to dispel these myths associated with insulin resistance.
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Affiliation(s)
- Sun H Kim
- Division of Endocrinology, Gerontology, and Metabolism, Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA.
| | - Fahim Abbasi
- Division of Cardiovascular Medicine, Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Clemente-Postigo M, Oliva-Olivera W, Coin-Aragüez L, Ramos-Molina B, Giraldez-Perez RM, Lhamyani S, Alcaide-Torres J, Perez-Martinez P, El Bekay R, Cardona F, Tinahones FJ. Metabolic endotoxemia promotes adipose dysfunction and inflammation in human obesity. Am J Physiol Endocrinol Metab 2019; 316:E319-E332. [PMID: 30422702 DOI: 10.1152/ajpendo.00277.2018] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Impaired adipose tissue (AT) lipid handling and inflammation is associated with obesity-related metabolic diseases. Circulating lipopolysaccharides (LPSs) from gut microbiota (metabolic endotoxemia), proposed as a triggering factor for the low-grade inflammation in obesity, might also be responsible for AT dysfunction. Nevertheless, this hypothesis has not been explored in human obesity. To analyze the relationship between metabolic endotoxemia and AT markers for lipogenesis, lipid handling, and inflammation in human obesity, 33 patients with obesity scheduled for surgery were recruited and classified according to their LPS levels. Visceral and subcutaneous AT gene and protein expression were analyzed and adipocyte and AT in vitro assays performed. Subjects with obesity with a high degree of metabolic endotoxemia had lower expression of key genes for AT function and lipogenesis ( SREBP1, FABP4, FASN, and LEP) but higher expression of inflammatory genes in visceral and subcutaneous AT than subjects with low LPS levels. In vitro experiments corroborated that LPS are responsible for adipocyte and AT inflammation and downregulation of PPARG, SCD, FABP4, and LEP expression and LEP secretion. Thus, metabolic endotoxemia influences AT physiology in human obesity by decreasing the expression of factors involved in AT lipid handling and function as well as by increasing inflammation.
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Affiliation(s)
- Mercedes Clemente-Postigo
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Wilfredo Oliva-Olivera
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Leticia Coin-Aragüez
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Bruno Ramos-Molina
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Rosa María Giraldez-Perez
- Departamento Biología Celular, Genética y Fisiología, Facultad de Ciencias. Universidad de Málaga , Spain
| | - Said Lhamyani
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario/Universidad de Málaga , Málaga , Spain
| | - Juan Alcaide-Torres
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Pablo Perez-Martinez
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
- Lipid and Atherosclerosis Research Unit, Reina Sofia University Hospital, University of Cordoba , Cordoba , Spain
| | - Rajaa El Bekay
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario/Universidad de Málaga , Málaga , Spain
| | - Fernando Cardona
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria/Universidad de Málaga. Málaga, Spain
- Centro de Investigación Biomédica En Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII) , Málaga , Spain
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Estrella ML, Pirzada A, Durazo-Arvizu RA, Cai J, Giachello AL, Espinoza Gacinto R, Siega-Riz AM, Daviglus ML. Correlates of and Body Composition Measures Associated with Metabolically Healthy Obesity Phenotype in Hispanic/Latino Women and Men: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Obes 2019; 2019:1251456. [PMID: 30775036 PMCID: PMC6350597 DOI: 10.1155/2019/1251456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
Background Individuals with "metabolically healthy obesity" (MHO) phenotype (i.e., obesity and absence of cardiometabolic abnormalities: favorable levels of blood pressure, lipids, and glucose) experience lower risk of cardiovascular disease compared with those with "metabolically at-risk obesity" (MAO) phenotype (i.e., obesity with concurrent cardiometabolic abnormalities). Among Hispanic/Latino women and men with obesity, limited data exist on the correlates of and body composition measures associated with obesity phenotypes. Methods Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) were used to estimate the age-adjusted distribution of obesity phenotypes among 5,426 women and men (aged 20-74 years) with obesity (BMI ≥ 30 kg/m2) and to compare characteristics between individuals with MHO and MAO phenotypes. Weighted Poisson regression models were used to examine cross-sectional associations between 1-standard deviation (SD) increase in body composition measures (i.e., body fat percentage, waist circumference, and body lean mass) and MHO phenotype prevalence. Results The age-adjusted proportion of the MHO phenotype was low (i.e., 12.5% in women and 6.5% in men). In bivariate analyses, women and men with the MHO phenotype were more likely to be younger, have higher education and acculturation levels, report lower lifetime cigarette use, and have fasting insulin and waist circumference levels than MAO. Adjusting for sociodemographic and lifestyle factors, among women, each 1-SD increase in body fat percentage, waist circumference, and lean body mass was, respectively, associated with a 21%, 33%, and 31% lower prevalence of the MHO phenotype. Among men, each 1-SD increase in waist circumference and lean body mass was, respectively, associated with a 20% and 15% lower prevalence of the MHO phenotype. Conclusions We demonstrated that higher waist circumference and higher lean body mass were independently associated with a lower proportion of the MHO phenotype in Hispanic/Latino women and men. Findings support the need for weight reduction interventions to manage cardiometabolic health among Hispanics/Latinos.
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Affiliation(s)
- Mayra L. Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
| | - Ramon A. Durazo-Arvizu
- Division of Biostatistics, Public Health Sciences, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC 27516, USA
| | - Aida L. Giachello
- Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Dr Suite, Chicago, IL 60611, USA
| | - Rebeca Espinoza Gacinto
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Anna Maria Siega-Riz
- School of Nursing and Departments of Public Health Sciences and Obstetrics and Gynecology, School of Medicine, University of Virginia, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street, Chicago, IL 60612, USA
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Amiri P, Naghizadeh M, Baradaran B, Saghafi-Asl M, Shanehbandi D, Mirmajidi S. Insulin resistance in relation to inflammatory gene expression and metabolic features in apparently healthy obese individuals. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Kopp W. How Western Diet And Lifestyle Drive The Pandemic Of Obesity And Civilization Diseases. Diabetes Metab Syndr Obes 2019; 12:2221-2236. [PMID: 31695465 PMCID: PMC6817492 DOI: 10.2147/dmso.s216791] [Citation(s) in RCA: 357] [Impact Index Per Article: 71.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/13/2019] [Indexed: 12/12/2022] Open
Abstract
Westernized populations are plagued by a plethora of chronic non-infectious degenerative diseases, termed as "civilization diseases", like obesity, diabetes, cardiovascular diseases, cancer, autoimmune diseases, Alzheimer's disease and many more, diseases which are rare or virtually absent in hunter-gatherers and other non-westernized populations. There is a growing awareness that the cause of this amazing discrepancy lies in the profound changes in diet and lifestyle during recent human history. This paper shows that the transition from Paleolithic nutrition to Western diets, along with lack of corresponding genetic adaptations, cause significant distortions of the fine-tuned metabolism that has evolved over millions of years of human evolution in adaptation to Paleolithic diets. With the increasing spread of Western diet and lifestyle worldwide, overweight and civilization diseases are also rapidly increasing in developing countries. It is suggested that the diet-related key changes in the developmental process include an increased production of reactive oxygen species and oxidative stress, development of hyperinsulinemia and insulin resistance, low-grade inflammation and an abnormal activation of the sympathetic nervous system and the renin-angiotensin system, all of which play pivotal roles in the development of diseases of civilization. In addition, diet-related epigenetic changes and fetal programming play an important role. The suggested pathomechanism is also able to explain the well-known but not completely understood close relationship between obesity and the wide range of comorbidities, like type 2 diabetes mellitus, cardiovascular disease, etc., as diseases of the same etiopathology. Changing our lifestyle in accordance with our genetic makeup, including diet and physical activity, may help prevent or limit the development of these diseases.
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Affiliation(s)
- Wolfgang Kopp
- Retired Head, Diagnostikzentrum Graz, Graz8043, Austria
- Correspondence: Wolfgang Kopp Mariatrosterstraße 41, Graz8043, Austria Email
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Bosy-Westphal A, Braun W, Albrecht V, Müller MJ. Determinants of ectopic liver fat in metabolic disease. Eur J Clin Nutr 2018; 73:209-214. [PMID: 30323174 DOI: 10.1038/s41430-018-0323-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/09/2018] [Indexed: 12/17/2022]
Abstract
Common obesity-associated hepatic steatosis (nonalcoholic fatty liver disease (NAFLD)) and insulin resistance are mainly caused by dysfunctional adipose tissue. This adipose tissue dysfunction leads to increased delivery of NEFA and glycerol to the liver that (i) drives hepatic gluconeogenesis and (ii) facilitates the accumulation of lipids and insulin signaling inhibiting lipid intermediates. Dysfunctional adipose tissue can be caused by impaired lipid storage (overflow hypothesis, characterized by large visceral adipocytes) or increased lipolysis (due to impaired postprandial suppression of lipolysis in inflamed, insulin-resistant adipocytes). In line with the adipose tissue expandability hypothesis the amount and distribution of adipose tissue correlate with its dysfunction and thus with liver fat. This relationship is however modified by endocrine effects on lipid storage and lipolysis as well as dietary effects on hepatic lipogenesis and lipid oxidation. The association between body composition characteristics like visceral obesity or fat cell size and ectopic liver fat is modified by these influences. Phenotyping obesity according to metabolic risk should integrate body composition characteristics, endocrine parameters and information on diet.
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Affiliation(s)
- Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany.
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Viktoria Albrecht
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
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Body composition and cardiometabolic health: the need for novel concepts. Eur J Clin Nutr 2018; 72:638-644. [PMID: 29748654 DOI: 10.1038/s41430-018-0158-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 12/31/2022]
Abstract
It seems reasonable that overweight and obesity should be defined based on body composition rather than indirect indices like BMI or waist circumference. The use of conventional parameters like fat mass or visceral fat is however of similar and limited value for disease risk prediction at the population level and does not contribute much beyond the use of simple BMI or waist circumference. This conundrum may be partly explained by using complex phenotypes (e.g., Metabolic Syndrome or whole body insulin resistance) rather than more disease-specific outcomes like liver- and muscle insulin resistance. In addition, there are multifactorial causes of similar body composition phenotypes that may add to explain the variance in metabolic consequences of these phenotypes. An intriguing hypothesis is that fat mass represents the metabolic load that interacts with fat-free mass that stands for metabolic capacity to determine disease risk. This concept has important implications for assessment of healthy growth and development and when it is challenged with weight gain in adults. Integration of body composition information at the whole body, organ-tissue and cellular level is not required to improve the diagnosis of obesity but facilitates a better understanding of the etiology of obesity-associated metabolic complications.
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Kopp W. Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension? Nutr Metab Insights 2018; 11:1178638818773072. [PMID: 30455570 PMCID: PMC6238249 DOI: 10.1177/1178638818773072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/04/2018] [Indexed: 01/09/2023] Open
Abstract
Benign prostatic hyperplasia and hypertension are common age-related comorbidities. Although the etiology of benign prostatic hyperplasia (BPH) is still largely unresolved and poorly understood, a significant age-independent association was found between BPH and hypertension, indicating a common pathophysiological factor for both diseases. It has previously been suggested that the development of essential hypertension may be related to diet-induced hyperinsulinemia. This study follows the question, whether BPH may develop due to the same mechanism, thereby explaining the well-known comorbidity of these 2 disorders. The scientific evidence presented shows that BPH and hypertension share the same pathophysiological changes, with hyperinsulinemia as the driving force. It further shows that significant dietary changes during human history cause disruption of a finely tuned metabolic balance that has evolved over millions of years of evolution: high-insulinemic food, typical of current “Western” diets, has the potential to cause hyperinsulinemia and insulin resistance, as well as an abnormally increased activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, alterations that play a pivotal role in the pathogenesis of BPH and hypertension.
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Affiliation(s)
- Wolfgang Kopp
- Former head of the Diagnostikzentrum Graz, Graz, Austria
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Burghardt KJ, Seyoum B, Mallisho A, Burghardt PR, Kowluru RA, Yi Z. Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies. Prog Neuropsychopharmacol Biol Psychiatry 2018; 83:55-63. [PMID: 29325867 PMCID: PMC5817633 DOI: 10.1016/j.pnpbp.2018.01.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 11/26/2022]
Abstract
Atypical antipsychotics increase the risk of diabetes and cardiovascular disease through their side effects of insulin resistance and weight gain. The populations for which atypical antipsychotics are used carry a baseline risk of metabolic dysregulation prior to medication which has made it difficult to fully understand whether atypical antipsychotics cause insulin resistance and weight gain directly. The purpose of this work was to conduct a systematic review and meta-analysis of atypical antipsychotic trials in healthy volunteers to better understand their effects on insulin sensitivity and weight gain. Furthermore, we aimed to evaluate the occurrence of insulin resistance with or without weight gain and with treatment length by using subgroup and meta-regression techniques. Overall, the meta-analysis provides evidence that atypical antipsychotics decrease insulin sensitivity (standardized mean difference=-0.437, p<0.001) and increase weight (standardized mean difference=0.591, p<0.001) in healthy volunteers. It was found that decreases in insulin sensitivity were potentially dependent on treatment length but not weight gain. Decreases in insulin sensitivity occurred in multi-dose studies <13days while weight gain occurred in studies 14days and longer (max 28days). These findings provide preliminary evidence that atypical antipsychotics cause insulin resistance and weight gain directly, independent of psychiatric disease and may be associated with length of treatment. Further, well-designed studies to assess the co-occurrence of insulin resistance and weight gain and to understand the mechanisms and sequence by which they occur are required.
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Affiliation(s)
- Kyle J. Burghardt
- Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences, Department of Pharmacy Practice; 259 Mack Avenue, Suite 2190, Detroit, MI 48201. USA
| | - Berhane Seyoum
- Wayne State University School of Medicine, Division of Endocrinology, 4201 St Antoine, Detroit, MI 48201, USA.
| | - Abdullah Mallisho
- Wayne State University School of Medicine, Division of Endocrinology, 4201 St Antoine, Detroit, MI 48201, USA.
| | - Paul R. Burghardt
- Wayne State University College of Liberal Arts & Sciences, Nutrition and Food Science; 5045 Cass Avenue, Detroit, MI 48202. USA
| | - Renu A. Kowluru
- Wayne State University School of Medicine, Department of Anatomy and Cell Biology; 540 E Canfield St, Detroit, MI 48201. USA
| | - Zhengping Yi
- Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences, Department of Pharmaceutical Science, 259 Mack Avenue, Detroit, MI 48201, USA.
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Santos C, Marques da Silva P. Hemodynamic patterns in obesity associated hypertension. BMC OBESITY 2018; 5:13. [PMID: 29692916 PMCID: PMC5902933 DOI: 10.1186/s40608-018-0190-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/05/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Catarina Santos
- Serviço de Nefrologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, 6000-085 Castelo Branco, Portugal.,2Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - Pedro Marques da Silva
- 3Núcleo de Investigação Arterial, Serviço de Medicina Interna, Centro Hospitalar de Lisboa Central, 1169-1024 Lisbon, Portugal
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Whole-genome transcriptomic insights into protective molecular mechanisms in metabolically healthy obese African Americans. NPJ Genom Med 2018; 3:4. [PMID: 29387454 PMCID: PMC5789085 DOI: 10.1038/s41525-018-0043-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 01/05/2018] [Accepted: 01/11/2018] [Indexed: 02/07/2023] Open
Abstract
Several clinical guidelines have been proposed to distinguish metabolically healthy obesity (MHO) from other subgroups of obesity but the molecular mechanisms by which MHO individuals remain metabolically healthy despite having a high fat mass are yet to be elucidated. We conducted the first whole blood transcriptomic study designed to identify specific sets of genes that might shed novel insights into the molecular mechanisms that protect or delay the occurrence of obesity-related co-morbidities in MHO. The study included 29 African-American obese individuals, 8 MHO and 21 metabolically abnormal obese (MAO). Unbiased transcriptome-wide network analysis was carried out to identify molecular modules of co-expressed genes that are collectively associated with MHO. Network analysis identified a group of 23 co-expressed genes, including ribosomal protein genes (RPs), which were significantly downregulated in MHO subjects. The three pathways enriched in the group of co-expressed genes are EIF2 signaling, regulation of eIF4 and p70S6K signaling, and mTOR signaling. The expression of ten of the RPs collectively predicted MHO status with an area under the curve of 0.81. Triglycerides/HDL (TG/HDL) ratio, an index of insulin resistance, was the best predictor of the expression of genes in the MHO group. The higher TG/HDL values observed in the MAO subjects may underlie the activation of endoplasmic reticulum (ER) and related-stress pathways that lead to a chronic inflammatory state. In summary, these findings suggest that controlling ER stress and/or ribosomal stress by downregulating RPs or controlling TG/HDL ratio may represent effective strategies to prevent or delay the occurrence of metabolic disorders in obese individuals.
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Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Transl Res 2017; 183:57-70. [PMID: 28130064 PMCID: PMC5393930 DOI: 10.1016/j.trsl.2017.01.001] [Citation(s) in RCA: 281] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/22/2016] [Accepted: 01/03/2017] [Indexed: 01/18/2023]
Abstract
The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiological mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review, we highlight current knowledge regarding the pathophysiological consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiological and molecular mechanisms that may contribute to these adverse outcomes.
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Affiliation(s)
- Johnathan D Tune
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind.
| | - Adam G Goodwill
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind
| | - Daniel J Sassoon
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind
| | - Kieren J Mather
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind; Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind
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Maniar K, Moideen A, Mittal A, Patil A, Chakrabarti A, Banerjee D. A story of metformin-butyrate synergism to control various pathological conditions as a consequence of gut microbiome modification: Genesis of a wonder drug? Pharmacol Res 2016; 117:103-128. [PMID: 27939359 DOI: 10.1016/j.phrs.2016.12.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/25/2016] [Accepted: 12/05/2016] [Indexed: 12/19/2022]
Abstract
The most widely prescribed oral anti-diabetic agent today in the world today is a member of the biguanide class of drugs called metformin. Apart from its use in diabetes, it is currently being investigated for its potential use in many diseases such as cancer, cardiovascular diseases, Alzheimer's disease, obesity, comorbidities of diabetes such as retinopathy, nephropathy to name a few. Numerous in-vitro and in-vivo studies as well as clinical trials have been and are being conducted with a vast amount of literature being published every day. Numerous mechanisms for this drug have been proposed, but they have been unable to explain all the actions observed clinically. It is of interest that insulin has a stimulatory effect on cellular growth. Metformin sensitizes the insulin action but believed to be beneficial in cancer. Like -wise metformin is shown to have beneficial effects in opposite sets of pathological scenario looking from insulin sensitization point of view. This requires a comprehensive review of the disease conditions which are claimed to be affected by metformin therapy. Such a comprehensive review is presently lacking. In this review, we begin by examining the history of metformin before it became the most popular anti-diabetic medication today followed by a review of its relevant molecular mechanisms and important clinical trials in all areas where metformin has been studied and investigated till today. We also review novel mechanistic insight in metformin action in relation to microbiome and elaborate implications of such aspect in various disease states. Finally, we highlight the quandaries and suggest potential solutions which will help the researchers and physicians to channel their research and put this drug to better use.
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Affiliation(s)
- Kunal Maniar
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amal Moideen
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Ankur Mittal
- Department of Experimental Medicine & Biotechnology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amol Patil
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amitava Chakrabarti
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Dibyajyoti Banerjee
- Department of Experimental Medicine & Biotechnology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
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Impact of weight loss-associated changes in detailed body composition as assessed by whole-body MRI on plasma insulin levels and homeostatis model assessment index. Eur J Clin Nutr 2016; 71:212-218. [PMID: 27759067 DOI: 10.1038/ejcn.2016.189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 08/11/2016] [Accepted: 08/18/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES We assessed the effect of weight loss-associated changes in detailed body composition on plasma insulin levels and homeostatic model assessment (HOMA) index to calculate the magnitude of reduction in different adipose tissue depots required to improve insulin sensitivity. SUBJECTS/METHODS A total of 50 subjects aged 20-69 years were studied. The participants were compiled from low-calorie diet interventions and bariatric surgery and differed in their baseline body mass index (BMI; range 21.6-54.4 kg/m2) and degree of weight losses (range -3.3 to -56.9 kg). Detailed body composition and liver fat were measured using whole-body magnetic resonance imaging (MRI). Insulin resistance was assessed by HOMA. RESULTS Mean body weight decreased by -16.0±13.6 kg. Significant changes were observed in total adipose tissue (TATMRI, range -0.5 to -36.0 kg), total subcutaneous adipose tissue (SATMRI), visceral adipose tissue (VATMRI), skeletal muscle, liver fat, plasma insulin levels and HOMA. Decreases in insulin and HOMA were correlated with reductions in TATMRI, SATMRI, VATMRI (just with HOMA) and liver fat. Losses of 2.9 and 6.5 kg body weight, 2.0 and 5.0 kg TATMRI as well as 1.6 and 6% liver fat were required to decrease plasma insulin levels by 1 μU/ml and HOMAadjusted for baseline HOMA by 1 point. Multiple regression analysis showed that baseline liver fat and changes in liver fat explained 49.7% and 55.1% of the variance in weight loss-associated changes in plasma insulin and HOMA, respectively. CONCLUSIONS Decreases of adipose tissues and liver fat are the major determinants of reduction in plasma insulin levels and improvement in HOMA index.
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Metabolic phenotypes of obesity: frequency, correlates and change over time in a cohort of postmenopausal women. Int J Obes (Lond) 2016; 41:170-177. [PMID: 27748744 DOI: 10.1038/ijo.2016.179] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/12/2016] [Accepted: 09/18/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The possibility that a subset of persons who are obese may be metabolically healthy-referred to as the 'metabolically healthy obese' (MHO) phenotype-has attracted attention recently. However, few studies have followed individuals with MHO or other obesity phenotypes over time to assess change in their metabolic profiles. The aim of the present study was to examine transitions over a 6-year period among different states defined simultaneously by body mass index (BMI) and the presence/absence of the metabolic syndrome (MetS). METHODS We used repeated measurements available for a subcohort of participants enrolled in the Women's Health Initiative (N=3512) and followed for an average of 6 years to examine the frequency of different metabolic obesity phenotypes at baseline, the 6-year transition probabilities to other states and predictors of the risk of different transitions. Six phenotypes were defined by cross-tabulating BMI (18.5-<25.0, 25.0-<30.0, ⩾30.0 kg m-2) by MetS (yes, no). A continuous-time Markov model was used to estimate 6-year transition probabilities from one state to another. RESULTS Over the 6 years of follow-up, one-third of women with the healthy obese phenotype transitioned to the metabolically unhealthy obese (MUO) phenotype. Overall, there was a marked tendency toward increased metabolic deterioration with increasing BMI and toward metabolic improvement with lower BMI. Among MHO women, the 6-year probability of becoming MUO was 34%, whereas among unhealthy normal-weight women, the probability of 'regressing' to the metabolically healthy normal-weight phenotype was 52%. CONCLUSIONS The present study demonstrated substantial change in metabolic obesity phenotypes over a 6-year period. There was a marked tendency toward metabolic deterioration with greater BMI and toward metabolic improvement with lower BMI.
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Liu T. A Comparison of Biological and Physical Risk Factors for Cardiovascular Disease in Overweight/Obese Individuals With and Without Prediabetes. Clin Nurs Res 2016; 26:674-693. [PMID: 27402725 DOI: 10.1177/1054773816658644] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Compared with type 2 diabetes, evaluating the direct biological and physical risk factors for cardiovascular disease (CVD) in overweight/obese adults with and without prediabetes is less understood. Therefore, the aim of the study was to compare baseline biological and physical risk factors for CVD among overweight/obese adults with and without prediabetes. A secondary data analysis was performed. Three hundred forty-one overweight/obese participants were included in the analysis. Compared with non-prediabetics, prediabetics had higher fasting blood glucose, body mass index, waist-to-hip ratio, and triglycerides. Prediabetics were also more likely to be insulin resistant than non-prediabetics. Participants with prediabetes had much lower cardiorespiratory fitness than those without prediabetes. Findings from this study suggest that healthy overweight/obese adults with prediabetes were likely at higher biological and physical risk of CVD at baseline compared with those without prediabetes. Early intervention to improve CVD risk progression among persons with prediabetes is essential.
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Doumatey AP, Zhou J, Zhou M, Prieto D, Rotimi CN, Adeyemo A. Proinflammatory and lipid biomarkers mediate metabolically healthy obesity: A proteomics study. Obesity (Silver Spring) 2016; 24:1257-65. [PMID: 27106679 PMCID: PMC4882259 DOI: 10.1002/oby.21482] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/11/2016] [Accepted: 01/11/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The metabolically healthy obesity (MHO) phenotype is an important obesity subtype in which obesity is not accompanied by any metabolic comorbidity. However, the underlying molecular mechanisms remain elusive. In this study, a shotgun proteomics approach to identify circulating biomolecules and pathways associated with MHO was used. METHODS The subjects were 20 African-American women: 10 MHO cases and 10 metabolically abnormal individuals with obesity (MAO) controls. Serum proteins were detected and quantified using label-free proteomics. Differential expression of proteins between the two groups was analyzed, and the list of differentially expressed proteins was analyzed to determine enriched biological pathways. RESULTS Twenty proteins were differentially expressed between MHO and controls. These proteins included: hemoglobin subunits (HBA1, P = 6.00 × 10(-18) ), haptoglobin-related protein (HPR, P = 1.2 × 10(-15) ), apolipoproteins (APOB-100, P = 1.50 × 10(-40) ; APOA4, P = 1.1 × 10(-14) ), retinol-binding protein 4 (RBP4, P = 7.1 × 10(-08) ), and CRP (P = 2.0 × 10(-04) ). MHO was associated with lower levels of proinflammatory and higher levels of anti-inflammatory biomarkers when compared with MAO. Pathway analysis showed enrichment of lipids and inflammatory pathways, including LXR/RXR and FXR/RXR activation, and acute phase response signaling. CONCLUSIONS These findings suggested that protection from dysregulated inflammatory and lipid processes were primary molecular hallmarks of MHO. The candidate biomarkers (AHSG, RBP4, and APOA4) identified in this study are potential prognostic markers for MHO.
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Affiliation(s)
- Ayo Priscille Doumatey
- Center for Research on Genomics and Global HealthNational Human Genome Research Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Jie Zhou
- Center for Research on Genomics and Global HealthNational Human Genome Research Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Ming Zhou
- Laboratory of Proteomics and Analytical Technologies (LPAT) Leidos Biomedical Research IncNational Cancer Institute, National Institutes of HealthFrederickMarylandUSA
| | - DaRue Prieto
- Laboratory of Proteomics and Analytical Technologies (LPAT) Leidos Biomedical Research IncNational Cancer Institute, National Institutes of HealthFrederickMarylandUSA
| | - Charles N. Rotimi
- Center for Research on Genomics and Global HealthNational Human Genome Research Institute, National Institutes of HealthBethesdaMarylandUSA
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global HealthNational Human Genome Research Institute, National Institutes of HealthBethesdaMarylandUSA
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Quispe R, Martin SS, Jones SR. Triglycerides to high-density lipoprotein-cholesterol ratio, glycemic control and cardiovascular risk in obese patients with type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 2016; 23:150-6. [PMID: 26863278 DOI: 10.1097/med.0000000000000241] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This article provides an update on the role of the triglyceride to high-density lipoprotein-cholesterol (triglyceride/HDL-C) ratio in the setting of obesity-related insulin resistance and type 2 diabetes mellitus. RECENT FINDINGS Insulin resistance and type 2 diabetes mellitus are well-established risk factors for cardiovascular diseases, and are commonly associated with metabolic abnormalities such as hypertriglyceridemia, low HDL-C and presence of small, dense low-dense lipoprotein (LDL) particles. Mounting evidence suggests that the triglyceride/HDL-C ratio is a marker of insulin resistance, although this relationship might vary as a function of ethnicity and sex. The triglyceride/HDL-C ratio has also been shown to correlate with other atherogenic lipid measurements, such as triglyceride-rich lipoproteins, remnant cholesterol and small dense LDL particles. Recent epidemiologic studies have shown that the triglyceride/HDL-C ratio associates with cardiovascular risk, mainly because of its association with insulin resistance. Finally, triglyceride/HDL-C can also be a marker of glycemic control, especially in obese patients with type 2 diabetes mellitus. SUMMARY The triglyceride/HDL-C integrates information on triglyceride-rich lipoproteins, insulin resistance and glycemic control. Future studies may better define its specific clinical role.
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Affiliation(s)
- Renato Quispe
- aJohns Hopkins Ciccarone Center for the Prevention of Heart Disease bWelch Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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de Matos MA, Duarte TC, Ottone VDO, Sampaio PFDM, Costa KB, de Oliveira MFA, Moseley PL, Schneider SM, Coimbra CC, Brito-Melo GEA, Magalhães FDC, Amorim FT, Rocha-Vieira E. The effect of insulin resistance and exercise on the percentage of CD16+monocyte subset in obese individuals. Cell Biochem Funct 2016; 34:209-16. [DOI: 10.1002/cbf.3178] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Mariana A. de Matos
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Tamiris C. Duarte
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Vinícius de O. Ottone
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Pâmela F. da M. Sampaio
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Karine B. Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | | | | | | | - Cândido C. Coimbra
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal de Minas Gerais; Endocrinology Laboratory; Belo Horizonte Brazil
| | - Gustavo E. A. Brito-Melo
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunology Laboratory; Diamantina Brazil
| | - Flávio de C. Magalhães
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Fabiano T. Amorim
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
| | - Etel Rocha-Vieira
- Sociedade Brasileira de Fisiologia (SBFis); Programa Multicêntrico de Pós-graduação em Ciências Fisiológicas (PMPGCF); Brazil
- Universidade Federal dos Vales do Jequitinhonha e Mucuri; Immunometabolism Group; Diamantina Brazil
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Abdominal fat distribution and carotid atherosclerosis in a general population: a semi-automated method using magnetic resonance imaging. Jpn J Radiol 2016; 34:414-22. [PMID: 27015838 DOI: 10.1007/s11604-016-0540-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Available evidence suggests functional differences in visceral and subcutaneous fat. We investigated the association between quantitative measures of central adiposity with indicators of carotid atherosclerosis including intima-media thickness (IMT) and plaque in a general population using a semi-automated method on magnetic resonance imaging (MRI) data. METHODS In this cross-sectional study 200 subjects (52 % female), aged 50-77 years, were randomly selected from Golestan Cohort Study. Participants underwent ultrasound examination of carotid arteries and abdominal MRI. Segmentation and calculation of visceral (VFA) and subcutaneous fat area (SFA) were performed on three levels using semi-automated software. Various conventional anthropometric indices were also measured. RESULTS Among 191 enrolled subjects, 77 (40 %) participants had IMT ≥0.8 mm. Carotid plaques were detected in 86 (44 %) subjects. In separate multivariate analysis models, unlike SFA and other anthropometric indices, the last tertile of VFA values was associated with at least threefold excess risk for IMT ≥0.8 mm (OR 3.8, 95 % CI 1.36-6.94, p = 0.02). There was no significant difference between mean values of categorized obesity indices in subjects with and without plaque, while participants in the highest tertile of VFA values were demonstrated to have higher risk of more than one plaque (OR 4.57, 95 % CI 1.03-20.11, p = 0.034). CONCLUSIONS A higher amount of visceral fat, measured by a semi-automated technique using MRI, is associated with increased IMT and having more than one carotid plaque in a general population, while subcutaneous fat measures are poor indicators for identifying carotid atherosclerosis.
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Boyer WR, Johnson TM, Fitzhugh EC, Richardson MR, Churilla JR. The Associations Between Increasing Degrees of HOMA-IR and Measurements of Adiposity Among Euglycemic U.S. Adults. Metab Syndr Relat Disord 2016; 14:108-13. [PMID: 26789259 DOI: 10.1089/met.2015.0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the associations between increasing degrees of insulin resistance (using the homeostatic model assessment of insulin resistance [HOMA-IR]) and two measures of adiposity in a nationally representative sample of euglycemic U.S. adults. MATERIALS AND METHODS Sample included adult participants (≥ 20 years of age) [N = 1586 (body mass index, BMI model), N = 1577 (waist circumference, WC model)] from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles. BMI and WC were examined continuously as the dependent variables. RESULTS Following adjustment for covariates, those with HOMA-IR values in the second, third, and fourth quartiles had significantly higher BMIs (P < 0.001) compared with subjects in the first quartile. In the model using WC, significantly higher WCs were found in subjects in the second, third, and fourth quartiles of HOMA-IR (P < 0.001) compared with those in the first quartile. A significant moderate correlation was found between HOMA-IR and BMI (R(2) = 0.4171, P < 0.001), as well as HOMA-IR and WC (R(2) = 0.4826, P < 0.001). CONCLUSIONS Having a higher HOMA-IR value is associated with higher BMI and WC values in euglycemic subjects.
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Affiliation(s)
- William R Boyer
- 1 Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee , Knoxville, Tennessee
| | - Tammie M Johnson
- 2 Department of Public Health, University of North Florida , Jacksonville, Florida
| | - Eugene C Fitzhugh
- 1 Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee , Knoxville, Tennessee
| | - Michael R Richardson
- 3 Department of Clinical and Applied Movement Sciences, University of North Florida , Jacksonville, Florida
| | - James R Churilla
- 3 Department of Clinical and Applied Movement Sciences, University of North Florida , Jacksonville, Florida
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Obesity-Related Diseases and Syndromes: Insulin Resistance, Type 2 Diabetes Mellitus, Non-alcoholic Fatty Liver Disease, Cardiovascular Disease, and Metabolic Syndrome. Obesity (Silver Spring) 2016. [DOI: 10.1007/978-3-319-39409-1_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Rajaraman G, Simcocks A, Hryciw DH, Hutchinson DS, McAinch AJ. G protein coupled receptor 18: A potential role for endocannabinoid signaling in metabolic dysfunction. Mol Nutr Food Res 2015; 60:92-102. [PMID: 26337420 DOI: 10.1002/mnfr.201500449] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/18/2015] [Accepted: 08/23/2015] [Indexed: 02/06/2023]
Abstract
Endocannabinoids are products of dietary fatty acids that are modulated by an alteration in food intake levels. Overweight and obese individuals have substantially higher circulating levels of the arachidonic acid derived endocannabinoids, anandamide and 2-arachidonoyl glycerol, and show an altered pattern of cannabinoid receptor expression. These cannabinoid receptors are part of a large family of G protein coupled receptors (GPCRs). GPCRs are major therapeutic targets for various diseases within the cardiovascular, neurological, gastrointestinal, and endocrine systems, as well as metabolic disorders such as obesity and type 2 diabetes mellitus. Obesity is considered a state of chronic low-grade inflammation elicited by an immunological response. Interestingly, the newly deorphanized GPCR (GPR18), which is considered to be a putative cannabinoid receptor, is proposed to have an immunological function. In this review, the current scientific knowledge on GPR18 is explored including its localization, signaling pathways, and pharmacology. Importantly, the involvement of nutritional factors and potential dietary regulation of GPR18 and its (patho)physiological roles are described. Further research on this receptor and its regulation will enable a better understanding of the complex mechanisms of GPR18 and its potential as a novel therapeutic target for treating metabolic disorders.
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Affiliation(s)
- Gayathri Rajaraman
- Centre for Chronic Disease Prevention and Management, College of Health & Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Anna Simcocks
- Centre for Chronic Disease Prevention and Management, College of Health & Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Deanne H Hryciw
- Department of Physiology, The University of Melbourne, Parkville, VIC, Australia
| | - Dana S Hutchinson
- Department of Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - Andrew J McAinch
- Centre for Chronic Disease Prevention and Management, College of Health & Biomedicine, Victoria University, Melbourne, VIC, Australia
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Bond B, Williams CA, Jackman SR, Woodward A, Armstrong N, Barker AR. Accumulating exercise and postprandial health in adolescents. Metabolism 2015; 64:1068-76. [PMID: 26116999 DOI: 10.1016/j.metabol.2015.05.016] [Citation(s) in RCA: 13] [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: 02/06/2015] [Revised: 05/05/2015] [Accepted: 05/08/2015] [Indexed: 01/11/2023]
Abstract
PURPOSE To examine the influence of exercise intensity on postprandial health outcomes in adolescents when exercise is accumulated throughout the day. METHODS 19 adolescents (9 male, 13.7±0.4 years old) completed three 1-day trials in a randomised order: (1) rest (CON); or four bouts of (2) 2×1 min cycling at 90% peak power with 75 s recovery (high-intensity interval exercise; HIIE); or (3) cycling at 90% of the gas exchange threshold (moderate-intensity exercise; MIE), which was work-matched to HIIE. Each bout was separated by 2 hours. Participants consumed a high fat milkshake for breakfast and lunch. Postprandial triacylglycerol (TAG), glucose, systolic blood pressure (SBP) and fat oxidation were assessed throughout the day. RESULTS There was no effect of trial on total area under the curve (TAUC) for TAG (P=0.87). TAUC-glucose was lower in HIIE compared to CON (P=0.03, ES=0.42) and MIE (P=0.04, ES=0.41), with no difference between MIE and CON (P=0.89, ES=0.04). Postprandial SBP was lower in HIIE compared to CON (P=0.04, ES=0.50) and MIE (P=0.04, ES=0.40), but not different between MIE and CON (P=0.52, ES=0.11). Resting fat oxidation was increased in HIIE compared to CON (P=0.01, ES=0.74) and MIE (P=0.05, ES=0.51), with no difference between MIE and CON (P=0.37, ES=0.24). CONCLUSION Neither exercise trial attenuated postprandial lipaemia. However, accumulating brief bouts of HIIE, but not MIE, reduced postprandial plasma glucose and SBP, and increased resting fat oxidation in adolescent boys and girls. The intensity of accumulated exercise may therefore have important implications for health outcomes in youth.
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Affiliation(s)
- Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom
| | - Sarah R Jackman
- Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom
| | - Adam Woodward
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom
| | - Neil Armstrong
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, United Kingdom.
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Changes in glucose disposal after a caloric restriction–induced weight loss program in obese postmenopausal women. Menopause 2015; 22:96-103. [DOI: 10.1097/gme.0000000000000273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Clemente-Postigo M, Roca-Rodriguez MDM, Camargo A, Ocaña-Wilhelmi L, Cardona F, Tinahones FJ. Lipopolysaccharide and lipopolysaccharide-binding protein levels and their relationship to early metabolic improvement after bariatric surgery. Surg Obes Relat Dis 2014; 11:933-9. [PMID: 25737102 DOI: 10.1016/j.soard.2014.11.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 10/31/2014] [Accepted: 11/26/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bariatric surgery usually results in metabolic improvements within a few days from intervention, but the underlying mechanism is not completely understood and may vary depending on the bariatric procedure. Lipopolysaccharides (LPS) from gut microbiota have been proposed as a triggering factor for the inflammatory state in obesity. Roux-en-Y Gastric Bypass (RYGB) leads to a LPS decrease in the medium-term. OBJECTIVE To analyze LPS and LPS-binding protein (LBP) in normoglycemic (NG) and diabetic morbidly obese patients in the short-term after 2 different bariatric surgery procedures. SETTING University Hospital, Spain. METHODS Fifty morbidly obese patients underwent bariatric surgery: 24 with sleeve gastrectomy (SG) and 26 with biliopancreatic diversion (BPD). Patients were classified according to their glycemic status as NG or prediabetic/diabetic. LPS and LBP levels and biochemical and anthropometric variables were determined before and at days 15 and 90 after surgery. RESULTS A significant LPS reduction was seen only in the prediabetic/diabetic patients at 90 days after SG. LBP levels rose at 15 days after BPD but at 90 days returned to baseline in both NG and prediabetic/diabetic patients. At 90 days after SG, LBP levels significantly decreased compared to baseline in NG and prediabetic/diabetic patients. After multivariate analysis only the change in BMI was independently associated with the change in LBP levels at 90 days. None of the changes in biochemical or anthropometrical variables were significantly associated with the changes in LPS levels at 15 days or 90 days. CONCLUSION This is the first study showing that the short-term LPS decrease after bariatric surgery depends on the surgical procedure used as well as on the previous glycemic status of the patient, with SG having the greatest short-term effect on LPS and LBP levels. LBP is closely related to anthropometric variables and may be an inflammatory marker in bariatric surgery patients.
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Affiliation(s)
- Mercedes Clemente-Postigo
- Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain.
| | - Maria del Mar Roca-Rodriguez
- Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain
| | - Antonio Camargo
- Lipid and Atherosclerosis Research Unit (IMIBIC). Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Luis Ocaña-Wilhelmi
- Unidad de Gestión Clínica de Cirugía General, Digestiva y Trasplantes. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria), Málaga, Spain
| | - Fernando Cardona
- Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain.
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Zhang L, Cui Y, Fu F, Li Z, Pan X, Li H, Li L. An insight into the key genes and biological functions associated with insulin resistance in adipose tissue with microarray technology. Mol Med Rep 2014; 11:1963-7. [PMID: 25385661 DOI: 10.3892/mmr.2014.2909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 04/08/2014] [Indexed: 11/05/2022] Open
Abstract
In the present study, the key genes and biological functions associated with insulin resistance were investigated by comparing the gene expression profiles of adipose tissue obtained from insulin‑sensitive and insulin‑resistant patients. The gene expression data set GSE20950 was downloaded from the Gene Expression Omnibus, including 39 adipose tissue samples obtained from insulin‑sensitive and insulin‑resistant patients undergoing gastric bypass surgery. Adipose samples were divided into two groups (the insulin‑sensitive and insulin‑resistant groups) and the differentially expressed genes (DEGs) were screened out with packages of R. The interactions among DEGs were retrieved with Osprey and functional enrichment analysis was performed with the WebGestalt system. Information regarding the interaction network and enriched biological functions was combined to construct a functional interaction network. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was then conducted using the Database for Annotation, Visualization and Integrated Discovery. A total of 170 DEGs were detected in the insulin‑sensitive group, 8 downregulated and 162 upregulated. Response to glucose stimulus was the most significantly over‑represented functional term. The focal adhesion pathway was identified to be significant in the genes of the functional interaction network. The present study revealed key biological functions and DEGs in adipose tissues associated with insulin resistance, which may facilitate the development of novel therapies for insulin resistance and diabetes.
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Affiliation(s)
- Li Zhang
- Department of Endocrinology, The Fourth People's Hospital of Jinan, Jinan, Shandong 250031, P.R. China
| | - Ying Cui
- Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250031, P.R. China
| | - Fangming Fu
- Department of Endocrinology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250031, P.R. China
| | - Zhenzuo Li
- Department of Endocrinology, The Fourth People's Hospital of Jinan, Jinan, Shandong 250031, P.R. China
| | - Xiaoxia Pan
- Department of Endocrinology, The Fourth People's Hospital of Jinan, Jinan, Shandong 250031, P.R. China
| | - Hongzhuan Li
- Department of Endocrinology, The Fourth People's Hospital of Jinan, Jinan, Shandong 250031, P.R. China
| | - Lin Li
- Department of Endocrinology, The General Hospital of Jinan Military Command, Jinan, Shandong 250031, P.R. China
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High intensity interval exercise is an effective alternative to moderate intensity exercise for improving glucose tolerance and insulin sensitivity in adolescent boys. J Sci Med Sport 2014; 18:720-4. [PMID: 25459232 DOI: 10.1016/j.jsams.2014.10.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/02/2014] [Accepted: 10/05/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVES High-intensity interval exercise (HIIE) may offer a time efficient means to improve health outcomes compared to moderate-intensity exercise (MIE). This study examined the acute effect of HIIE compared to a work-matched bout of MIE on glucose tolerance, insulin sensitivity (IS), resting fat oxidation and exercise enjoyment in adolescent boys. DESIGN Within-measures design with counterbalanced experimental conditions. METHODS Nine boys (14.2 ± 0.4 years) completed three conditions on separate days in a counterbalanced order: (1) HIIE; (2) work matched MIE, both on a cycle ergometer; and (3) rest (CON). An oral glucose tolerance test (OGTT) was performed after exercise or rest and the area under curve (AUC) responses for plasma [glucose] and [insulin] were calculated, and IS estimated (Cederholm index). Energy expenditure and fat oxidation were measured following the OGTT using indirect calorimetry. Exercise enjoyment was assessed using the Physical Activity Enjoyment Scale. RESULTS The incremental AUC (iAUC) for plasma [glucose] was reduced following both MIE (-23.9%, P = 0.013, effect size [ES] = -0.64) and HIIE (-28.9%, P=0.008, ES = -0.84) compared to CON. The iAUC for plasma [insulin] was lower for HIIE (-24.2%, P = 0.021, ES = -0.71) and MIE (-29.1%, P = 0.012, ES = -0.79) compared to CON. IS increased by 11.2% after HIIE (P = 0.03, ES = 0.76) and 8.4% after MIE (P = 0.10, ES = 0.58). There was a trend for an increase in fat oxidation following HIIE (P = 0.097, ES = 0.70). Both HIIE and MIE were rated as equally enjoyable (P > 0.05, ES < 0.01). CONCLUSION A single bout of time efficient HIIE is an effective alternative to MIE for improving glucose tolerance and IS in adolescent boys immediately after exercise.
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Seaman DR, Palombo AD. An Overview of the Identification and Management of the Metabolic Syndrome in Chiropractic Practice. J Chiropr Med 2014; 13:210-9. [DOI: 10.1016/j.jcm.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/06/2014] [Accepted: 06/09/2014] [Indexed: 10/24/2022] Open
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Proof-of-concept for a virus-induced obesity vaccine; vaccination against the obesity agent adenovirus 36. Int J Obes (Lond) 2014; 38:1470-4. [PMID: 24614097 DOI: 10.1038/ijo.2014.41] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 02/23/2014] [Accepted: 03/04/2014] [Indexed: 01/21/2023]
Abstract
Human adenovirus 36 (Ad36) is positively associated with obesity in humans and animals. Ad36 infection is characterized by increased adiposity and inflammation. To investigate the possibility that a prophylactic vaccine candidate might protect against Ad36-induced obesity and inflammation, we purified Ad36 and ultraviolet-irradiated virus to obtain a vaccine candidate. After immunizing the mice with the vaccine candidate (vaccinated group), live Ad36 was injected into mice as a challenge test. Unvaccinated mice (control group) were immunized with phosphate-buffered saline and then challenged with live Ad36. Fourteen weeks after challenge, we compared adiposity and inflammation in vaccinated and control mice. The control group showed 17% greater body weight and 20% more epididymal fats compared with the vaccinated group. In addition, the vaccinated group had decreased serum levels of pro-inflammatory cytokines, and infiltrated immune cells, especially M1 macrophages, in fat tissue. Therefore, the vaccine candidate for Ad36 was able to protect against Ad36-increased body weight and fat as well as inflammatory states after challenge. These results provide proof-of-concept for prophylactic vaccination against virus-induced adiposity.
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Zhang M, Tong W, Chen J, Zhang Y, Li S. Metabolically healthy obesity and its associates in Mongolian Chinese adults. Metab Syndr Relat Disord 2014; 12:185-90. [PMID: 24460218 DOI: 10.1089/met.2013.0102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Not all obese individuals show cardiometabolic abnormalities. We examined metabolically healthy obesity (MHO) and its associates in 2530 Mongolian Chinese adults. METHODS MHO was defined by waist circumference, low-density lipoprotein (LDL-C) cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose. RESULTS Only 3.0% of the participants had MHO, with 0.8% of men and 4.5% of women having this condition (P < 0.001 for sex difference). Despite striking differences in obesity measures, MHO individuals had a comparable cardiometabolic profile to that for metabolically healthy, nonobese individuals (MHNO) and an improved cardiometabolic profile, i.e., lower levels of blood pressure, glucose, insulin, LDL-C, TGs, and higher levels of HDL-C compared to metabolically abnormal individuals (all P < 0.01, except for insulin). MHO individuals had lower levels of high-sensitivity C-reactive protein and soluble intercellular adhesion molecule-1, compared to metabolically abnormal individuals, and had comparable levels of these markers to those in MHNO individuals. Furthermore, only 5.3% of MHO individuals had a family history of hypertension, comparable to 5.0% in MHNO individuals, and much lower than 15.9% in metabolically abnormal, nonobese individuals and 12.8% in metabolically abnormal, obese individuals (overall P < 0.001). CONCLUSIONS We conclude that MHO is associated with a low inflammation state, and family history of hypertension may play a role in the MHO phenotype.
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Affiliation(s)
- Mingzhi Zhang
- 1 Department of Epidemiology, School of Public Health, Soochow University , Suzhou, Jiangsu, China
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Tuvdendorj D, Chandalia M, Batbayar T, Saraf M, Beysen C, Murphy EJ, Abate N. Altered subcutaneous abdominal adipose tissue lipid synthesis in obese, insulin-resistant humans. Am J Physiol Endocrinol Metab 2013; 305:E999-E1006. [PMID: 23982159 PMCID: PMC3798696 DOI: 10.1152/ajpendo.00194.2013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to evaluate the variability of subcutaneous abdominal adipose tissue (AT) dynamics in obese subjects with a wide range of insulin sensitivity (IS) and the correlation between these two metabolic measures. Ten obese (BMI 30-40 kg/m²) nondiabetic subjects with (n = 6) and without (n = 4) the metabolic syndrome were studied following a 12-wk ²H₂O labeling period. Subcutaneous abdominal AT biopsies were collected. Deuterium incorporation into triglyceride (TG)-glycerol and TG-palmitate were measured by gas chromatography-mass spectrometry for the calculation of fractional TG synthesis (fTG) and fractional de novo lipogenesis (fDNL). Muscle IS and insulin-mediated nonesterified fatty acid (NEFA) suppression (a measure for adipose IS) indexes were derived from the oral glucose tolerance test (OGTT). The ability of subcutaneous abdominal AT to synthesize lipids varied significantly in obese subjects (fTG range 7-28%, fDNL range 1.1-4.6%) with significantly lower values (>35% reduction) for both parameters in obese with the metabolic syndrome. fTG correlated positively with muscle IS (r = 0.64, P = 0.04) and inversely with NEFA suppression during the OGTT (r = -0.69, P = 0.03). These results demonstrate a large variability in subcutaneous abdominal AT lipid turnover in obesity. Moreover, a reduced capacity for subcutaneous abdominal AT fat storage is associated with muscle and adipose tissue insulin resistance as well as with the metabolic syndrome, thus identifying a form of obesity at heightened risk for type 2 diabetes and cardiovascular disease.
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Affiliation(s)
- Demidmaa Tuvdendorj
- Department of Medicine, Division of Endocrinology and Institute for Translational Science; University of Texas Medical Branch at Galveston, Texas
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Stefan N, Häring HU, Hu FB, Schulze MB. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol 2013; 1:152-62. [PMID: 24622321 DOI: 10.1016/s2213-8587(13)70062-7] [Citation(s) in RCA: 558] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obesity has become a worldwide epidemic that poses substantial health problems for both individuals and society. However, a proportion of obese individuals might not be at an increased risk for metabolic complications of obesity and, therefore, their phenotype can be referred to as metabolically healthy obesity. This novel concept of metabolically healthy obesity might become increasingly important to stratify individuals in the clinical treatment of obesity. However, no universally accepted criteria exist to define metabolically healthy obesity. Furthermore, many questions have been raised regarding the biological basis of this phenotype, the transitory nature of metabolically healthy obesity over time, and predictors of this phenotype. We describe the observational studies that gave rise to the idea of metabolically healthy obesity and the key parameters that can help to distinguish it from the general form of obesity. We also discuss potential biological mechanisms underlying metabolically healthy obesity and its public health and clinical implications.
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Affiliation(s)
- Norbert Stefan
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany; Institute of Diabetes Research and Metabolic Diseases, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Frank B Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Matthias B Schulze
- German Center for Diabetes Research, Neuherberg, Germany; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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Hosseinpanah F, Nazeri P, Ghareh S, Tohidi M, Azizi F. Predictors of the incident metabolic syndrome in healthy obese subjects: a decade of follow-up from the Tehran Lipid and Glucose Study. Eur J Clin Nutr 2013; 68:295-9. [PMID: 23963276 DOI: 10.1038/ejcn.2013.142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/25/2013] [Accepted: 06/27/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVE There is limited data from long-term prospective studies on the natural course of metabolic syndrome (MetS) incidence in healthy obese phenotypes. The aim of this study was to determine the incidence and predictors of the MetS in healthy obese subjects without the MetS at baseline after a decade of follow-up. SUBJECTS/METHODS In this prospective cohort study, 438 obese subjects free from MetS at baseline, aged ≥20 years, were selected from among the participants of the Tehran Lipid and Glucose Study and followed up for 10 years for development of MetS. Based on national data, central obesity was defined as waist circumference cutoff point of 89 cm for men and 91 cm for women. RESULTS Initially, subjects had a mean age of 41.1 ± 11.8 years and a body mass index of 32.7 ± 2.7 kg/m(2). At the end of follow-up, the cumulative incidence (95% confidence interval) of MetS was 44.0 (36.8-51.1)%. In the multivariable analysis, the adjusted odds ratios of hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) and insulin resistance for the development of MetS were 3.08 (1.39-6.79), 2.84 (1.26-6.42), 6.49 (3.18-13.25) and 2.87 (1.55-5.32), respectively. The area under receiver operating characteristic curve of all the components was significantly higher than various combinations of MetS components, except for the two models including combinations of three components, that is, triglycerides (TGs), HDL-C and fasting blood sugar, as well as, TGs, HDL-C and systolic blood pressure. CONCLUSIONS Our findings demonstrate that MetS developed in nearly half of the individuals during the 10 years of follow-up. Predictors of MetS in healthy obese subjects may differ from the general population, and waist circumference does not have an independent role.
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Affiliation(s)
- F Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P Nazeri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Ghareh
- Faculty of Medicine, Islamic Azad University, Mashhad Medical Branch, Mashhad, Iran
| | - M Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kemp DM. Does chronic low-grade endotoxemia define susceptibility of obese humans to insulin resistance via dietary effects on gut microbiota? Adipocyte 2013; 2:188-90. [PMID: 23991367 PMCID: PMC3756109 DOI: 10.4161/adip.24776] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 04/19/2013] [Accepted: 04/22/2013] [Indexed: 01/06/2023] Open
Abstract
Recent studies, including one from our own lab, report that different subpopulations of obese individuals display a variable inflammatory signature in their visceral adipose tissue that may contribute significantly to their risk for developing insulin resistance, type 2 diabetes, and other metabolic diseases. Understanding the molecular mechanisms and signaling pathways that lead to these differences in susceptibility to insulin resistance will equip us with important targets to help stem the tide of such debilitating diseases. Here we discuss an emerging theory that chronic, low-grade endotoxemia may represent a causal factor in obesity-related inflammatory states, and that diet-induced changes in the gut microbiome may be a key regulator of metabolic health. The implications to both disease prevention and to therapeutic intervention are also highlighted.
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