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Verma S, Giagnocavo SD, Curtin MC, Arumugam M, Osburn-Staker SM, Wang G, Atkinson A, Nix DA, Lum DH, Cox JE, Hilgendorf KI. Zinc-alpha-2-glycoprotein Secreted by Triple-Negative Breast Cancer Promotes Peritumoral Fibrosis. CANCER RESEARCH COMMUNICATIONS 2024; 4:1655-1666. [PMID: 38888911 PMCID: PMC11224648 DOI: 10.1158/2767-9764.crc-24-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
Obesity is a modifiable predisposition factor for postmenopausal breast cancer. This suggests a localized, reciprocal interaction between breast cancer cells and the surrounding mammary white adipose tissue. To investigate how breast cancer cells alter the composition and function of adipose tissue, we screened the secretomes of 10 human breast cancer cell lines for the ability to modulate the differentiation of adipocyte stem and progenitor cells. The screen identified an adipogenic modulator, zinc-alpha-2-glycoprotein (ZAG/AZGP1) that is secreted by triple-negative breast cancer (TNBC) cells. TNBC-secreted ZAG inhibits adipogenesis and instead induces the expression of fibrotic genes. Accordingly, depletion of ZAG in TNBC cells attenuates fibrosis in white adipose tissue and inhibits tumor growth. Further, high expression of ZAG is linked to poor prognosis in patients with TNBC but not in patients with other clinical subtypes of breast cancer. Our findings suggest a role of TNBC-secreted ZAG in promoting the transdifferentiation of adipocyte stem and progenitor cells into cancer-associated fibroblasts to support tumorigenesis. SIGNIFICANCE Functional screening of breast cancer secretomes revealed that triple-negative breast cancer promotes fibrosis in the adipose tissue microenvironment by secreting zinc-alpha-2-glycoprotein and promoting the transdifferentiation of adipocyte stem cells into myofibroblasts.
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Affiliation(s)
- Surbhi Verma
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, Utah.
| | | | - Meghan C. Curtin
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Menusha Arumugam
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Sandra M. Osburn-Staker
- Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, Utah.
| | - Guoying Wang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - Aaron Atkinson
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - David A. Nix
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - David H. Lum
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - James E. Cox
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, Utah.
- Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, Utah.
| | - Keren I. Hilgendorf
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, Utah.
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
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Du M, Qiu M, Qian Y, Wang T, Chen X. Serum Copper/Zinc Ratio in Overweight and Obese Children: a Cross-Sectional Study. Biol Trace Elem Res 2024; 202:1539-1549. [PMID: 37505435 DOI: 10.1007/s12011-023-03790-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
To assess the association between serum copper/zinc ratio (CZR) and overweight/obesity in children. Sociodemographic and clinical data of children aged 8-18 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. These associations were explored using weighted univariate and multivariate logistic regression analyses with the odds ratios (ORs) and 95% confidence intervals (CIs). High serum CZR level was related to higher odds of overweight (OR = 1.74), obesity (OR = 5.26), and central obesity (OR = 2.99). Subgroup analyses showed that high serum CZR levels were associated with high odds of overweight in children aged ≥ 12 years old (OR = 2.19) and females (OR = 2.02), while the increased odds of obesity and central obesity were found in children aged ≥ 12 years old and both male and female. Elevated serum CZR level was linked to high odds of childhood overweight, obesity, and central obesity, and this relationship was also found in children with different age and gender.
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Affiliation(s)
- Mu Du
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Mingfang Qiu
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Ye Qian
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Tianqi Wang
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Xiaobo Chen
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China.
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3
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Xie L, Wang H, Hu J, Liu Z, Hu F. The role of novel adipokines and adipose-derived extracellular vesicles (ADEVs): Connections and interactions in liver diseases. Biochem Pharmacol 2024; 222:116104. [PMID: 38428826 DOI: 10.1016/j.bcp.2024.116104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024]
Abstract
Adipose tissues (AT) are an important endocrine organ that secretes various functional adipokines, peptides, non-coding RNAs, and acts on AT themselves or other distant tissues or organs through autocrine, paracrine, or endocrine manners. An accumulating body of evidence has suggested that many adipokines play an important role in liver metabolism. Besides the traditional adipokines such as adiponectin and leptin, many novel adipokines have recently been identified to have regulatory effects on the liver. Additionally, AT can produce extracellular vesicles (EVs) that act on peripheral tissues. However, under pathological conditions, such as obesity and diabetes, dysregulation of adipokines is associated with functional changes in AT, which may cause liver diseases. In this review, we focus on the newly discovered adipokines and EVs secreted by AT and highlight their actions on the liver under the context of obesity, nonalcoholic fatty liver diseases (NAFLD), and some other liver diseases. Clarifying the action of adipokines and adipose tissue-derived EVs on the liver would help to identify novel therapeutic targets or biomarkers for metabolic diseases.
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Affiliation(s)
- Lijun Xie
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huiying Wang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jinying Hu
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhuoying Liu
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Health Law Research Center, School of Law, Central South University, Changsha, China.
| | - Fang Hu
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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4
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Verma S, Giagnocavo SD, Curtin MC, Arumugam M, Osburn-Staker SM, Wang G, Atkinson A, Nix DA, Lum DH, Cox JE, Hilgendorf KI. Zinc Alpha-2-Glycoprotein (ZAG/AZGP1) secreted by triple-negative breast cancer promotes tumor microenvironment fibrosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.04.583349. [PMID: 38496643 PMCID: PMC10942361 DOI: 10.1101/2024.03.04.583349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Obesity is a predisposition factor for breast cancer, suggesting a localized, reciprocal interaction between breast cancer cells and the surrounding mammary white adipose tissue. To investigate how breast cancer cells alter the composition and function of adipose tissue, we screened the secretomes of ten human breast cancer cell lines for the ability to modulate the differentiation of adipocyte stem and progenitor cells (ASPC). The screen identified a key adipogenic modulator, Zinc Alpha-2-Glycoprotein (ZAG/AZGP1), secreted by triple-negative breast cancer (TNBC) cells. TNBC-secreted ZAG inhibits adipogenesis and instead induces the expression of fibrotic genes. Accordingly, depletion of ZAG in TNBC cells attenuates fibrosis in white adipose tissue and inhibits tumor growth. Further, high expression of ZAG in TNBC patients, but not other clinical subtypes of breast cancer, is linked to poor prognosis. Our findings suggest a role of TNBC-secreted ZAG in promoting the transdifferentiation of ASPCs into cancer-associated fibroblasts to support tumorigenesis.
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Affiliation(s)
- Surbhi Verma
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | | | - Meghan C Curtin
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Menusha Arumugam
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Sandra M Osburn-Staker
- Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Guoying Wang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Aaron Atkinson
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - David A Nix
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - David H Lum
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - James E Cox
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
- Metabolomics, Proteomics and Mass Spectrometry Core, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Keren I Hilgendorf
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Lead contact:
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Wang Y, Sun Z, Zang G, Zhang L, Wang Z. Role of ceramides in diabetic foot ulcers (Review). Int J Mol Med 2023; 51:26. [PMID: 36799149 PMCID: PMC9943538 DOI: 10.3892/ijmm.2023.5229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/20/2023] [Indexed: 02/09/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder, which if not managed properly, can lead to serious health problems over time and impose significant financial burden on the patient, their family and society as a whole. The study of this disease and the underlying biological mechanism is gaining momentum. Multiple pieces of conclusive evidence show that ceramides are involved in the occurrence and development of diabetes. The present review focuses on the function of ceramides, a type of sphingolipid signaling molecule, to provide a brief description of ceramides and their metabolism, discuss the significant roles of ceramides in the healthy skin barrier, and speculate on the potential involvement of ceramides in the pathogenesis and development of diabetic foot ulcers (DFUs). Understanding these aspects of this disease more thoroughly is crucial to establish how ceramides contribute to the etiology of diabetic foot infections and identify possible therapeutic targets for the treatment of DFUs.
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Affiliation(s)
| | | | | | | | - Zhongqun Wang
- Correspondence to: Dr Zhongqun Wang, Department of Cardiology, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Jingkou, Zhenjiang, Jiangsu 212001, P.R. China, E-mail:
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Fan W, Si Y, Xing E, Feng Z, Ding Z, Liu Y, Wei C, Tian Y, Zhang Y, Liu J, Sun L. Human epicardial adipose tissue inflammation correlates with coronary artery disease. Cytokine 2023; 162:156119. [PMID: 36603481 DOI: 10.1016/j.cyto.2022.156119] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/09/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS This study investigates the expression of novel adipocytokines and inflammatory cells infiltration in epicardial adipose tissue (EAT) and subcutaneous adipose tissue (SAT) between 27 coronary artery disease (CAD) and 21 non-CAD (NCAD) patients enrolled from September 2020 to September 2021. METHODS AND RESULTS Serum, gene, and protein expression levels of the novel adipocytokines were determined using ELISA, RT-qPCR, and western blot analyses. The number of blood vessels and adipocytes morphology were measured via hematoxylin-eosin staining, and inflammatory cells infiltration was examined via immunohistochemistry. Serum ANGPTL8, CTRP5, and Wnt5a levels were higher in the CAD than in the NCAD group, while serum CTRP3, Sfrp5, and ZAG levels were lower in the CAD than in the NCAD group. Compared to the EAT of NCAD and SAT of CAD patients, the EAT of CAD patients had higher mRNA levels of ANGPTL8, CTRP5, and Wnt5a while lower levels of CTRP3, Sfrp5, and ZAG; higher protein expression levels of ANGPTL8 and CTRP5 but lower levels of CTRP3; more blood vessels; and higher infiltration rates of macrophages (CD68 + ), pro-inflammatory M1 macrophages (CD11c + ), mast cells (Tryptase + ), T lymphocytes (CD3 + ), and B lymphocytes (CD20 + ) but lower infiltration rates of anti-inflammatory M2 macrophages (CD206 + ). CONCLUSION Novel adipocytokines and inflammatory cells infiltration are dysregulated in human EAT, and could be important pathophysiological mechanisms and novelly promising medicating targets of CAD.
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Affiliation(s)
- Wenjun Fan
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Yueqiao Si
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Enhong Xing
- Central Laboratory of Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Zengbin Feng
- Department of Cardiac Surgery, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Zhenjiang Ding
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Yixiang Liu
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Chen Wei
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Yanan Tian
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Ying Zhang
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Jingyi Liu
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
| | - Lixian Sun
- Department of Cardiology, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
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7
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Sahin RB, Kilic FA, Hizli P, Baykan O. Serum zinc-alpha-2 glycoprotein and insulin levels and their correlation with metabolic syndrome in patients with rosacea. J Cosmet Dermatol 2023; 22:645-650. [PMID: 36207990 DOI: 10.1111/jocd.15447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Metabolic syndrome and insulin resistance may accompany rosacea. Zinc-alpha-2 glycoprotein (ZAG) is an adipokine involved in lipid, glucose, and insulin metabolism and might be associated with metabolic syndrome and insulin resistance. AIMS To investigate the serum ZAG levels, presence of metabolic syndrome, insulin resistance, and the correlation between ZAG levels, rosacea severity, and metabolic syndrome in patients with rosacea. PATIENTS/METHODS Seventy-nine patients with rosacea and 80 healthy volunteers were included. Anthropometric and demographic features, personal and family histories, clinical data, the subtype, severity, and duration of rosacea were recorded. Metabolic syndrome, insulin resistance, and dyslipidemia were evaluated in both groups. Fasting blood sugar, lipid panel, C-reactive protein, sedimentation rate, insulin, and serum ZAG levels were investigated. RESULTS Frequency of metabolic syndrome, systolic and diastolic blood pressures, and C-reactive protein levels were significantly higher in the rosacea group (p < 0.001 and p = 0.001, respectively). Frequency of dyslipidemia and insulin resistance did not significantly differ between the groups (p = 0.175 and 0.694, respectively). The mean serum ZAG levels were lower in the rosacea group, but no significant difference was evident. In rosacea patients with metabolic syndrome, serum ZAG levels were significantly lower (p = 0.043); however, serum ZAG levels, insulin, and the homeostasis model assessment-estimated insulin resistance values were significantly higher (p = 0.168, 0.013 and 0.001, respectively). CONCLUSION Metabolic syndrome, high blood pressure, and high C-reactive protein levels were associated with rosacea indicating chronic systemic inflammation. ZAG levels were associated with metabolic syndrome in patients with rosacea but not associated with rosacea subtype and disease severity.
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Affiliation(s)
| | - Fatma Arzu Kilic
- Department of Dermatology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Pelin Hizli
- Department of Dermatology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Ozgur Baykan
- Department of Biochemistry, Faculty of Medicine, Balikesir University, Balikesir, Turkey
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Martínez-Montoro JI, Ocaña-Wilhelmi L, Soler-Humanes R, Motahari-Rad H, González-Jiménez A, Rivas-Becerra J, Rodríguez-Muñoz A, Moreno-Ruiz FJ, Tomé M, Rodríguez-Capitán J, García-Fuentes E, Tinahones FJ, Garrido-Sánchez L, Murri M. Evaluation of Adipose Tissue Zinc-Alpha 2-Glycoprotein Gene Expression and Its Relationship with Metabolic Status and Bariatric Surgery Outcomes in Patients with Class III Obesity. Biomedicines 2022; 10:biomedicines10071502. [PMID: 35884810 PMCID: PMC9312495 DOI: 10.3390/biomedicines10071502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Zinc-α2 glycoprotein (ZAG) is an adipokine involved in adipocyte metabolism with potential implications in the pathogenesis of metabolic disorders. Our aim was to evaluate the relationship between visceral (VAT) and subcutaneous adipose tissue (SAT) ZAG expression and metabolic parameters in patients with class III obesity, along with the impact of basal ZAG expression on short- and medium-term outcomes related to bariatric surgery. 41 patients with class III obesity who underwent bariatric surgery were included in this study. ZAG gene expression was quantified in SAT and VAT. Patients were classified into two groups according to SAT and VAT ZAG percentile. Anthropometric and biochemical variables were obtained before and 15 days, 45 days, and 1 year after surgery. The lower basal SAT ZAG expression percentile was associated with higher weight and waist circumference, while the lower basal VAT ZAG expression percentile was associated with higher weight, waist circumference, insulin, insulin resistance, and the presence of metabolic syndrome. Basal SAT ZAG expression was inversely related to weight loss at 45 days after surgery, whereas no associations were found between basal VAT ZAG expression and weight loss after surgery. Additionally, a negative association was observed between basal SAT and VAT ZAG expression and the decrease of gamma-glutamyl transferase after bariatric surgery. Therefore, lower SAT and VAT ZAG expression levels were associated with an adverse metabolic profile. However, this fact did not seem to confer worse bariatric surgery-related outcomes. Further research is needed to assess the clinical significance of the role of ZAG expression levels in the dynamics of hepatic enzymes after bariatric surgery.
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Affiliation(s)
- José Ignacio Martínez-Montoro
- Clinical Management Unit (UGC) of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (J.I.M.-M.); (L.G.-S.); (M.M.)
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Faculty of Medicine, University of Malaga, 29010 Malaga, Spain;
| | - Luis Ocaña-Wilhelmi
- Clinical Management Unit (UGC) of General and Digestive Surgery, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (L.O.-W.); (R.S.-H.)
| | - Rocío Soler-Humanes
- Clinical Management Unit (UGC) of General and Digestive Surgery, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (L.O.-W.); (R.S.-H.)
| | - Hanieh Motahari-Rad
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran;
| | - Andrés González-Jiménez
- Common Support Structures (ECAI) Bioinformática, Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain;
| | - José Rivas-Becerra
- Department of General, Digestive and Transplant Surgery, Regional University Hospital of Malaga, 29010 Malaga, Spain; (J.R.-B.); (F.J.M.-R.)
| | | | - Francisco J. Moreno-Ruiz
- Department of General, Digestive and Transplant Surgery, Regional University Hospital of Malaga, 29010 Malaga, Spain; (J.R.-B.); (F.J.M.-R.)
| | - Mónica Tomé
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Department of Endocrinology and Nutrition, Regional University Hospital of Malaga, 29010 Malaga, Spain
| | - Jorge Rodríguez-Capitán
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Clinical Management Unit (UGC) of Heart, Virgen de la Victoria University Hospital, 29010 Malaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eduardo García-Fuentes
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Department of Gastroenterology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain
- Correspondence: (E.G.-F.); (F.J.T.)
| | - Francisco J. Tinahones
- Clinical Management Unit (UGC) of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (J.I.M.-M.); (L.G.-S.); (M.M.)
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Faculty of Medicine, University of Malaga, 29010 Malaga, Spain;
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (E.G.-F.); (F.J.T.)
| | - Lourdes Garrido-Sánchez
- Clinical Management Unit (UGC) of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (J.I.M.-M.); (L.G.-S.); (M.M.)
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mora Murri
- Clinical Management Unit (UGC) of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain; (J.I.M.-M.); (L.G.-S.); (M.M.)
- Instituto de Investigación Biomédica de Malaga (IBIMA), 29010 Malaga, Spain; (M.T.); (J.R.-C.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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9
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Alenad AM, Alkaltham LF, Sabico S, Khattak MNK, Wani K, Al-Daghri NM, Alokail MS. Associations of zinc-α-2-glycoprotein with metabolic syndrome and its components among adult Arabs. Sci Rep 2022; 12:4908. [PMID: 35318405 PMCID: PMC8941079 DOI: 10.1038/s41598-022-09022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies suggest that the Zinc-α-2-glycoprotein (ZAG) plays significant physiological roles. In this study we investigate whether ZAG could be considered as a clinical biomarker in the diagnosis and prognosis of metabolic syndrome (MetS) in Saudi population. As such insights urgently required for management of MetS. Thus, we have determined serum levels of ZAG in patients with MetS and normal individuals. We have also assessed the correlation between ZAG and different components of MetS. In this case–control study, clinical information of 200 Saudi male and female subjects (age range 30–65) with MetS (n = 100) and healthy controls (n = 100) were extracted from the database of the Chair of Biomarkers of Chronic Disease (CBCD) in King Saud University (KSU), Riyadh, Saudi Arabia. MetS was screened according to NCEP ATP III criteria (National Cholesterol Education Program Adult Treatment Panel III). Fasting glucose and lipid profile levels were measured using Konelab. Serum TNF-α, IL- 6, CRP and ZAG levels were measured using commercially available assays. There was an age-dependent significant increase in ZAG level among MetS subjects than controls (43.8 ± 19.5 vs 48.1 ± 14.8; P = 0.04). A significant inverse correlation between ZAG and serum HDL-cholesterol (r = − 0.20, P < 0.05) was observed. Whereas, triglycerides (r = 0.25, P < 0.01), waist circumference (WHR) (r = 0.17, P < 0.05) and CRP (r = 0.24, P < 0.01) were all significantly and positively associated with ZAG. Circulating ZAG is associated with MetS in an age-dependent manner. Serum ZAG is a potential biomarker for MetS.
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Affiliation(s)
- Amal M Alenad
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Lamya F Alkaltham
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Malak N K Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Kaiser Wani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia.
| | - Majed S Alokail
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451, Saudi Arabia
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Wang YY, Wang YD, Qi XY, Liao ZZ, Mai YN, Xiao XH. Organokines and Exosomes: Integrators of Adipose Tissue Macrophage Polarization and Recruitment in Obesity. Front Endocrinol (Lausanne) 2022; 13:839849. [PMID: 35273574 PMCID: PMC8902818 DOI: 10.3389/fendo.2022.839849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 12/21/2022] Open
Abstract
The prevalence of obesity is escalating and has become a worldwide health challenge coinciding with the development of metabolic diseases. Emerging evidence has shown that obesity is accompanied by the infiltration of macrophages into adipose tissue, contributing to a state of low-grade chronic inflammation and dysregulated metabolism. Moreover, in the state of obesity, the phenotype of adipose tissue macrophages switches from the M2 polarized state to the M1 state, thereby contributing to chronic inflammation. Notably, multiple metabolic organs (adipose tissue, gut, skeletal muscle, and the liver) communicate with adipose tissue macrophages via secreting organokines or exosomes. In this review, we systematically summarize how the organokines (adipokines, gut microbiota and its metabolites, gut cytokines, myokines, and hepatokines) and exosomes (adipocyte-, skeletal muscle-, and hepatocyte-derived exosomes) act as important triggers for macrophage recruitment in adipose tissue and adipose tissue macrophage polarization, thus providing further insight into obesity treatment. In addition, we also highlight the complex interaction of organokines with organokines and organokines with exosomes, revealing new paths in understanding adipose tissue macrophage recruitment and polarization.
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11
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Namkhah Z, Naeini F, Ostadrahimi A, Tutunchi H, Hosseinzadeh-Attar MJ. The association of the adipokine zinc-alpha2-glycoprotein with non-alcoholic fatty liver disease and related risk factors: A comprehensive systematic review. Int J Clin Pract 2021; 75:e13985. [PMID: 33404166 DOI: 10.1111/ijcp.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/03/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND AIM The adipokine zinc-alpha2-glycoprotein (ZAG), a multidisciplinary protein, is involved in lipid metabolism, glucose homeostasis and energy balance. Accumulating evidence demonstrates that the expression of ZAG is mainly downregulated in obesity and obesity-related conditions. In the present study, we assessed the association of ZAG with non-alcoholic fatty liver disease (NAFLD) and the related risk factors including obesity, metabolic factors and inflammatory parameters, with emphasis on potential mechanisms underlying these associations. METHODS PRISMA guidelines were followed in this review. Systematic searches were performed using the PubMed/Medline, ScienceDirect, Scopus, EMBASE, ProQuest and Google Scholar databases, up to August 2020 for all relevant published papers. RESULTS Out of 362 records screened, 34 articles were included in the final analysis. According to the studies reviewed here, ZAG appears to exert a protective effect against NAFLD by enhancing mRNA expression levels of peroxisome proliferator-activated receptor α (PPARα) and PPARγ, promoting mRNA expression levels of the lipolysis-related genes, reducing mRNA expression levels of the lipogenesis-related genes, increasing hepatic fatty acid oxidation, ameliorating hepatic steatosis, promoting the activity of brown adipose tissue and the expression of thermogenesis-related genes, modulating energy balance and glucose homeostasis, and elevating plasma levels of healthy adipokines such as adiponectin. ZAG can also be involved in the regulation of inflammatory responses by attenuation of the expression of pro-inflammatory and pro-fibrotic mediators. CONCLUSION According to the studies reviewed here, ZAG is suggested to be a promising therapeutic target for NAFLD. However, the favourable effects of ZAG need to be confirmed in prospective cohort studies.
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Affiliation(s)
- Zahra Namkhah
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Helda Tutunchi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Banaszak M, Górna I, Przysławski J. Zinc and the Innovative Zinc-α2-Glycoprotein Adipokine Play an Important Role in Lipid Metabolism: A Critical Review. Nutrients 2021; 13:nu13062023. [PMID: 34208404 PMCID: PMC8231141 DOI: 10.3390/nu13062023] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 12/14/2022] Open
Abstract
Numerous studies indicate that zinc and the new zinc-related adipokine, zinc-α2-glycoprotein (ZAG), are involved in lipid metabolism. Excess body fat lowers blood concentrations of Zn and ZAG, leading not only to the development of obesity but also to other components of the metabolic syndrome. Zinc homeostasis disorders in the body negatively affect the lipid profile and cytokine secretion. Zinc appears to be a very important ZAG homeostasis regulator. The physiological effects of ZAG are related to lipid metabolism, but studies show that ZAG also affects glucose metabolism and is linked to insulin resistance. ZAG has a zinc binding site in its structure, which may indicate that ZAG mediates the effect of zinc on lipid metabolism. The review aimed to verify the available studies on the effects of zinc and ZAG on lipid metabolism. A literature review within the scope of this research area was conducted using articles available in PubMed (including MEDLINE), Web of Science and Cochrane Library databases. An analysis of available studies has shown that zinc improves hepatic lipid metabolism and has an impact on the lipid profile. Numerous studies have found that zinc supplementation in overweight individuals significantly reduced blood levels of total cholesterol, LDL (Low-density lipoprotein)cholesterol and triglycerides, potentially reducing cardiovascular morbidity and mortality. Some results also indicate that it increases HDL-C (High-density lipoprotein) cholesterol levels. ZAG has been shown to play a significant role in reducing obesity and improving insulin sensitivity, both in experimental animal model studies and in human studies. Furthermore, ZAG at physiologically relevant concentrations increases the release of adiponectin from human adipocytes. In addition, ZAG has been shown to inhibit in vitro leptin production. Further studies are needed to provide more data on the role of zinc and zinc-α2-glycoprotein.
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Affiliation(s)
- Michalina Banaszak
- Faculty of Medical Sciences, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Ilona Górna
- Department of Bromatology, Poznan University of Medical Sciences, 60-354 Poznan, Poland;
- Correspondence: ; Tel.: +48-61-854-7204
| | - Juliusz Przysławski
- Department of Bromatology, Poznan University of Medical Sciences, 60-354 Poznan, Poland;
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Xu H, Wang L, Yan K, Zhu H, Pan H, Yang H, Liu M, Gong F. Nuciferine Inhibited the Differentiation and Lipid Accumulation of 3T3-L1 Preadipocytes by Regulating the Expression of Lipogenic Genes and Adipokines. Front Pharmacol 2021; 12:632236. [PMID: 33841152 PMCID: PMC8025837 DOI: 10.3389/fphar.2021.632236] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/08/2021] [Indexed: 12/16/2022] Open
Abstract
Purposes: Nuciferine, a main aporphine alkaloid component found in lotus leaf (Nelumbo nucifera), has been demonstrated to possess the property of reducing fat mass and alleviating dyslipidemia in vivo. The purpose of this study is to explore the effects of nuciferine on the proliferation and differentiation of 3T3-L1 cells and further investigate the possible underlying molecular mechanisms. Methods: 3T3-L1 preadipocytes were treated with 0∼20 μM nuciferine for 24∼120 h, the cell viability was assessed using CCK8. 3T3-L1 preadipocytes and human primary preadipocytes were then induced differentiation and the effects of nuciferine on the lipid metabolism in differentiating and fully differentiated adipocytes were observed by the methods of intracellular triglyceride (TG) assay, Oil Red O staining, RT-qPCR and western blot. Transient transfection and dual luciferase reporter gene methods were used to assess the effects of nuciferine on FAS promoter activities. Results: Nuciferine inhibited the proliferation of 3T3-L1 preadipocytes in a dose- and time-dependent manner. 20 μM nuciferine significantly attenuated lipid accumulation and reduced intracellular TG contents by 47.2, 59.9 and 55.4% on the third, sixth and ninth day of preadipocytes differentiation, respectively (all p < 0.05). Moreover, the mRNA levels of PPARγ, C/EBPα, C/EBPβ, FAS, ACC, HSL and ATGL were notably decreased by 39.2∼92.5% in differentiating preadipocytes when treated with 5∼20 μM nuciferine (all p < 0.05). In fully differentiated adipocytes treated with 20 μM nuciferine for 48 h, the mRNA levels of FAS, ACC and SREBP1 were remarkably downregulated by 22.6∼45.2% compared with the controls (0 μM) (all p < 0.05), whereas the expression of adipokines FGF21 and ZAG were notably promoted by nuciferine. Similarly, in fully differentiated human primary adipocytes, the mRNA levels of FAS, ACC, SREBP1 were decreased and the expression of FGF21 and ZAG were elevated after treated with nuciferine (all p < 0.05). Further mechanism studies showed that 2.5∼20 μM nuciferine significantly decreased FAS promoter activities in 3T3-L1 preadipocytes. Conclusion: Nuciferine inhibited the proliferation and differentiation of 3T3-L1 preadipocytes. The inhibitory effects of nuciferine on adipogenesis might be due to the downregulation of PPARγ, C/EBPα and C/EBPβ, which led to the reduction of intracellular lipid accumulation in 3T3-L1 cells and by downregulating the expression of critical lipogenic enzymes, especially of FAS, which was achieved by inhibiting the FAS promoter activities. Besides, nuciferine promoted the expression of adipokines in fully differentiated adipocytes.
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Affiliation(s)
- Hanyuan Xu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Linjie Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kemin Yan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meijuan Liu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengying Gong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Adipokines, Myokines, and Hepatokines: Crosstalk and Metabolic Repercussions. Int J Mol Sci 2021; 22:ijms22052639. [PMID: 33807959 PMCID: PMC7961600 DOI: 10.3390/ijms22052639] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Adipose, skeletal, and hepatic muscle tissues are the main endocrine organs that produce adipokines, myokines, and hepatokines. These biomarkers can be harmful or beneficial to an organism and still perform crosstalk, acting through the endocrine, paracrine, and autocrine pathways. This study aims to review the crosstalk between adipokines, myokines, and hepatokines. Far beyond understanding the actions of each biomarker alone, it is important to underline that these cytokines act together in the body, resulting in a complex network of actions in different tissues, which may have beneficial or non-beneficial effects on the genesis of various physiological disorders and their respective outcomes, such as type 2 diabetes mellitus (DM2), obesity, metabolic syndrome, and cardiovascular diseases (CVD). Overweight individuals secrete more pro-inflammatory adipokines than those of a healthy weight, leading to an impaired immune response and greater susceptibility to inflammatory and infectious diseases. Myostatin is elevated in pro-inflammatory environments, sharing space with pro-inflammatory organokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), resistin, and chemerin. Fibroblast growth factor FGF21 acts as a beta-oxidation regulator and decreases lipogenesis in the liver. The crosstalk mentioned above can interfere with homeostatic disorders and can play a role as a potential therapeutic target that can assist in the methods of diagnosing metabolic syndrome and CVD.
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Yang Y, Liu J, Deng K, Lu L, Zhu H, Lian X, Bao X, Duan L, Yao Y. Clinical and Therapeutic Characteristics of Pituitary TSH-Secreting Adenoma in Adolescent-Onset Patients: Six Case Studies and Literature Review. Front Endocrinol (Lausanne) 2021; 12:771673. [PMID: 35002961 PMCID: PMC8734954 DOI: 10.3389/fendo.2021.771673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Thyrotropin-secreting adenoma (TSH-oma) is a very rare kind of functional pituitary adenoma, especially that which occurs in adolescents. However, its potential clinical and therapeutic characteristics are still unknown. OBJECTIVES The study was aimed to summarize the clinical and therapeutic characteristics of patients with adolescent-onset TSH-oma. METHODS We retrospectively analyzed six (4.1%) adolescent-onset TSH-oma cases from 148 patients who were diagnosed with TSH-oma at our hospital between January 2012 and October 2020. A literature review was performed on the PubMed online database, and 14 adolescent-onset TSH-oma cases were retrieved. Then, the characteristics of clinical manifestations, treatment outcomes, and follow-ups were analyzed and compared to the adult TSH-oma patients. RESULTS Altogether, 20 adolescent-onset cases were included in this study having mean onset age of 13.4 ± 3.3 years. Males were found to be slightly predominant (M: F = 1.5:1) in our study. The median baseline levels of TSH, FT3, and FT4 in adolescent-onset cases were found to be 6.30 [interquartile range (IQR) 9.82] µIU/ml, 9.18 (IQR 11.61) pg/ml, and 3.22 (IQR 1.90) ng/dl, respectively, which were all significantly higher than the adult patients of our hospital. Also, the adolescent-onset cases showed more large tumor ratio (36.8% vs. 9.3%, p = 0.007) compared to the adult patients. Compared to the patients of all ages in the literature, the biochemical remission rate of SSAs (57.1%) and remission rate of TSS (38.9%) were found to be considerably lower in adolescent-onset patients, while the recurrence rate (44.4%) was found to be considerably higher. CONCLUSIONS Adolescent-onset TSH-oma patients showed higher TSH and thyroid hormone levels, more large tumors, and worse treatment outcomes than adult cases. Hence, early diagnosis, multidisciplinary therapy, and close follow-up should be highlighted to improve the prognosis.
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Affiliation(s)
- Yamei Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jie Liu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Kan Deng
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lin Lu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiaolan Lian
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xinjie Bao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lian Duan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- *Correspondence: Lian Duan, ; Yong Yao,
| | - Yong Yao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- *Correspondence: Lian Duan, ; Yong Yao,
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