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Cornejo-Pareja I, Amiar MR, Ocaña-Wilhelmi L, Soler-Humanes R, Arranz-Salas I, Garrido-Sánchez L, Gutiérrez-Repiso C, Tinahones FJ. Non-alcoholic fatty liver disease in patients with morbid obesity: the gut microbiota axis as a potential pathophysiology mechanism. J Gastroenterol 2024; 59:329-341. [PMID: 38265508 PMCID: PMC10959783 DOI: 10.1007/s00535-023-02075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND/AIM Alterations in gut microbiota are associated with the pathogenesis of metabolic diseases, including metabolic-associated fatty liver disease (MAFLD). The aim of this study was to evaluate gut microbiota composition and functionality in patients with morbid obesity with different degrees of MAFLD, as assessed by biopsy. SUBJECTS/METHODS 110 patients with morbid obesity were evaluated by biopsy obtained during bariatric surgery for MAFLD. Stool samples were collected prior to surgery for microbiota analysis. RESULTS Gut microbiota from patients with steatosis and non-alcoholic steatohepatitis (NASH) were characterized by an enrichment in Enterobacteriaceae (an ethanol-producing bacteria), Acidaminococcus and Megasphaera and the depletion of Eggerthellaceae and Ruminococcaceae (SCFA-producing bacteria). MAFLD was also associated with enrichment of pathways related to proteinogenic amino acid degradation, succinate production, menaquinol-7 (K2-vitamin) biosynthesis, and saccharolytic and proteolytic fermentation. Basic histological hepatic alterations (steatosis, necroinflammatory activity, or fibrosis) were associated with specific changes in microbiota patterns. Overall, the core microbiome related to basic histological alterations in MAFLD showed an increase in Enterobacteriaceae and a decrease in Ruminococcaceae. Specifically, Escherichia coli was associated with steatosis and necroinflammatory activity, whilst Escherichia-shigella was associated with fibrosis and necroinflammatory activity. CONCLUSIONS We established a link between gut microbiota alterations and histological injury in liver diagnosis using biopsy. Harmful products such as ethanol or succinate may be involved in the pathogenesis and progression of MAFLD. Thus, these alterations in gut microbiota patterns and their possible metabolic pathways could add information to the classical predictors of MAFLD severity and suggest novel metabolic targets.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga University, Campus Teatinos S/N, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain.
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010, Málaga, Spain.
- Department of Medicine and Dermatology, Faculty of Medicine, University of Málaga, 29010, Málaga, Spain.
| | - Mohamed Reda Amiar
- Department of Medicine and Dermatology, Faculty of Medicine, University of Málaga, 29010, Málaga, Spain
- Department of Clinical Analysis Laboratory, Virgen de la Victoria Hospital, 29010, Málaga, Spain
| | - Luís Ocaña-Wilhelmi
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain
- Department of General and Digestive Surgery, Virgen de la Victoria University Hospital, 29010, Málaga, Spain
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, 29010, Málaga, Spain
| | - Rocío Soler-Humanes
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain
- Department of General and Digestive Surgery, Virgen de la Victoria University Hospital, 29010, Málaga, Spain
| | - Isabel Arranz-Salas
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain
- Department of Human Physiology, Human Histology, Anatomical Pathology and Physical Education, Malaga University, 29010, Málaga, Spain
- Department of Anatomical Pathology, Virgen de la Victoria Hospital, Málaga, Spain
| | - Lourdes Garrido-Sánchez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga University, Campus Teatinos S/N, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain.
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010, Málaga, Spain.
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga University, Campus Teatinos S/N, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010, Málaga, Spain
| | - Francisco Jose Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga University, Campus Teatinos S/N, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, Malaga University, 2ª Planta, Campus Teatinos S/N, 29010, Málaga, Spain
- Centro de Investigacion Biomedica en Red de la Fisiopatología de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010, Málaga, Spain
- Department of Medicine and Dermatology, Faculty of Medicine, University of Málaga, 29010, Málaga, Spain
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2
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Linares-Pineda TM, Peña-Montero N, Gutiérrez-Repiso C, Lima-Rubio F, Sánchez-Pozo A, Tinahones FJ, Molina-Vega M, Picón-César MJ, Morcillo S. Epigenome wide association study in peripheral blood of pregnant women identifies potential metabolic pathways related to gestational diabetes. Epigenetics 2023; 18:2211369. [PMID: 37192269 DOI: 10.1080/15592294.2023.2211369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/18/2023] Open
Abstract
Gestational diabetes mellitus (GDM) increases the risk of developing metabolic disorders in both pregnant women and their offspring. Factors such as nutrition or the intrauterine environment may play an important role, through epigenetic mechanisms, in the development of GDM. The aim of this work is to identify epigenetic marks involved in the mechanisms or pathways related to gestational diabetes. A total of 32 pregnant women were selected, 16 of them with GDM and 16 non-GDM. DNA methylation pattern was obtained from Illumina Methylation Epic BeadChip, from peripheral blood samples at the diagnostic visit (26-28 weeks). Differential methylated positions (DMPs) were extracted using ChAMP and limma package in R 2.9.10, with a threshold of FDR <0.05, deltabeta >|5|% and B >0. A total of 1.141 DMPs were found, and 714 were annotated in genes. A functional analysis was performed, and we found 23 genes significantly related to carbohydrate metabolism. Finally, a total of 27 DMPs were correlated with biochemical variables such as glucose levels at different points of oral glucose tolerance test, fasting glucose, cholesterol, HOMAIR and HbA1c, at different visits during pregnancy and postpartum. Our results show that there is a differentiated methylation pattern between GDM and non-GDM. Furthermore, the genes annotated to the DMPs could be implicated in the development of GDM as well as in alterations in related metabolic variables.
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Affiliation(s)
- Teresa María Linares-Pineda
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Departamento de Bioquímica y Biología Molecular 2, Universidad de Granada, Granada, Spain
| | - Nerea Peña-Montero
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Fuensanta Lima-Rubio
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
| | - Antonio Sánchez-Pozo
- Departamento de Bioquímica y Biología Molecular 2, Universidad de Granada, Granada, Spain
| | - Francisco J Tinahones
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain
| | - María Molina-Vega
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
| | - María José Picón-César
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
| | - Sonsoles Morcillo
- Departamento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Obesidad, diabetes y sus comorbilidades: prevención y tratamiento, Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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3
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Fernández-Valero A, Peña-Montero N, Lima-Rubio F, Gutiérrez-Repiso C, Linares-Pineda TM, Picón-César MJ, Sancho-Marín R, Tinahones FJ, Morcillo S, Molina-Vega M. Changes in Oxidative Stress and Intestinal Permeability during Pregnancy in Women with Gestational Diabetes Mellitus Treated with Metformin or Insulin and Healthy Controls: A Randomized Controlled Trial. Antioxidants (Basel) 2023; 12:1981. [PMID: 38001834 PMCID: PMC10669428 DOI: 10.3390/antiox12111981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
Both oxidative stress and intestinal permeability are increased in hyperglycemic situations and have been shown to be reduced by metformin in type 2 diabetes mellitus (T2DM) patients. The aim of this study was to elucidate the effect of metformin on oxidative stress and intestinal permeability in women with gestational diabetes mellitus (GDM) treated with metformin compared to those treated with insulin and healthy controls. A total of 120 women were included from August 2016 to February 2022: 41 received metformin (MET group), 38 received insulin (INS group), and 41 were healthy controls. Baseline and antenatal visits were carried out at 25.4 ± 4.8 and 36.1 ± 0.8 weeks of pregnancy, respectively. Advanced oxidation protein products (AOPPs), total antioxidant capacity (TAC), and zonulin levels were measured at every visit. Zonulin levels from baseline to prepartum visit increased significantly in both healthy controls (0.6 ± 0.9 to 1.2 ± 1.7 ng/mL, p = 0.004) and the INS group (0.4 ± 0.3 to 0.6 ± 0.5 ng/mL, p = 0.034) but did not significantly change in the MET group (0.4 ± 0.4 to 0.5 ± 0.4 ng/mL, p = 0.202). However, TAC and AOPP levels significantly increased in women with GDM, both in the INS and MET groups but not in the healthy controls. In conclusion, in our population, metformin has been shown to avoid an increase in intestinal permeability but failed to avoid an increase in oxidative stress related to hyperglycemia.
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Affiliation(s)
- Andrea Fernández-Valero
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Department of Medicine and Dermatology, Málaga University, 29010 Málaga, Spain
| | - Nerea Peña-Montero
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Fuensanta Lima-Rubio
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Teresa María Linares-Pineda
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - María José Picón-César
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
| | - Raquel Sancho-Marín
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Department of Medicine and Dermatology, Málaga University, 29010 Málaga, Spain
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Sonsoles Morcillo
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain (M.M.-V.)
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, 29010 Málaga, Spain
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4
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Gutiérrez-Repiso C, Cantarero-Cuenca A, González-Jiménez A, Linares-Pineda T, Peña-Montero N, Ocaña-Wilhelmi L, Tinahones FJ, Morcillo S. Epigenetic Marks as Predictors of Metabolic Response to Bariatric Surgery: Validation from an Epigenome Wide Association Study. Int J Mol Sci 2023; 24:14778. [PMID: 37834223 PMCID: PMC10572880 DOI: 10.3390/ijms241914778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Little is known about the potential role of epigenetic marks as predictors of the resolution of obesity-related comorbidities after bariatric surgery. In this study, 20 patients were classified according to the metabolic improvement observed 6 months after sleeve gastrectomy, based on the diagnosis of metabolic syndrome, into responders if metabolic syndrome reversed after bariatric surgery (n = 10) and non-responders if they had metabolic syndrome bariatric surgery (n = 10). Blood DNA methylation was analyzed at both study points using the Infinium Methylation EPIC Bead Chip array-based platform. Twenty-six CpG sites and their annotated genes, which were previously described to be associated with metabolic status, were evaluated. Cg11445109 and cg19469447 (annotated to Cytochrome P450 2E1 (CYP2E1) gene) were significantly more hypomethylated in the responder group than in the non-responder group at both study points, whilst cg25828445 (annotated to Nucleolar Protein Interacting With The FHA Domain Of MKI67 Pseudogene 3 (NIFKP3) gene) showed to be significantly more hypermethylated in the non-responder group compared to the responder group at both study points. The analysis of the methylation sites annotated to the associated genes showed that CYP2E1 had 40% of the differentially methylated CpG sites, followed by Major Histocompatibility Complex, Class II, DR Beta 1 (HLA-DRB1) (33.33%) and Zinc Finger Protein, FOG Family Member 2 (ZFPM2) (26.83%). Cg11445109, cg19469447 and cg25828445 could have a role in the prediction of metabolic status and potential value as biomarkers of response to bariatric surgery.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, 29010 Málaga, Spain; (T.L.-P.); (N.P.-M.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Campus de Teatinos s/n, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio Cantarero-Cuenca
- ECAI Bioinformática, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain; (A.C.-C.); (A.G.-J.)
| | - Andrés González-Jiménez
- ECAI Bioinformática, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain; (A.C.-C.); (A.G.-J.)
| | - Teresa Linares-Pineda
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, 29010 Málaga, Spain; (T.L.-P.); (N.P.-M.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Campus de Teatinos s/n, 29010 Málaga, Spain
| | - Nerea Peña-Montero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, 29010 Málaga, Spain; (T.L.-P.); (N.P.-M.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Campus de Teatinos s/n, 29010 Málaga, Spain
| | - Luis Ocaña-Wilhelmi
- Unidad de Gestión Clínica de Cirugía General, Digestiva y Trasplantes, Hospital Universitario Virgen de la Victoria, 29590 Málaga, Spain;
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología, Universidad de Málaga, 29590 Málaga, Spain
| | - Francisco J. Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, 29010 Málaga, Spain; (T.L.-P.); (N.P.-M.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Campus de Teatinos s/n, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29590 Málaga, Spain
| | - Sonsoles Morcillo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, 29010 Málaga, Spain; (T.L.-P.); (N.P.-M.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Campus de Teatinos s/n, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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5
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Linares-Pineda T, Peña-Montero N, Fragoso-Bargas N, Gutiérrez-Repiso C, Lima-Rubio F, Suarez-Arana M, Sánchez-Pozo A, Tinahones FJ, Molina-Vega M, Picón-César MJ, Sommer C, Morcillo S. Epigenetic marks associated with gestational diabetes mellitus across two time points during pregnancy. Clin Epigenetics 2023; 15:110. [PMID: 37415231 PMCID: PMC10324212 DOI: 10.1186/s13148-023-01523-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
An adverse intrauterine or periconceptional environment, such as hyperglycemia during pregnancy, can affect the DNA methylation pattern both in mothers and their offspring. In this study, we explored the epigenetic profile in maternal peripheral blood samples through pregnancy to find potential epigenetic biomarkers for gestational diabetes mellitus (GDM), as well as candidate genes involved in GDM development. We performed an epigenome-wide association study in maternal peripheral blood samples in 32 pregnant women (16 with GDM and 16 non-GDM) at pregnancy week 24-28 and 36-38. Biochemical, anthropometric, and obstetrical variables were collected from all the participants. The main results were validated in an independent cohort with different ethnic origin (European = 307; South Asians = 165). Two hundred and seventy-two CpGs sites remained significantly different between GDM and non-GDM pregnant women across two time points during pregnancy. The significant CpG sites were related to pathways associated with type I diabetes mellitus, insulin resistance and secretion. Cg01459453 (SELP gene) was the most differentiated in the GDM group versus non-GDM (73.6 vs. 60.9, p = 1.06E-11; FDR = 7.87E-06). Three CpG sites (cg01459453, cg15329406, and cg04095097) were able to discriminate between GDM cases and controls (AUC = 1; p = 1.26E-09). Three differentially methylated positions (DMPs) were replicated in an independent cohort. To conclude, epigenetic marks during pregnancy differed between GDM cases and controls suggesting a role for these genes in GDM development. Three CpGs were able to discriminate GDM and non-GDM groups with high specificity and sensitivity, which may be biomarker candidates for diagnosis or prediction of GDM.
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Affiliation(s)
- Teresa Linares-Pineda
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
- Departamento de Bioquímica y Biología Molecular 2, Universidad de Granada, Granada, Spain
| | - Nerea Peña-Montero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
| | - Nicolás Fragoso-Bargas
- Department of Endocrinology Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 29029, Madrid, Spain
| | - Fuensanta Lima-Rubio
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
| | - María Suarez-Arana
- Departamento de Obstetricia y Ginecología, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Regional Universitario de Málaga, 29009, Málaga, Spain
| | - Antonio Sánchez-Pozo
- Departamento de Bioquímica y Biología Molecular 2, Universidad de Granada, Granada, Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
- Department of Endocrinology Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010, Málaga, Spain
| | - María Molina-Vega
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain
| | - María José Picón-César
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain.
| | - Christine Sommer
- Department of Endocrinology Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sonsoles Morcillo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, 29010, Málaga, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 29029, Madrid, Spain.
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6
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Linares-Pineda TM, Gutiérrez-Repiso C, Peña-Montero N, Molina-Vega M, Rubio FL, Arana MS, Tinahones FJ, Picón-César MJ, Morcillo S. Higher β cell death in pregnant women, measured by DNA methylation patterns of cell-free DNA, compared to new-onset type 1 and type 2 diabetes subjects: a cross-sectional study. Diabetol Metab Syndr 2023; 15:115. [PMID: 37264478 DOI: 10.1186/s13098-023-01096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
Diabetes is a metabolic disorder of glucose homeostasis in which β cell destruction occurs silently and is detected mainly when symptoms appear. In the last few years, it has emerged a great interest in developing markers capable of detecting pancreatic β cell death focused on improving early diagnosis and getting a better treatment response, mainly in type 1 diabetes. But other types of diabetes would also benefit from early detection of β cell death. Differentially methylated circulating DNA is being studied as minimally invasive biomarker of cell death. We aimed to explore whether the unmethylated/methylated ratio of the insulin and amylin genes might be a good biomarker of β cell death in different types of diabetes. A lower index ∆Ct indicates a higher rate of β-cell death. Plasma samples from subjects without diabetes, pregnant women, pregnant with gestational diabetes (GDM), type 1 diabetes and type 2 diabetes were analyzed. A qPCR reaction with specific primers for both methylated and unmethylated fragments of insulin and amylin genes were carried out. Pregnant women, GDM and non- GDM, showed a higher β-cell death for both markers (∆INS = 3.8 ± 2.1 and ∆Amylin = 8.5 ± 3.6), whereas T1D presented lower rate (∆INS = 6.2 ± 2.1 and ∆Amylin = 10.7 ± 2.9) comparable to healthy subjects. The insulin methylation index was associated with the newborn birth weight (r = 0.46; p = 0.033) and with insulin resistance (r = -0.533; p = 0.027) in the GDM group. The higher rate of β-cell death was observed in pregnant women independently of their metabolic status. These indexes could be a good indicator of β cell death in processes caused by defects on insulin secretion, insulin action, or both.
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Affiliation(s)
- Teresa María Linares-Pineda
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Nerea Peña-Montero
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María Molina-Vega
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Fuensanta Lima Rubio
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María Suárez Arana
- Department of Obstetrics and Gynecology, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain
| | - María José Picón-César
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Sonsoles Morcillo
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
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7
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Martínez-Montoro JI, Generoso-Piñar M, Ocaña-Wilhelmi L, Gutiérrez-Repiso C, Sánchez-García A, Soler-Humanes R, Fernández-Serrano JL, Sánchez-Gallego P, Martínez-Moreno JM, García-Fuentes E, Tinahones FJ, Garrido-Sánchez L. Hypertension and hypercholesterolemia are predictive factors associated with type 2 diabetes persistence after metabolic surgery: A prospective study. Diabetes Res Clin Pract 2023; 199:110650. [PMID: 37015259 DOI: 10.1016/j.diabres.2023.110650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Metabolic surgery is the most effective therapeutic strategy for the management of type 2 diabetes (T2DM). Several preoperative clinical factors have been associated with T2DM remission after metabolic surgery. However, other potential predictors remain unexplored. AIM To assess the role of basal (pre-surgery) clinical and biochemical parameters in T2DM remission after metabolic surgery. METHODS A prospective study including 98 patients with T2DM undergoing metabolic surgery was performed. Clinical, anthropometric, and biochemical data were collected at baseline and 1 year following metabolic surgery. RESULTS Patients without T2DM remission 1 year after metabolic surgery presented a longer duration of diabetes and higher glycated hemoglobin (HbA1c) levels; a higher percentage of these subjects were using insulin therapy, antihypertensive drugs, and lipid-lowering therapies before metabolic surgery, compared to those patients with T2DM remission. A lower percentage of T2DM remission after metabolic surgery was observed among patients with hypertension/hypercholesterolemia before surgery, compared to those patients without hypertension/hypercholesterolemia (51.7 % vs 86.8 %, p < 0.001, and 38.5 % vs 75 %, p < 0.001, respectively), and among patients with longer duration of diabetes (≥5 years vs <5 years; 44.4 % vs 83 %, respectively; p < 0.001). In the logistic regression model, diabetes duration, basal HbA1c, and the presence of hypertension and hypercholesterolemia before surgery were inversely related to T2DM remission following metabolic surgery, after adjusting for sex, age, waist circumference, and type of surgery. CONCLUSIONS In a cohort of patients with obesity and T2DM, preoperative hypertension and hypercholesterolemia, together with a longer diabetes duration and higher HbA1c concentrations, were independent predictors of T2DM persistence after metabolic surgery.
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Affiliation(s)
- José Ignacio Martínez-Montoro
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Marta Generoso-Piñar
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Luis Ocaña-Wilhelmi
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Faculty of Medicine, University of Málaga, Málaga, Spain; Department of General and Digestive System Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Sánchez-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Soler-Humanes
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Department of General and Digestive System Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | - José Luis Fernández-Serrano
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Department of General and Digestive System Surgery, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Pilar Sánchez-Gallego
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - José M Martínez-Moreno
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Eduardo García-Fuentes
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Department of Gastroenterology, Virgen de la Victoria University Hospital, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto Salud Carlos III, Madrid, Spain.
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Faculty of Medicine, University of Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Lourdes Garrido-Sánchez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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8
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Linares-Pineda TM, Boughanem H, Gutiérrez-Repiso C, Macías-González M, Andrés-León E, Rojo-Martínez G, Valdés S, Tinahones FJ, Morcillo S. Epigenetic changes in the metabolically healthy obese: A case-control versus a prospective study. Eur J Clin Invest 2022; 52:e13783. [PMID: 35342930 PMCID: PMC9539510 DOI: 10.1111/eci.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/17/2022] [Accepted: 03/26/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Teresa Maria Linares-Pineda
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Hatim Boughanem
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, Málaga, Spain
| | - Manuel Macías-González
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, Málaga, Spain
| | - Eduardo Andrés-León
- Bioinformatics Unit, Instituto de Parasitología y Biomedicina "López Neyra", CSIC, Granada, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, Málaga, Spain
| | - Sonsoles Morcillo
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, Málaga, Spain
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9
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Gutiérrez-Repiso C, Garrido-Sánchez L, Alcaide-Torres J, Cornejo-Pareja I, Ocaña-Wilhelmi L, García-Fuentes E, Moreno-Indias I, Tinahones FJ. Predictive Role of Gut Microbiota in Weight Loss Achievement after Bariatric Surgery. J Am Coll Surg 2022; 234:861-871. [PMID: 35426398 DOI: 10.1097/xcs.0000000000000145] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Bariatric surgery induces changes in gut microbiota that have been suggested to contribute to weight loss and metabolic improvement. However, whether preoperative gut microbiota composition could predict response to bariatric surgery has not yet been elucidated. STUDY DESIGN Seventy-six patients who underwent sleeve gastrectomy were classified according to the percentage of excess weight loss (%EWL) 1 year after surgery in the responder group: >50%EWL (n=50) and the nonresponder group: <50%EWL (n=26). Patients were evaluated before surgery, and 3 months and 1 year after surgery. Gut microbiota composition was analyzed before surgery (n=76) and 3 months after bariatric surgery (n=40). RESULTS Diversity analysis did not show differences between groups before surgery or 3 months after surgery. Before surgery, there were differences in the abundance of members belonging to Bacteroidetes and Firmicutes phyla (nonresponder group: enriched in Bacteroidaceae, Bacteroides, Bacteroides uniformis, Alistipes finegoldii, Alistipes alistipes, Dorea formicigenerans, and Ruminococcus gnavus. Responder group: enriched in Peptostreptococcaceae, Gemmiger, Gemiger formicilis, Barnesiella, Prevotellaceae, and Prevotella; linear discriminant analysis >2; p < 0.05). Prevotella-to-Bacteroides ratio was significantly lower in the nonresponder group compared to the responder group (p = 0.048). After surgery, the responder group showed an enrichment in taxa that have been shown to have beneficial effects on host metabolism. Before surgery, PICRUSt analysis showed an enrichment in pathways involved in the biosynthesis components of the O-antigen polysaccharideunits in lipopolysaccharides in the nonresponder group. CONCLUSIONS Preoperative gut microbiota could have an impact on bariatric surgery outcomes. Prevotella-to-Bacteroides ratio could be used as a predictive tool for weight loss trajectory. Early after surgery, patients who experienced successful weight loss showed an enrichment in taxa related to beneficial effects on host metabolism.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Lourdes Garrido-Sánchez
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Alcaide-Torres
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Cornejo-Pareja
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Ocaña-Wilhelmi
- Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo (Ocaña-Wilhelmi), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología (Ocaña-Wilhelmi), Universidad de Málaga, Málaga, Spain
| | - Eduardo García-Fuentes
- Unidad de Gestión Clínica de Aparato Digestivo (García-Fuentes), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) (García-Fuentes), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Moreno-Indias
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J Tinahones
- From the Unidad de Gestión Clínica de Endocrinología y Nutrición (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn) (Gutiérrez-Repiso, Garrido-Sánchez, Alcaide-Torres, Cornejo-Pareja, Moreno-Indias, Tinahones), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina y Dermatología (Tinahones), Universidad de Málaga, Málaga, Spain
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10
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Gutiérrez-Repiso C, Moreno-Indias I, Tinahones FJ. Shifts in gut microbiota and their metabolites induced by bariatric surgery. Impact of factors shaping gut microbiota on bariatric surgery outcomes. Rev Endocr Metab Disord 2021; 22:1137-1156. [PMID: 34287758 DOI: 10.1007/s11154-021-09676-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 02/06/2023]
Abstract
Evidence suggests that bariatric surgery alters gut microbiota, although its impact at compositional and functional level is not well described. In this review, the most relevant findings, mainly described in Roux-en-Y gastric bypass and sleeve gastrectomy, are outlined. Although the number of studies has increased in the last years, conclusive assertions cannot be elaborated. An issue to address is to know the influence of these alterations on host metabolism and the contribution of gut microbiota derived metabolites. New lines of research have been focusing on analysing gut microbiota functionality rather than evaluating changes at compositional level, and the functions of gut microbiota metabolites in host metabolism, what will bring more relevant information about the influence of gut microbiota in bariatric surgery outcomes. Personalized medicine, because of the predictive value of gut microbiota, is another promising field. The possibility of a specific gut microbiota pattern that could predict type 2 diabetes remission or weight loss failure after bariatric surgery is a matter of great interest. However, little is known about how gut microbiota manipulation could contribute to the beneficial effects of bariatric surgery. Peri-operative antibiotics prophylaxis or probiotic supplementation early after surgery, are strategies barely studied so far, and could constitute a novel tool in the management of weight loss and metabolic profile improvement after surgery.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología Y Nutrición del Hospital Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA) Málaga. Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y La Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Isabel Moreno-Indias
- Unidad de Gestión Clínica de Endocrinología Y Nutrición del Hospital Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA) Málaga. Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y La Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica de Endocrinología Y Nutrición del Hospital Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA) Málaga. Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y La Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina Y Dermatología, Universidad de Málaga, Málaga, Spain
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11
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Molina-Vega M, Picón-César MJ, Gutiérrez-Repiso C, Fernández-Valero A, Lima-Rubio F, González-Romero S, Moreno-Indias I, Tinahones FJ. Metformin action over gut microbiota is related to weight and glycemic control in gestational diabetes mellitus: A randomized trial. Biomed Pharmacother 2021; 145:112465. [PMID: 34844107 DOI: 10.1016/j.biopha.2021.112465] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Metformin, which is known to produce profound changes in gut microbiota, is being increasingly used in gestational diabetes mellitus (GDM). The aim of this study was to elucidate the differences in gut microbiota composition and function in women with GDM treated with metformin compared to those treated with insulin. METHODS From May to December 2018, 58 women with GDM were randomized to receive insulin (INS; n = 28) or metformin (MET; n = 30) at the University Hospital Virgen de la Victoria, Málaga, Spain. Basal visits, with at least 1 follow-up visit and prepartum visit, were performed. At the basal and prepartum visits, blood and stool samples were collected. The gut microbiota profile was determined through 16S rRNA analysis. RESULTS Compared to INS, women on MET presented a lower mean postprandial glycemia and a lower increase in weight and body mass index (BMI). Firmicutes and Peptostreptococcaceae abundance declined, while Proteobacteria and Enterobacteriaceae abundance increased in the MET group. We found inverse correlations between changes in the abundance of Proteobacteria and mean postprandial glycemia (p = 0.023), as well as between Enterobacteriaceae and a rise in BMI and weight gain (p = 0.031 and p = 0.036, respectively). Regarding the metabolic profile of gut microbiota, predicted metabolic pathways related to propionate degradation and ubiquinol biosynthesis predominated in the MET group. CONCLUSION Metformin in GDM affects the composition and metabolic profile of gut microbiota. These changes could mediate, at least in part, its clinical effects. Studies designed to assess how these changes influence metabolic control during and after pregnancy are necessary.
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Affiliation(s)
- María Molina-Vega
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain
| | - María J Picón-César
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, Madrid, Spain
| | - Andrea Fernández-Valero
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Fuensanta Lima-Rubio
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain
| | - Stella González-Romero
- Department of Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Isabel Moreno-Indias
- Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, Madrid, Spain.
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, Madrid, Spain
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Ocaña-Wilhelmi L, Martín-Núñez GM, Ruiz-Limón P, Alcaide J, García-Fuentes E, Gutiérrez-Repiso C, Tinahones FJ, Moreno-Indias I. Gut Microbiota Metabolism of Bile Acids Could Contribute to the Bariatric Surgery Improvements in Extreme Obesity. Metabolites 2021; 11:metabo11110733. [PMID: 34822391 PMCID: PMC8620296 DOI: 10.3390/metabo11110733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 01/03/2023] Open
Abstract
Bariatric surgery is the only procedure to obtain and maintain weight loss in the long term, although the mechanisms driving these benefits are not completely understood. In the last years, gut microbiota has emerged as one of the drivers through its metabolites, especially secondary bile acids. In the current study, we have compared the gut microbiota and the bile acid pool, as well as anthropometric and biochemical parameters, of patient with morbid obesity who underwent bariatric surgery by two different techniques, namely Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Gut microbiota populations differed after the respective procedures, particularly with respect to the Enterobacteriaceae family. Both techniques resulted in changes in the bile acids pool, but RYGB was the procedure which suffered the greatest changes, with a reduction in most of their levels. Blautia and Veillonella were the two genera that more relationships showed with secondary bile acids, indicating a possible role in their formation and inhibition, respectively. Correlations with the anthropometric and biochemical variables showed that secondary bile acids could have a role in the amelioration of the glucose and HDL-cholesterol levels. Thus, we have observed a possible relationship between the interaction of the bile acids pool metabolized by the gut microbiota in the metabolic improvements obtained by bariatric surgery in the frame of morbid obesity, deserving further investigation in greater cohorts to decipher the role of each bile acid in the homeostasis of the host for their possible use in the development of microbiota-based therapeutics, such as new drugs, postbiotics or probiotics.
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Affiliation(s)
- Luis Ocaña-Wilhelmi
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología, Universidad de Málaga, 29010 Málaga, Spain;
- Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Gracia María Martín-Núñez
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
| | - Patricia Ruiz-Limón
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
| | - Juan Alcaide
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
| | - Eduardo García-Fuentes
- Department of Gastroenterology, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Málaga (IBIMA), Málaga University, 29010 Málaga, Spain;
- CIBER Enfermedades Hepáticas y Digestivas-CIBEREHD, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
- Correspondence: (C.G.-R.); (F.J.T.); (I.M.-I.)
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
- Correspondence: (C.G.-R.); (F.J.T.); (I.M.-I.)
| | - Isabel Moreno-Indias
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga University, 29010 Málaga, Spain; (G.M.M.-N.); (P.R.-L.); (J.A.)
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29029 Madrid, Spain
- Correspondence: (C.G.-R.); (F.J.T.); (I.M.-I.)
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Molina-Vega M, Gutiérrez-Repiso C, Lima-Rubio F, Suárez-Arana M, Linares-Pineda TM, Cobos Díaz A, Tinahones FJ, Morcillo S, Picón-César MJ. Impact of the Gestational Diabetes Diagnostic Criteria during the Pandemic: An Observational Study. J Clin Med 2021; 10:4904. [PMID: 34768425 PMCID: PMC8585066 DOI: 10.3390/jcm10214904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To analyze the effect of applying alternative diagnostic criteria for gestational diabetes mellitus (GDM) during the COVID-19 pandemic on GDM prevalence and obstetrical and perinatal outcomes, in comparison to usual diagnostic approaches. METHODS Data from women referred to GDM diagnosis from 1 September to 30 November 2019 were retrospectively collected (2019-group). The same data from the same period in 2020 were prospectively collected (2020-group). In both cases, a two-step diagnostic approach was used, the first step being a screening test (1 h 50 goral glucose tolerance test, OGTT). In 2019 it was followed by a 100 gr OGTT for diagnosis. In 2020, this was replaced by a blood test for the measurement of plasma glucose and HbA1c, according to alternative GDM diagnostic criteria during the COVID-19 pandemic. RESULTS From 237 women in the 2019 group, 40 (16.9%) were diagnosed with GDM, while from 255 women in the 2020 group, 37 (14.5%) had GDM (p = 0.470). More women in the 2020 group, in comparison to the 2019 group, were nulligravid (41.9% vs. 47.2%, p = 0.013), had a personal history of GDM (11.4% vs. 4.6%, p = 0.013) and had macrosomia in previous pregnancies (10.2% vs. 2.1%, p = 0.001). Obstetrical and perinatal outcomes were similar when comparing women with GDM to non-GDM women in the 2019 and 2020 groups and between GDM women and non-GDM women. CONCLUSION In a Spanish population, GDM prevalence during the COVID-19 pandemic using the alternative diagnostic criteria was similar to that found in 2019 using the usual diagnostic criteria. Despite women referred for GDM diagnosis during the pandemic having more GDM risk factors, obstetrical and perinatal outcomes were comparable to those observed before the pandemic.
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Affiliation(s)
- María Molina-Vega
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
| | - Carolina Gutiérrez-Repiso
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Fuensanta Lima-Rubio
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
| | - María Suárez-Arana
- Departmento de Obstetricia y Ginecología, Hospital Regional Universitario de Málaga, IBIMA, 29009 Málaga, Spain;
| | - Teresa María Linares-Pineda
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Andrés Cobos Díaz
- Laboratorio de Análisis Clínico, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | - Francisco J. Tinahones
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Sonsoles Morcillo
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - María J. Picón-César
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
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Gutiérrez-Repiso C, Linares-Pineda TM, Gonzalez-Jimenez A, Aguilar-Lineros F, Valdés S, Soriguer F, Rojo-Martínez G, Tinahones FJ, Morcillo S. Epigenetic Biomarkers of Transition from Metabolically Healthy Obesity to Metabolically Unhealthy Obesity Phenotype: A Prospective Study. Int J Mol Sci 2021; 22:ijms221910417. [PMID: 34638758 PMCID: PMC8508854 DOI: 10.3390/ijms221910417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Identifying those parameters that could potentially predict the deterioration of metabolically healthy phenotype is a matter of debate. In this field, epigenetics, in particular DNA methylation deserves special attention. Results: The aim of the present study was to analyze the long-term evolution of methylation patterns in a subset of metabolically healthy subjects in order to search for epigenetic markers that could predict the progression to an unhealthy state. Twenty-six CpG sites were significantly differentially methylated, both at baseline and 11-year follow-up. These sites were related to 19 genes or pseudogenes; a more in-depth analysis of the methylation sites of these genes showed that CYP2E1 had 50% of the collected CpG sites differently methylated between stable metabolically healthy obesity (MHO) and unstable MHO, followed by HLA-DRB1 (33%), ZBTB45 (16%), HOOK3 (14%), PLCZ1 (14%), SLC1A1 (12%), MUC2 (12%), ZFPM2 (12.5%) and HLA-DQB2 (8%). Pathway analysis of the selected 26 CpG sites showed enrichment in pathways linked to th1 and th2 activation, antigen presentation, allograft rejection signals and metabolic processes. Higher methylation levels in the cg20707527 (ZFPM2) could have a protective effect against the progression to unstable MHO (OR: 0.21, 95%CI (0.067–0.667), p < 0.0001), whilst higher methylation levels in cg11445109 (CYP2E1) would increase the progression to MUO; OR: 2.72, 95%CI (1.094–6.796), p < 0.0014; respectively). Conclusions: DNA methylation status is associated with the stability/worsening of MHO phenotype. Two potential biomarkers of the transition to an unhealthy state were identified and deserve further investigation (cg20707527 and cg11445109). Moreover, the described differences in methylation could alter immune system-related pathways, highlighting these pathways as therapeutic targets to prevent metabolic deterioration in MHO patients.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (T.M.L.-P.); (F.A.-L.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Teresa María Linares-Pineda
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (T.M.L.-P.); (F.A.-L.)
| | - Andres Gonzalez-Jimenez
- ECAI Bioinformática Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
| | - Francisca Aguilar-Lineros
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (T.M.L.-P.); (F.A.-L.)
| | - Sergio Valdés
- Departamento de Endocrinología and Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (S.V.); (F.S.); (G.R.-M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Federico Soriguer
- Departamento de Endocrinología and Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (S.V.); (F.S.); (G.R.-M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Gemma Rojo-Martínez
- Departamento de Endocrinología and Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (S.V.); (F.S.); (G.R.-M.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Francisco J. Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (T.M.L.-P.); (F.A.-L.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Málaga, Spain
- Correspondence: (F.J.T.); (S.M.)
| | - Sonsoles Morcillo
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (T.M.L.-P.); (F.A.-L.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (F.J.T.); (S.M.)
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Mateo-Gallego R, Moreno-Indias I, Bea AM, Sánchez-Alcoholado L, Fumanal AJ, Quesada-Molina M, Prieto-Martín A, Gutiérrez-Repiso C, Civeira F, Tinahones FJ. An alcohol-free beer enriched with isomaltulose and a resistant dextrin modulates gut microbiome in subjects with type 2 diabetes mellitus and overweight or obesity: a pilot study. Food Funct 2021; 12:3635-3646. [PMID: 33900319 DOI: 10.1039/d0fo03160g] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We aimed to study the effect of consuming an alcohol-free beer with modified carbohydrates composition (almost completely eliminating maltose and adding isomaltulose (16.5 g day-1) and resistant maltodextrin (5.28 g day-1)) in gut microbiome, compared to regular alcohol-free beer in subjects with T2DM or prediabetes and overweight/obesity. This is a pilot, randomized, double-blinded, crossover study including a sub-sample of a global study with 14 subjects: (a) consuming 66 cl day-1 of regular alcohol-free beer for the first 10 weeks and 66 cl day-1 of modified alcohol-free beer for the next 10 weeks; (b) the same described intervention in opposite order. BMI homogeneously decreased after both interventions. Glucose and HOMA-IR significantly decreased just after the participants consumed modified alcohol-free beer. These findings were in the same line as those reported in the global study. Dominant bacteria at baseline were Bacteroidetes, Firmicutes, Proteobacteria and Tenericutes. Parabacteroides, from the Porphymonadaceae family, resulted as the feature with the greatest difference between beers (ANCOM analysis, W = 15). Feature-volatility analysis confirmed the importance of Parabacteroides within the model. Alcohol-free beers consumption resulted in an enhancement of pathways related to metabolism according to PICRUSt analysis, including terpenoid-quinone, lipopolysaccharides and N-glycan biosynthesis. Thus, an alcohol-free beer including the substitution of regular carbohydrates for low doses of isomaltulose and the addition of maltodextrin within meals significantly impacts gut microbiota in diabetic subjects with overweight or obesity. This could, at least partially, explain the improvement in insulin resistance previously found after taking modified alcohol-free alcohol.Clinical Trial Registration: Registered under ClinicalTrials.gov identifier no. NCT03337828.
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Affiliation(s)
- Rocío Mateo-Gallego
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain.
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Gutiérrez-Repiso C, Molina-Vega M, Bernal-López MR, Garrido-Sánchez L, García-Almeida JM, Sajoux I, Moreno-Indias I, Tinahones FJ. Different Weight Loss Intervention Approaches Reveal a Lack of a Common Pattern of Gut Microbiota Changes. J Pers Med 2021; 11:jpm11020109. [PMID: 33567649 PMCID: PMC7915884 DOI: 10.3390/jpm11020109] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 02/07/2023] Open
Abstract
Options for treatment of obesity include dietary approaches and bariatric surgery. Previous studies have shown that weight loss interventions have an impact on gut microbiota. However, a pattern of gut microbiota changes associated with weight loss independently of the type of intervention has not been described yet. This study includes 61 individuals who followed different weight loss strategies in three different trials: 21 followed a hypocaloric Mediterranean diet (MedDiet), 18 followed a very-low-calorie ketogenic diet (VLCKD) and 22 patients underwent sleeve gastrectomy bariatric surgery (BS). Gut microbiota profile was assessed by next-generation sequencing. A common taxon that had significantly changed within the three weight loss interventions could not be find. At the family level, Clostiridiaceae significantly increased its abundance with MedDiet and VLCKD, whilst Porphyromonadacean and Rikenellaceae significantly increased with VLCKD and BS. At genus level, in VLCKD and BS, Parabacteroides and Alistipes significantly increased their abundance whilst Lactobacillus decreased. At the species level, BS and VLCKD produced an increase in Parabacteroidesdistasonis and a decrease in Eubactieriumventriosum and Lactobacillusrogosae, whilst Orodibactersplanchnicus increased its abundance after the BS and MedDiet. Predicted metagenome analysis suggested that most of the changes after VLCKD were focused on pathways related to biosynthesis and degradation/utilization/assimilation, while BS seems to decrease most of the biosynthesis pathways. MedDiet was enriched in several pathways related to fermentation to short-chain fatty acids. Our results show that weight loss is not associated with a specific pattern of gut microbiota changes independently of the strategy used. Indeed, gut microbiota changes according to type of weight loss intervention.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - María Molina-Vega
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - M. Rosa Bernal-López
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Departamento de Medicina Interna del Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain
| | - Lourdes Garrido-Sánchez
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - José M. García-Almeida
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Ignacio Sajoux
- Pronokal Group, Medical Department Pronokal, 08009 Barcelona, Spain;
| | - Isabel Moreno-Indias
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence: ; Tel.: +34-95-103-2647 (ext. 48); Fax: +34-95-1924651
| | - Francisco J. Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (C.G.-R.); (M.M.-V.); (L.G.-S.); (J.M.G.-A.); (F.J.T.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Málaga, Spain
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Vila-Bedmar R, Cruces-Sande M, Arcones AC, Willemen HLDM, Prieto P, Moreno-Indias I, Díaz-Rodríguez D, Francisco S, Jaén RI, Gutiérrez-Repiso C, Heijnen CJ, Boscá L, Fresno M, Kavelaars A, Mayor F, Murga C. GRK2 levels in myeloid cells modulate adipose-liver crosstalk in high fat diet-induced obesity. Cell Mol Life Sci 2020; 77:4957-4976. [PMID: 31927610 DOI: 10.1007/s00018-019-03442-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
Macrophages are key effector cells in obesity-associated inflammation. G protein-coupled receptor kinase 2 (GRK2) is highly expressed in different immune cell types. Using LysM-GRK2+/- mice, we uncover that a reduction of GRK2 levels in myeloid cells prevents the development of glucose intolerance and hyperglycemia after a high fat diet (HFD) through modulation of the macrophage pro-inflammatory profile. Low levels of myeloid GRK2 confer protection against hepatic insulin resistance, steatosis and inflammation. In adipose tissue, pro-inflammatory cytokines are reduced and insulin signaling is preserved. Macrophages from LysM-GRK2+/- mice secrete less pro-inflammatory cytokines when stimulated with lipopolysaccharide (LPS) and their conditioned media has a reduced pathological influence in cultured adipocytes or naïve bone marrow-derived macrophages. Our data indicate that reducing GRK2 levels in myeloid cells, by attenuating pro-inflammatory features of macrophages, has a relevant impact in adipose-liver crosstalk, thus preventing high fat diet-induced metabolic alterations.
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Affiliation(s)
- Rocío Vila-Bedmar
- Departamento de ciencias básicas de la salud, área de Bioquímica y Biología Molecular, Universidad Rey Juan Carlos (URJC), Madrid, Spain
| | - Marta Cruces-Sande
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Alba C Arcones
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Hanneke L D M Willemen
- Laboratory of Translational Immunology (LTI), University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Patricia Prieto
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain
| | - Isabel Moreno-Indias
- CIBER de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Endocrinología y Nutrición, Hospital Universitario Virgen de Victoria de Malaga, Universidad de Málaga, Málaga, Spain
| | - Daniel Díaz-Rodríguez
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain
| | - Sara Francisco
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain
| | - Rafael I Jaén
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain
| | - Carolina Gutiérrez-Repiso
- CIBER de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Endocrinología y Nutrición, Hospital Universitario Virgen de Victoria de Malaga, Universidad de Málaga, Málaga, Spain
| | - Cobi J Heijnen
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lisardo Boscá
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain
| | - Manuel Fresno
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
| | | | - Federico Mayor
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain.
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Cristina Murga
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa", Universidad Autónoma de Madrid (CSIC/UAM), C/Nicolás Cabrera 1, 28049, Madrid, Spain.
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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18
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Mateo-Gallego R, Moreno-Indias I, Bea A, Sánchez-Alcoholado L, Fumanal A, Quesada-Molina M, Prieto-Martín A, Gutiérrez-Repiso C, Civeira F, Tinahones F. Effect of an alcohol-free beer enriched with isomaltulose and a resistant dextrin on gut microbiome in diabetic subjects with overweight or obesity. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Molina-Vega M, Gutiérrez-Repiso C, Muñoz-Garach A, Lima-Rubio F, Morcillo S, Tinahones FJ, Picón-César MJ. Relationship between environmental temperature and the diagnosis and treatment of gestational diabetes mellitus: An observational retrospective study. Sci Total Environ 2020; 744:140994. [PMID: 32717465 DOI: 10.1016/j.scitotenv.2020.140994] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Environmental temperature has been described to affect plasma glucose levels after oral glucose tolerance testing (OGTT). AIMS We evaluated the relationship between seasons and environmental temperature and gestational diabetes mellitus (GDM) diagnosis and treatment. METHODS We analyzed data from 2374 women retrospectively. GDM was diagnosed in 473 patients by a 100-g OGTT. OGTT results and needing of insulin therapy were evaluated in relation to seasons and environmental temperature (mean temperature and temperature change) the day of the OGTT and the preceding 14 and 28 days. RESULTS We found significant seasonal differences in the percentage of GDM: 24.4% in summer vs. 15.6% in autumn (p < 0.01). The odds ratio (OR) for being diagnosed with GDM was 1.78 in summer relative to autumn, after controlling for age. A higher mean temperature the day of the OGTT and the preceding 14 and 28 days increased the risk of being diagnosed with GDM the months in which temperature was rising (March-August) but not the months in which temperature was decreasing (September-February). We observed a negative correlation between temperature and fasting glucose and a positive correlation with post-load glucose. Neither the season nor the environmental temperature affected the risk of requiring insulin therapy. CONCLUSIONS There is a higher prevalence of GDM diagnosis at warmer seasons and at rising temperatures the 2-4 weeks prior to the OGTT. The impact of temperature is different between fasting and post-load glucose.
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Affiliation(s)
- Maria Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga, Spain; Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain
| | - Carolina Gutiérrez-Repiso
- Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Araceli Muñoz-Garach
- Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain
| | - Fuensanta Lima-Rubio
- Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain
| | - Sonsoles Morcillo
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga, Spain; Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
| | - Francisco J Tinahones
- Research Laboratory, IBIMA, Virgen de la Victoria Universitary Hospital, Malaga, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
| | - Mª Jose Picón-César
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga, Spain
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20
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Gutiérrez-Repiso C, Moreno-Indias I, Martín-Núñez GM, Ho-Plágaro A, Rodríguez-Cañete A, Gonzalo M, García-Fuentes E, Tinahones FJ. Mucosa-associated microbiota in the jejunum of patients with morbid obesity: alterations in states of insulin resistance and metformin treatment. Surg Obes Relat Dis 2020; 16:1575-1585. [PMID: 32475753 DOI: 10.1016/j.soard.2020.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Stool samples have been widely used to evaluate gut microbiota; however, little is known about the composition of human small intestinal microbiota and the alterations provoked by insulin resistance. OBJECTIVE To describe the composition of jejunal microbiota in morbidly obese patients, as well as its link with insulin resistance and metformin treatment. SETTING Virgen de la Victoria University Hospital and Regional University Hospital, Málaga, Spain. METHODS Jejunal biopsies from 46 morbidly obese patients were analyzed by next-generation sequencing method. Patients were classified in the following 3 groups: low homeostasis model assessment of insulin resistance index (HOMA-IR) value, high HOMA-IR value, and metformin-treated type 2 diabetes patients (T2D-metf). RESULTS Richness (q = .011) together with Proteobacteria (W = 2), Fusobacteria (W = 2), and Bacteroidetes (W = 1) phyla were significantly higher in high HOMA-IR compared with low HOMA-IR group. At family level, several differences were found between low HOMA-IR and T2D-metf group, being the most important the higher abundance of Halomonadacea in T2D-metf group (W = 22). PICRUSt analysis showed that predicted genes involved in trimethylamine-N-oxide biosynthesis pathway could be increased in jejunal microbiota of T2D-metf group compared with the low HOMA-IR group, while indole biosynthesis pathway could be increased in the low HOMA-IR group compared with the high HOMA-IR group. CONCLUSION An increase in richness and an enrichment in Proteobacteria, Fusobacteria, and Bacteroidetes was observed in jejunal from morbidly obese patients with high insulin resistance. Halomonadaceae family was significantly increased in metformin-treated patients. Functional analysis of predicted metagenome suggests that trimethylamine-N-oxide biosynthesis pathway could be increased in the jejunal microbiota of T2D-meft group, while indole biosynthesis pathway could be increased in low HOMA-IR group. These results contribute to the increase in the scarce knowledge about the mucosal microbiota of the hardly accessible small intestine.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Madrid, Spain
| | - Isabel Moreno-Indias
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Madrid, Spain
| | - Gracia M Martín-Núñez
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Madrid, Spain
| | - Ailec Ho-Plágaro
- Unidad de Gestión Clínica de Aparato Digestivo del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain
| | - Alberto Rodríguez-Cañete
- Unidad de Gestión Clínica de Cirugía General, Digestiva y Trasplantes, Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología, Universidad de Málaga, Málaga, Spain
| | - Monserrat Gonzalo
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - Eduardo García-Fuentes
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Madrid, Spain; Unidad de Gestión Clínica de Aparato Digestivo del Hospital Virgen de la Victoria. Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
| | - Francisco J Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Madrid, Spain.
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21
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Sánchez-Alcoholado L, Fernández-García JC, Gutiérrez-Repiso C, Bernal-López MR, Ocaña-Wilhelmi L, García-Fuentes E, Moreno-Indias I, Tinahones FJ. Incidental Prophylactic Appendectomy Is Associated with a Profound Microbial Dysbiosis in the Long-Term. Microorganisms 2020; 8:microorganisms8040609. [PMID: 32340272 PMCID: PMC7232405 DOI: 10.3390/microorganisms8040609] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022] Open
Abstract
Incidental prophylactic surgeries are performed in certain situations. Incidental prophylactic appendectomies were common practice within opened bariatric surgeries. The gut microbiota has emerged as an important actor within the homeostasis of the host. A new hypothesis has been formulated about the appendix function in relation to gut microbiota. Our objective was to study the gut microbiota profiles of patients that had suffered from an incidental prophylactic appendectomy during their bariatric surgeries, while comparing them to patients whose appendixes had remained intact. A case-control observational prospective study of 40 patients who underwent bariatric surgery, with or without an incidental prophylactic appendectomy, during 2004–2008 with an evaluation of their gut microbiota populations at the end of 2016 was conducted by sequencing the 16 S rRNA gene by Next Generation Sequencing of patients’ stools and appendix tissues. Patients with their appendix removed showed lower levels of richness and diversity of their gut microbiota populations. Odoribacter, Bilophila, Butyricimonas, and Faecalibacterium levels were increased in the Intact group, while Lachnobacterium suffered an expansion in the group without the appendix. Moreover, a linear regression model introduced the concept that Butyricimonas and Odoribacter may be implicated in insulin regulation. Thus, gut microbiota should be considered in the decisions of practical surgery, regarding the appendix as a mediator of homeostasis in the host. Butyricimonas and Odoribacter require further investigation as key bacteria implicated in insulin regulation.
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Affiliation(s)
- Lidia Sánchez-Alcoholado
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (L.S.-A.); (J.C.F.-G.); (C.G.-R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
| | - José Carlos Fernández-García
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (L.S.-A.); (J.C.F.-G.); (C.G.-R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
| | - Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (L.S.-A.); (J.C.F.-G.); (C.G.-R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
| | - M Rosa Bernal-López
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain
| | - Luis Ocaña-Wilhelmi
- Department of Surgery, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, 29010 Malaga, Spain;
| | - Eduardo García-Fuentes
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
- Unidad de Gestión Clínica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Isabel Moreno-Indias
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (L.S.-A.); (J.C.F.-G.); (C.G.-R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
- Correspondence: (I.M.-I.); (F.J.T.); Tel.: +34-951-032-647 (I.M.-I.); +34-951-932-734 (F.J.T.)
| | - Francisco J. Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (L.S.-A.); (J.C.F.-G.); (C.G.-R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobn, 28029 Madrid, Spain; (M.R.B.-L.); (E.G.-F.)
- Correspondence: (I.M.-I.); (F.J.T.); Tel.: +34-951-032-647 (I.M.-I.); +34-951-932-734 (F.J.T.)
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22
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Sánchez-Alcoholado L, Gutiérrez-Repiso C, Gómez-Pérez AM, García-Fuentes E, Tinahones FJ, Moreno-Indias I. Gut microbiota adaptation after weight loss by Roux-en-Y gastric bypass or sleeve gastrectomy bariatric surgeries. Surg Obes Relat Dis 2019; 15:1888-1895. [PMID: 31648978 DOI: 10.1016/j.soard.2019.08.551] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/19/2019] [Accepted: 08/31/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Gut microbiota could be involved in the metabolic improvement after surgery. OBJECTIVE The aim of the present study was to evaluate the short-term evolution of the gut microbiome after different bariatric surgery procedures and their functionality and relate it with obesity resolution. SETTING University hospital, Spain. METHODS We studied 28 patients with severe obesity; 14 underwent a Roux-en-Y gastric bypass (RYGB) and 14 underwent laparoscopic sleeve gastrectomy (SG). All patients were examined before and 3 months after the correspondent bariatric surgery. Gut microbiome profile was assessed by the sequencing of amplicons from the 16S rDNA gene by next-generation sequencing. RESULTS Gut microbiota profiles significantly differed between surgical procedures. RYGB suffered the largest changes in the microbiota population. SG and RYGB differed in their profiles with higher levels of Akkermansia, Eubacterium, Haemophilus, and Blautia for SG, while Veillonella, Slackia, Granucatiella, and Acidaminococcus occurred with greater levels in RYGB. RYGB microbiota changes were reflected also at the level of functionality, especially in pathways related to environmental adaptation. A biomarker discovery analysis revealed the genus Blautia as characteristic in SG, while Veillonella was of RYGB. CONCLUSION Our study shows a shift of the gut microbiome after a bariatric surgery in a procedure-related manner. Gut microbiome changes are related to the adaptation to the changing gut environment and could be related to the pH fluctuations.
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Affiliation(s)
- Lidia Sánchez-Alcoholado
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana María Gómez-Pérez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain
| | - Eduardo García-Fuentes
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, Madrid, Spain; Department of Gastroenterology, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, Madrid, Spain.
| | - Isabel Moreno-Indias
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA) and University of Malaga, Malaga, Spain; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, Madrid, Spain.
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23
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Cornejo-Pareja I, Martín-Núñez GM, Roca-Rodríguez MM, Cardona F, Coin-Aragüez L, Sánchez-Alcoholado L, Gutiérrez-Repiso C, Muñoz-Garach A, Fernández-García JC, Moreno-Indias I, Tinahones FJ. H. pylori Eradication Treatment Alters Gut Microbiota and GLP-1 Secretion in Humans. J Clin Med 2019; 8:jcm8040451. [PMID: 30987326 PMCID: PMC6517938 DOI: 10.3390/jcm8040451] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 02/07/2023] Open
Abstract
Changes in the intestinal microbial community and some metabolic disturbances, including obesity and type2 diabetes, are related. Glucagon-like peptide-1 (GLP-1) regulates glucose homeostasis. Microbiota have been linked to incretin secretion. Antibiotic use causes changes in microbial diversity and composition. Our aim was to evaluate the relationship between microbiota changes and GLP-1 secretion. A prospective case-control study with a Helicobacter pylori-positive patient model involving subjects under eradication therapy (omeprazole, clarithromycin, and amoxicillin). Forty patients with H. pylori infection and 20 matched participants, but negative for H. pylori antigen. Patients were evaluated before and two months after treatment. We analyzed anthropometric measurements, carbohydrate metabolism, lipid profile, and C-reactive protein. Gut microbiota composition was analyzed through 16S rRNA amplicon sequencing (IlluminaMiSeq). Eradication treatment for H. pylori decreased bacterial richness (Chao1, p = 0.041). Changes in gut microbiota profiles were observed at phylum, family, genus and species levels. GLP-1 secretion and variables of carbohydrate metabolism were improved. Correlations were seen between GLP-1 changes and variations within microbial community abundances, specifically Bifidobacterium adolescentis, the Lachnobacterium genus, and Coriobacteriaceae family. A conventional treatment to eradicate H. pylori could improve carbohydrate metabolism possibly in relation with an increase in GLP-1 secretion. GLP-1 secretion may be related to alterations in intestinal microbiota, specifically Lachnobacterium, B. adolescentis and Coriobacteriaceae.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Gracia M Martín-Núñez
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
| | - M Mar Roca-Rodríguez
- Department of Endocrinology and Nutrition, Puerta del Mar University Hospital, 11009 Cadiz, Spain.
| | - Fernando Cardona
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Leticia Coin-Aragüez
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Lidia Sánchez-Alcoholado
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
| | - Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - José C Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Isabel Moreno-Indias
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain.
- Centro de Investigacion Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN CB06/003), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Gutiérrez-Repiso C, Moreno-Indias I, de Hollanda A, Martín-Núñez GM, Vidal J, Tinahones FJ. Gut microbiota specific signatures are related to the successful rate of bariatric surgery. Am J Transl Res 2019; 11:942-952. [PMID: 30899393 PMCID: PMC6413284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
Bariatric surgery (BS) success rates vary in the long-time. A better understanding of weight-loss response may help improve the outcomes of BS. Gut microbiome could be implicated in the successful rate of BS. The aim of the study is to analyze the role of gut microbiome in the successful rate of BS. This is a cross-sectional study of a prospective cohort of 24 patients who underwent gastric bypass. Patients were classified based on excess weight loss (EWL) as: Success (EWL50% at nadir weight and throughout follow-up), Primary Failure (EWL<50% at nadir weight and thereafter), and Weight Regain (EWL>50% at nadir weight, but <50% at last follow-up visit). Gut microbiome analysis was assessed by High Throughput Sequencing. Cholesterol metabolism was shown as the most affected parameter among groups. Studied groups registered minor changes between their gut microbiome abundances, with Butyrivibrio, Lachnospira and Sarcina among them. However, Success group shared a more diverse core microbiome than the other groups. We showed evidence of a possible role of gut microbiome in the cholesterol metabolism, possibly through bile acids, relative to the success or failure of BS outcomes. Acinetobacter and Serratia, from Primary Failure core microbiome, could have implications in its successful rate. Sarcina abundance was presented as the best genera related to the body mass index (BMI) post-surgery. Gut microbiota could mediate, at least partially, the success rate of BS through their interaction with the bile acids milieu. Further studies are necessary to validate this probe of concept.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de MálagaMálaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobnMadrid, Spain
| | - Isabel Moreno-Indias
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de MálagaMálaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobnMadrid, Spain
| | - Ana de Hollanda
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clinic UniversitariVillarroel 170, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)Barcelona, Spain
| | - Gracia María Martín-Núñez
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de MálagaMálaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobnMadrid, Spain
| | - Josep Vidal
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clinic UniversitariVillarroel 170, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)Barcelona, Spain
| | - Francisco J Tinahones
- Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de MálagaMálaga, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición, CIBERobnMadrid, Spain
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25
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Valdés S, Maldonado-Araque C, Lago-Sampedro A, Lillo-Muñoz JA, Garcia-Fuentes E, Perez-Valero V, Gutiérrez-Repiso C, Garcia-Escobar E, Goday A, Urrutia I, Peláez L, Calle-Pascual A, Bordiú E, Castaño L, Castell C, Delgado E, Menéndez E, Franch-Nadal J, Gaztambide S, Girbés J, Ortega E, Vendrell J, Chacón MR, Javier Chaves F, Soriguer F, Rojo-Martínez G. Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study. Obesity (Silver Spring) 2017; 25:788-793. [PMID: 28276648 DOI: 10.1002/oby.21796] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/22/2016] [Accepted: 01/12/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. METHODS The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [TPO Abs] <50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). RESULTS The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 µUI/mL in the underweight category (BMI<20 kg/m2 ), 0.6 to 5.5 µUI/mL in the normal-weight category (BMI 20-24.9 kg/m2 ), 0.6 to 5.5 µUI/mL in the overweight category (BMI 25-29.9 kg/m2 ), 0.5 to 5.9 µUI/mL in the obesity category (BMI 30-39.9 kg/m2 ), and 0.7 to 7.5 µUI/mL in the morbid obesity category (BMI ≥40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). CONCLUSIONS Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them.
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Affiliation(s)
- Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Cristina Maldonado-Araque
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Ana Lago-Sampedro
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | | | - Eduardo Garcia-Fuentes
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Vidal Perez-Valero
- UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Eva Garcia-Escobar
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Laura Peláez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Spain
| | - Elena Bordiú
- Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Conxa Castell
- Public Health Agency, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - Elias Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces - UPV-EHU, Baracaldo, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Emilio Ortega
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Matilde R Chacón
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - F Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
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26
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García-García E, Vázquez-López MA, García-Fuentes E, Galera-Martínez R, Gutiérrez-Repiso C, García-Escobar I, Bonillo-Perales A. Thyroid Function and Thyroid Autoimmunity in Relation to Weight Status and Cardiovascular Risk Factors in Children and Adolescents: A Population-Based Study. J Clin Res Pediatr Endocrinol 2016; 8:157-62. [PMID: 26761948 PMCID: PMC5096470 DOI: 10.4274/jcrpe.2687] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE In obese subjects, slight increases have been observed in thyrotropin [thyroid-stimulating hormone (TSH)] levels, but data in children are scarce. The aim of this study was to evaluate whether thyroid function and autoimmunity vary with weight status in a healthy population of children and adolescents and to determine whether hyperthyrotropinemia is associated with any cardiovascular risk factor. METHODS This cross-sectional epidemiological study was conducted in Almería (Spain) on a representative sample of 1317 healthy subjects aged 2-16 years. Thyroid function, thyroid autoimmunity and cardiovascular risk factors were measured. Chi-square test, analysis of variance and multiple linear regression were used in the statistical analyses. RESULTS The obese children and adolescents had thyrotropin levels (mean ± standard deviation) of 3.12±2.44 mU/L. These levels were higher than those of overweight subjects (2.79±1.51 mU/L) and of normal weight subjects (2.73±1.30 mU/L) (p=0.02). Levels of free thyroxine and urinary iodine did not differ significantly between the groups. The prevalence (95% confidence interval) of thyroid autoimmunity was lower in the individuals with normal weight (2.9%; 2.0-4.2) than in the overweight (6.3%; 3.9-9.9) and obese subjects (5.6%, 2.5-11.3) (p=0.02). TSH levels were associated with obesity (β=0.36; p<0.001) and thyroid autoimmunity (β=1.10; p<0.001). They were not associated with any cardiovascular risk factor. CONCLUSION Obese children and adolescents had higher levels of thyrotropin than those who were overweight and of normal weight. The differences among the groups were of very little clinical significance and could possibly be linked to the higher prevalence of thyroid autoimmunity in obese subjects. The hyperthyrotropinemia in these subjects was not associated with any cardiovascular risk factor.
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Affiliation(s)
- Emilio García-García
- Hospital Torrecárdenas, Clinic of Pediatrics, Almeria, Spain Phone: +34 605076059 E-mail:
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27
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García-Fuentes E, Santiago-Fernández C, Gutiérrez-Repiso C, Mayas MD, Oliva-Olivera W, Coín-Aragüez L, Alcaide J, Ocaña-Wilhelmi L, Vendrell J, Tinahones FJ, Garrido-Sánchez L. Hypoxia is associated with a lower expression of genes involved in lipogenesis in visceral adipose tissue. J Transl Med 2015; 13:373. [PMID: 26619907 PMCID: PMC4663723 DOI: 10.1186/s12967-015-0732-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 11/18/2015] [Indexed: 01/17/2023] Open
Abstract
Background A key role for HIF-1α in the promotion and maintenance of dietary obesity has been proposed. We analyzed the association between hypoxia and de novo lipogenesis in human adipose tissue. Methods We studied HIF-1α mRNA and protein expression in fasting status in visceral adipose tissue (VAT) from non-obese and morbidly obese subjects, and in VAT from wild-type and ob/ob C57BL6J mice in both fasting and feeding status. We also analyzed the effect of hypoxia on the VAT mRNA expression of genes involved in lipogenesis. Results HIF-1α was increased in VAT from morbidly obese subjects. In fasting status, C57BL6J ob/ob mice had a higher VAT HIF-1α mRNA expression than C57BL6J wild-type mice. In feeding status, VAT HIF-1α mRNA expression significantly increased in C57BL6J wild-type, but not in C57BL6J ob/ob mice. In humans, HIF-1α mRNA expression correlated positively with body mass index and insulin resistance. VAT HIF-1α mRNA expression correlated negatively with ACC1, PDHB and SIRT3 mRNA expression, and positively with PPAR-γ. VAT explants incubated in hypoxia showed reduced SIRT3 and increased PPAR-γ, SREBP-1c, ACLY, ACC1 and FASN mRNA expression. Conclusions Morbidly obese subjects have a higher level of VAT HIF-1α. Postprandial status is associated with an increase in HIF-1α mRNA expression in C57BL6J wild-type mice. Hypoxia alters the mRNA expression of genes involved in de novo lipogenesis in human VAT.
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Affiliation(s)
- Eduardo García-Fuentes
- Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital, Malaga, Spain. .,CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Laboratorio de Investigación, Hospital Civil, Plaza del Hospital Civil s/n, 29009, Málaga, Spain.
| | - Concepción Santiago-Fernández
- Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Carolina Gutiérrez-Repiso
- Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital, Malaga, Spain.
| | - María D Mayas
- Department of Physiology, University of Jaen, Jaén, Spain.
| | - Wilfredo Oliva-Olivera
- CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Leticia Coín-Aragüez
- CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Juan Alcaide
- CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Luis Ocaña-Wilhelmi
- Department of Surgery, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Joan Vendrell
- CIBERDEM, Institute of Health Carlos III, Tarragona, Spain. .,Department of Endocrinology and Nutrition, Joan XXIII University Hospital, Pere Virgili Institute, Rovira i Virgili University, Tarragona, Spain.
| | - Francisco J Tinahones
- CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
| | - Lourdes Garrido-Sánchez
- CIBEROBN, Institute of Health Carlos III, Malaga, Spain. .,Department of Endocrinology and Nutrition, Institute of Biomedical Research of Malaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Malaga, Spain.
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28
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Garcia-Serrano S, Gutiérrez-Repiso C, Gonzalo M, Garcia-Arnes J, Valdes S, Soriguer F, Perez-Valero V, Alaminos-Castillo MA, Francisco Cobos-Bravo J, Moreno-Ruiz FJ, Rodriguez-Cañete A, Rodríguez-Pacheco F, Garcia-Escobar E, García-Fuentes E. C-peptide modifies leptin and visfatin secretion in human adipose tissue. Obesity (Silver Spring) 2015; 23:1607-15. [PMID: 26146822 DOI: 10.1002/oby.21137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/24/2015] [Accepted: 03/29/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The effects of C-peptide on adipose tissue, an organ involved in the development of obesity and insulin resistance, are not yet well known. The aim of this study was to determine whether C-peptide could be involved in the regulation of the adipocytokine synthesis in human visceral adipose tissue. METHODS The association between C-peptide and different serum adipocytokines, with an intravenous glucose tolerance test (IVGTT), and in an in vitro study in subjects without obesity and in subjects with morbid obesity were analyzed. RESULTS In different multiple regression analysis models, C-peptide and C-peptide increase above basal levels during total IVGTT and between 0 and 10 min were associated positively with leptin and negatively with visfatin. Rhodamine-labeled C-peptide binds to human adipocytes, and this binding was blocked with excess of unlabeled C-peptide. Exposure of human visceral explants and adipocytes from subjects with morbid obesity to C-peptide at 1 and 10 nM induced a significant increase in leptin and a decrease in visfatin secretion. In subjects without obesity, these C-peptide effects were found mainly at 10 nM. These effects can be inhibited by phosphatidylinositol 3-kinase (PI3K) or protein kinase B (PKB) inhibitors. CONCLUSIONS C-peptide may be involved in the regulation of leptin and visfatin secretion, molecules intimately involved in energy homeostasis processes, through PI3K or PKB pathways.
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Affiliation(s)
- Sara Garcia-Serrano
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER De Diabetes Y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Montserrat Gonzalo
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Juan Garcia-Arnes
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Sergio Valdes
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER De Diabetes Y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Federico Soriguer
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER De Diabetes Y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
- CIBER Fisiopatología De La Obesidad Y Nutrición (CIBEROBN), Málaga, Spain
| | - Vidal Perez-Valero
- Unidad De Gestión Clínica De Laboratorio, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Miguel A Alaminos-Castillo
- Unidad De Gestión Clínica De Laboratorio, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Juan Francisco Cobos-Bravo
- Unidad De Gestión Clínica De Cirugía General, Digestiva Y Trasplantes, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Francisco J Moreno-Ruiz
- Unidad De Gestión Clínica De Cirugía General, Digestiva Y Trasplantes, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Alberto Rodriguez-Cañete
- Unidad De Gestión Clínica De Cirugía General, Digestiva Y Trasplantes, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Francisca Rodríguez-Pacheco
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER De Diabetes Y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Eva Garcia-Escobar
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER De Diabetes Y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Eduardo García-Fuentes
- Unidad De Gestión Clínica De Endocrinología Y Nutrición, Instituto De Investigacion Biomédica De Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- CIBER Fisiopatología De La Obesidad Y Nutrición (CIBEROBN), Málaga, Spain
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Lago-Sampedro AM, Gutiérrez-Repiso C, Valdés S, Maldonado C, Colomo N, Almaraz MC, Rubio-Martín E, Morcillo S, Esteva I, Ruiz de Adana MS, Perez-Valero V, Soriguer F, Rojo-Martínez G, García-Fuentes E. Changes in thyroid function with age: results from the Pizarra population-based longitudinal study. Int J Clin Pract 2015; 69:577-87. [PMID: 25604441 DOI: 10.1111/ijcp.12545] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/19/2014] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Results of studies examining the influence of age on thyroid function and TSH levels, in the absence of thyroid disease, remain controversial. The aim of this study was to determine the course of thyroid function over 11 years in a population with normal thyroid function. METHODS This is a population-based prospective study started in 1995-1997 (first phase), and reassessed 6 (second phase) and 11 years later (third phase). RESULTS The TSH and FT4 in the third phase were significantly increased (p=0.001 and p=0.001, respectively), with the values being higher particularly from the age of 50 years. In those persons with a baseline TSH≥1.2 and <3 μIU/mL, the OR of having a TSH of 3-5 μIU/mL in the third phase was 6.10 (p=0.004). In those with a baseline TSH≥3 and ≤5 μIU/mL, the OR of having a TSH of 3-5 μIU/mL in the third phase was 20.8 (p<0.0001). Similar results were found for FT4. CONCLUSION In a population free of clinical thyroid disease, TSH and FT4 values rise over the years. This increase occurs in all age groups, but depends mainly on the basal concentrations of TSH and FT4.
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Affiliation(s)
- A Ma Lago-Sampedro
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain
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30
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Soriguer F, Colomo N, Valdés S, Goday A, Rubio-Martín E, Esteva I, Castaño L, Ruiz de Adana MS, Morcillo S, Calle A, García-Fuentes E, Catalá M, Gutiérrez-Repiso C, Delgado E, Gomis R, Ortega E, Rojo-Martínez G. Modifications of the homeostasis model assessment of insulin resistance index with age. Acta Diabetol 2014; 51:917-25. [PMID: 24687694 DOI: 10.1007/s00592-013-0523-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/03/2013] [Indexed: 12/20/2022]
Abstract
The aim of the study was to analyze the association between aging and insulin resistance estimated by the homeostasis model assessment of insulin resistance (HOMA-IR). This work involved two studies: (1) the Di@bet.es study is a cross-sectional study including 4,948 subjects, comprising a representative sample of the adult Spanish population; (2) the Pizarra study is a population-based cohort study undertaken in Pizarra (Spain), in which 1,051 subjects were evaluated at baseline and 714 completed the 6-year follow-up study. Study variables included a clinical and demographic structured survey, a lifestyle survey, a physical examination, and an oral glucose tolerance test in subjects without diabetes. In the Di@bet.es study overall, an increase occurred in blood glucose until the age of 50, after which it remained stable (data adjusted for gender, body mass index, abnormal glucose regulation [AGR]). The HOMA-IR increased significantly with age (p = 0.01), due to a higher prevalence of obesity (p < 0.0001) and AGR (p < 0.001). In non-obese subjects without AGR, HOMA-IR values were not modified with age (p = 0.30), but they were with body mass index (p < 0.001). In the Pizarra study, the HOMA-IR was significantly lower after 6-year follow-up in the whole study population. Subjects with a HOMA-IR level higher than the 75th percentile at baseline were more likely to develop diabetes (OR 2.2, 95 % CI 1.2-3.9; p = 0.007) than subjects with a lower HOMA-IR. We concluded that age per se did not increase HOMA-IR levels, changes that might be related to higher rates of obesity and AGR in older subjects. The HOMA-IR was associated with an increased risk of developing type 2 diabetes 6 years later.
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Affiliation(s)
- Federico Soriguer
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona, Spain
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31
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Gutiérrez-Repiso C, Soriguer F, Rojo-Martínez G, García-Fuentes E, Valdés S, Goday A, Calle-Pascual A, López-Alba A, Castell C, Menéndez E, Bordiú E, Delgado E, Ortega E, Pascual-Manich G, Urrutia I, Mora-Peces I, Vendrell J, Vázquez JA, Franch J, Girbés J, Castaño L, Serrano-Ríos M, Martínez-Larrad MT, Catalá M, Carmena R, Gomis R, Casamitjana R, Gaztambide S. Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study. Nutr Metab Cardiovasc Dis 2014; 24:947-955. [PMID: 24984822 DOI: 10.1016/j.numecd.2014.04.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations. METHODS AND RESULTS Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA. CONCLUSIONS Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Federico Soriguer
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Eduardo García-Fuentes
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Sergio Valdés
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | | | - Conxa Castell
- Public Health Division, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos de Madrid, Madrid, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Emilio Ortega
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain
| | - Gemma Pascual-Manich
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain
| | - Inés Urrutia
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
| | | | - Joan Vendrell
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | | | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Juan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Luis Castaño
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
| | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain
| | - María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain
| | - Miguel Catalá
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Rafael Carmena
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Ramón Gomis
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain
| | - Roser Casamitjana
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Biomedic Diagnostic Centre University Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sonia Gaztambide
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
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Gutiérrez-Repiso C, Soriguer F, Rubio-Martín E, Esteva de Antonio I, Ruiz de Adana MS, Almaraz MC, Olveira-Fuster G, Morcillo S, Valdés S, Lago-Sampedro AM, García-Fuentes E, Rojo-Martínez G. Night-time sleep duration and the incidence of obesity and type 2 diabetes. Findings from the prospective Pizarra study. Sleep Med 2014; 15:1398-404. [PMID: 25262361 DOI: 10.1016/j.sleep.2014.06.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 06/09/2014] [Accepted: 06/12/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several recent studies have related short sleep duration with different health problems, though the results related with the risk of obesity and type 2 diabetes (T2D) are far from conclusive. The aim of this study was to investigate the association between night-time sleep duration and the incidence of obesity and T2D in a prospective study with a follow-up of 11 years. MATERIAL AND METHODS The study comprised 1145 people evaluated in 1997-1998 and re-evaluated after 6 years and 11 years. At the three study points, subjects without known diabetes mellitus (KDM) were given an oral glucose tolerance test (OGTT). Anthropometric and biochemical variables were measured. The subjects were asked about their number of hours of night-time sleep. RESULTS After adjustment, the OR of becoming obese was significantly higher in subjects who slept ≤ 7 hours per night, at both the 6-year follow-up (OR = 1.99; 95% CI = 1.12-3.55) and the 11-year follow-up (OR = 2.73; 95% CI = 1.47-5.04). The incidence of T2D at the 6-year follow-up in subjects without T2D at baseline was higher in those who slept ≤ 7 hours per night (OR = 1.96; 95% CI = 1.10-3.50). However, this association was not independent of obesity, weight gain or abnormal glucose regulation at baseline. At the 11-year follow-up however there was no association between night-time sleep duration and the incidence of T2D. CONCLUSIONS The incidence of obesity over the 11-year follow-up increased in subjects with fewer hours of night-time sleep. The incidence of T2D according to the hours of night-time sleep depended on obesity and the carbohydrate metabolism phenotype.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Federico Soriguer
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Elehazara Rubio-Martín
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Isabel Esteva de Antonio
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María Soledad Ruiz de Adana
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María Cruz Almaraz
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gabriel Olveira-Fuster
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Sonsoles Morcillo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
| | - Sergio Valdés
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana María Lago-Sampedro
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Eduardo García-Fuentes
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Gutiérrez-Repiso C, Colomo N, Rojo-Martinez G, Valdés S, Tapia MJ, Esteva I, Ruiz de Adana MS, Rubio-Martin E, Lago-Sampedro A, Santiago P, Velasco I, Garcia-Fuentes E, Moreno JC, Soriguer F. Evolution of urinary iodine excretion over eleven years in an adult population. Clin Nutr 2014; 34:712-8. [PMID: 25155806 DOI: 10.1016/j.clnu.2014.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 08/04/2014] [Accepted: 08/04/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Few prospective cohort studies have evaluated dietary iodine intake and urinary iodine concentrations in the general adult population. We assess the evolution of urinary iodine excretion and factors that may influence it in an adult population followed for 11 years. METHODS A population-based cohort study was undertaken in Pizarra (Spain). In the three study phases (baseline (n = 886), and 6 (n = 788) and 11 years later (n = 501)), participants underwent an interview and a standardized clinical examination that included a food questionnaire, and thyroid hormone and urinary iodine determinations. Subjects with thyroid dysfunction, palpable goiter or urinary iodine excretion >400 μg/L were excluded. RESULTS Urinary iodine increased over the years (100.6 ± 70.0 μg/L at baseline vs. 125.4 ± 95.2 μg/L at 6 years and 141.6 ± 81.4 μg/L at 11 years; p < 0.0001). Urinary iodine was significantly higher in subjects who reported iodized salt consumption and in subjects with a higher intake of dairy products (p < 0.05). Consumption of iodized salt (Risk ratio (RR) = 1.23, 95% CI [1.01-2.05]) and dairy products (RR = 2.07, 95% CI [1.01-4.23]), and a baseline urinary iodine concentration ≥100 μg/L (RR = 1.26, 95% CI [1.04-1.53]) were significantly associated with urinary iodine concentrations ≥100 μg/L at 11 years. There is no correlation between thyroid function (TSH, free triiodothyronine or free thyroxine levels) and urinary iodine concentrations in conditions of iodine sufficiency. CONCLUSIONS The increase in urinary iodine concentrations over eleven years is associated with an increase in iodized salt intake and with the dairy products intake, and possibly with a higher iodine content of dairy products. However, individual variability in urinary iodine excretion was not fully explained by dietary iodine intake alone; previous urinary iodine concentrations were also important.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain
| | - Natalia Colomo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain
| | - Gemma Rojo-Martinez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
| | - Sergio Valdés
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
| | - Maria J Tapia
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
| | - Isabel Esteva
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
| | - Maria S Ruiz de Adana
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
| | - Elehazara Rubio-Martin
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain
| | - Ana Lago-Sampedro
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain
| | - Piedad Santiago
- Endocrinology and Nutrition Department, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Ines Velasco
- Unidad de Gestión Clínica Materno-Infantil, Hospital de Riotinto, Huelva, Spain
| | - Eduardo Garcia-Fuentes
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain.
| | - Jose C Moreno
- Molecular Thyroid Laboratory, INGEMM-Institute for Medical and Molecular Genetics, La Paz University Hospital, Madrid, Spain
| | - Federico Soriguer
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos IIII, Málaga, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
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Gutiérrez-Repiso C, Velasco I, Garcia-Escobar E, Garcia-Serrano S, Rodríguez-Pacheco F, Linares F, Ruiz de Adana MS, Rubio-Martin E, Garrido-Sanchez L, Cobos-Bravo JF, Priego-Puga T, Rojo-Martinez G, Soriguer F, García-Fuentes E. Does dietary iodine regulate oxidative stress and adiponectin levels in human breast milk? Antioxid Redox Signal 2014; 20:847-53. [PMID: 24001137 PMCID: PMC3910559 DOI: 10.1089/ars.2013.5554] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Little is known about the association between iodine and human milk composition. In this study, we investigated the association between iodine and different markers of oxidative stress and obesity-related hormones in human breast milk. This work is composed of two cross-sectional studies (in lactating women and in the general population), one prospective and one in vitro. In the cross-sectional study in lactating women, the breast milk iodine correlated negatively with superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) activities, and with adiponectin levels. An in vitro culture of human adipocytes with 1 μM potassium iodide (KI, dose similar to the human breast milk iodine concentration) produced a significant decrease in adiponectin, GSH-Px, SOD1, and SOD2 mRNA expression. However, after 2 months of treatment with KI in the prospective study, a positive correlation was found between 24-h urinary iodine and serum adiponectin. Our observations lead to the hypothesis that iodine may be a factor directly involved in the regulation of oxidative stress and adiponectin levels in human breast milk.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Inés Velasco
- Unidad de Gestión Clínica Materno-Infantil, Hospital de Riotinto, Huelva, Spain
| | - Eva Garcia-Escobar
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Sara Garcia-Serrano
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Francisca Rodríguez-Pacheco
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Francisca Linares
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Maria Soledad Ruiz de Adana
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Elehazara Rubio-Martin
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Lourdes Garrido-Sanchez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
- CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN), Málaga, Spain
| | - Juan Francisco Cobos-Bravo
- Unidad de Gestión Clínica de Cirugia General, Digestiva y Transplantes, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Tatiana Priego-Puga
- Unidad de Gestión Clínica de Cirugia General, Digestiva y Transplantes, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Gemma Rojo-Martinez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
| | - Federico Soriguer
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain
- CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN), Málaga, Spain
| | - Eduardo García-Fuentes
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
- CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN), Málaga, Spain
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Velasco I, Martín J, Gallego M, Gutiérrez-Repiso C, Santiago P, López-Siguero JP, Mesa EG, Peral JH, Pérez V, García-Fuentes E, Soriguer F. Maternal-fetal thyroid function at the time of birth and its relation with iodine intake. Thyroid 2013; 23:1619-26. [PMID: 23763592 DOI: 10.1089/thy.2013.0035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of moderate variations in dietary iodine intake on maternal and fetal thyroid function are poorly understood. Recent studies question the usefulness of neonatal screening of congenital hypothyroidism as a tool for monitoring iodine deficiency. We proposed to test the hypothesis of an association between iodine intake during the last trimester of pregnancy and fetal thyroid function at the time of birth. METHODS The study was undertaken at term in 233 healthy pregnant women (29.7±5.6 years) and in their newborn. Inclusion of women in the study was done within the 24 hours before delivery. RESULTS The median maternal urinary iodine concentration was 126.5 μg/L. The maternal free triiodothyronine (FT3), although not thyrotropin (TSH) and free thyroxine (FT4), correlated significantly with the urinary iodine concentration (r=0.17, p=0.013). The cord blood TSH, FT4, and FT3 correlated positively with the maternal urinary iodine concentration at the time of delivery (r=0.24, p=0.001; r=0.16, p=0.032; and r=0.24, p=0.003, respectively). The cord blood and heel blood TSH correlated positively with the amniotic fluid iodine concentration (r=0.21, p=0.015 and r=0.15, p=0.036). The cord blood TSH correlated positively with the cord blood FT4 (r=0.21, p=0.022) and FT3 (r=0.32, p=0.017). The maternal TSH correlated significantly with the cord blood TSH (r=0.22, p=0.014) and with the heel blood TSH (r=0.13, p=0.050). CONCLUSIONS The results of this study show the presence of a positive association of TSH-FT4 at the time of delivery, which may be modulated by the amount of iodine consumed by the mother during pregnancy.
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Affiliation(s)
- Inés Velasco
- 1 Gynecology & Obstetrics Service, Riotinto Hospital, Huelva, Spain
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Soriguer F, Gutiérrez-Repiso C, Rubio-Martín E, García-Fuentes E, Almaraz MC, Colomo N, Esteva de Antonio I, de Adana MSR, Chaves FJ, Morcillo S, Valdés S, Rojo-Martínez G. Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study. J Clin Endocrinol Metab 2013; 98:2318-25. [PMID: 23559087 DOI: 10.1210/jc.2012-4253] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prospective longitudinal studies evaluating the relevance of "Metabolically Healthy but Obese" (MHO) phenotype at risk for type 2 diabetes mellitus (T2D) and cardiovascular diseases are few and results are contradictory. METHODS As a representative of the general population, 1051 individuals were evaluated in 1997-1998 and re-evaluated after 6 years and 11 years. Subjects without known T2D were given an oral glucose tolerance test. Anthropometric and biochemical variables were measured. Four sets of criteria were considered to define MHO subjects besides body mass index ≥30 kg/m(2): A: Homeostatic Model of Assessment-Insulin Resistance Index (HOMA-IR) <90th percentile; B: HOMA-IR <90th percentile, high-density lipoprotein cholesterol >40 mg/dL in men and high-density lipoprotein cholesterol >50 mg/dL in women, triglycerides <150 mg/dL, fasting glucose <110 mg/dL, and blood pressure ≤140/90 mm Hg; C: HOMA-IR <90th percentile, triglycerides <150 mg/dL, fasting glucose <110 mg/dL, and blood pressure ≤140/90 mm Hg; D: HOMA-IR <90th percentile, triglycerides <150 mg/dL, and fasting glucose <110 mg/dL. Subjects with T2D at baseline were excluded from the calculations of incidence of T2D. RESULTS The baseline prevalence of MHO phenotype varied between 3.0% and 16.9%, depending on the set of criteria chosen. Metabolically nonhealthy obese subjects were at highest risk for becoming diabetic after 11 years of follow-up (odds ratio = 8.20; 95% confidence interval = 2.72-24.72; P < .0001). In MHO subjects the risk for becoming diabetic was lower than in metabolically nonhealthy obese subjects, but this risk remained significant (odds ratio = 3.13; 95% confidence interval = 1.07-9.17; P = .02). In subjects who lost weight during the study, the association between MHO phenotype and T2D incidence disappeared, even after adjusting for HOMA-IR. CONCLUSIONS The results suggest that MHO is a dynamic concept that should be taken into account over time. As a clinical entity, it may be questionable.
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Affiliation(s)
- Federico Soriguer
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, 29029 Madrid, Spain
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Rubio-Martín E, Soriguer F, Gutiérrez-Repiso C, Garrido-Sánchez L, de Adana MSR, García-Fuentes E, Morcillo S, Esteva I, Chaves FJ, Rojo-Martinez G. C-reactive protein and incidence of type 2 diabetes in the Pizarra study. Eur J Clin Invest 2013; 43:159-67. [PMID: 23278315 DOI: 10.1111/eci.12027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 11/13/2012] [Indexed: 12/11/2022]
Abstract
AIM To determine the association between serum levels of high-sensitivity C-reactive protein (hs-CRP) and the incidence of type 2 diabetes in a prospective cohort from southern Spain (Pizarra study). MATERIALS AND METHODS The study formed part of the Pizarra cohort study, a prospective study started in 1995 with a follow-up of 11 years. Anthropometric and metabolic variables were measured at baseline and at 6 years and 11 years of follow-up. All subjects underwent an oral glucose tolerance test. Serum levels of TNFα and its receptors, hs-CRP, IL-6, leptin, adiponectin and FABP4 were measured at 6 years of follow-up. RESULTS After adjusting for age, sex and obesity, subjects with levels of hs-CRP> 2.9 mg/L in the second study (2003-4) had a higher risk of developing type 2 diabetes by the third study (2008-9) (OR = 7.97; 95% CI = 1.72-36.89; P = 0.008), and subjects with adiponectin levels > 13.2 mg/L had a lower risk of developing type 2 diabetes (OR = 0.23, P = 0.02). High values of hs-CRP and high values of adiponectin were associated positively (OR = 8.26; 95% CI = 1.84-37.19; P = 0.006) and negatively (OR = 0.17; 95% CI = 0.04-0.69; P = 0.01), respectively, with the risk of having HbA1c ≥ 6.5% at 11 years of follow-up. CONCLUSIONS Subjects with high serum hs-CRP levels and low serum adiponectin levels have a higher risk of developing type 2 diabetes within five years.
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Affiliation(s)
- Elehazara Rubio-Martín
- Department of Endocrinology and Nutrition, Hospital Universitario Carlos Haya, Málaga, Spain.
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