ACC2 gene polymorphisms,metabolic syndrome,and gene-nutrient interactions with dietary fat

Acetyl-CoA carboxylase β (ACC2) plays a key role in fatty acid synthesis and oxidation pathways. Disturbance of these pathways is associated with impaired insulin responsiveness and metabolic syndrome (MetS). Gene-nutrient interactions may affect MetS risk. This study determined the relationship between ACC2 polymorphisms (rs2075263, rs2268387, rs2284685, rs2284689, rs2300453, rs3742023, rs3742026, rs4766587, and rs6606697) and MetS risk, and whether dietary fatty acids modulate this in the LIPGENE-SU.VI.MAX study of MetS cases and matched controls (n = 1754). Minor A allele carriers of rs4766587 had increased MetS risk (OR 1.29 [CI 1.08, 1.58], P = 0.0064) compared with the GG homozygotes, which may in part be explained by their increased body mass index (BMI), abdominal obesity, and impaired insulin sensitivity (P < 0.05). MetS risk was modulated by dietary fat intake (P = 0.04 for gene-nutrient interaction), where risk conferred by the A allele was exacerbated among individuals with a high-fat intake (>35% energy) (OR 1.62 [CI 1.05, 2.50], P = 0.027), particularly a high intake (>5.5% energy) of n-6 polyunsaturated fat (PUFA) (OR 1.82 [CI 1.14, 2.94], P = 0.01; P = 0.05 for gene-nutrient interaction). Saturated and monounsaturated fat intake did not modulate MetS risk. Importantly, we replicated some of these findings in an independent cohort. In conclusion, the ACC2 rs4766587 polymorphism influences MetS risk, which was modulated by dietary fat, suggesting novel gene-nutrient interactions.     

恩格列净对2型糖尿病合并非酒精性脂肪性肝病的影响

摘要 目的：探讨恩格列净单独及联合胰岛素治疗对2型糖尿病合并非酒精性脂肪性肝病（NAFLD）患者的影响。方法：本研究选择2021.3-2022.8于石家庄市第二医院门诊就诊的2型糖尿病合并NAFLD的300例患者作为研究对象,分为胰岛素治疗组（100例）、恩格列净单药治疗组（100例）及恩格列净联合胰岛素治疗组（100例）,治疗48周,采集患者治疗前后体重、体质指数（BMI）、谷草转氨酶（AST）、谷丙转氨酶（ALT）、谷酰转肽酶（GGT）、血常规、HbA1c、肝脏脂肪含量等指标,计算患者NFS、FIB-4指标,比较不同治疗方案治疗前后患者临床特征的变化。观察三组临床治疗期间不良反应的发生情况。结果：应用胰岛素治疗的患者HbA1c及空腹血糖显著下降;BMI、ALT、AST、GGT、肝脏脂肪含量、NFS、FIB-4无变化。恩格列净单药治疗的患者,ALT、AST、GGT、NFS、FIB-4、肝脏脂肪含量均显著下降（P<0.05）;恩格列净联合胰岛素治疗的患者ALT、AST、GGT、NFS、FIB-4、肝脏脂肪含量显著下降（P<0.05）。多元线性回归提示应用恩格列净和肝脏脂肪含量的变化相关（P<0.05）,BMI、HbA1c的变化和肝脏脂肪含量的变化无关（P<0.05）。三组患者治疗期间总不良反应发生率差异无统计学意义（P＞0.05）。结论：恩格列净单药治疗或联合胰岛素治疗均可降低2型糖尿病合并NAFLD患者肝脏脂肪含量均、转氨酶水平,改善肝纤维化。     

大鼠肝线粒体中的脂肪酸分析

用双 2 乙基己基酚酞酸酯 (DEHP)诱导大鼠肝过氧化物酶体增殖 ,然后用蔗糖密度梯度离心法分离大鼠肝线粒体 ,用毛细管气相色谱法测定肝线粒体中的脂肪酸含量。测定结果 :所测 1 4种脂肪酸的总量 ,青年正常组大于青年诱导组 (P <0 .0 1 ) ,青年正常组大于老年正常组 (P <0 .0 5 )。不饱和脂肪酸与脂肪酸总量的比例 ,老年诱导组大于老年正常组 (P <0 .0 5 ) ,青年正常组大于老年正常组 (P <0 .0 5 )。长链脂肪酸与脂肪酸总量的比例 ,老年正常组小于老年诱导组 (P <0 .0 5 )。结果表明 ,用DEHP诱导大鼠肝过氧化物酶体增值 ,影响肝线粒体脂肪酸正常代谢 ,使线粒体膜结构发生变化 ,这种变化 ,青年鼠与老年鼠不同     

肝细胞甘油三酯代谢途径异常与脂肪肝

脂肪肝(NAFLD)既可是一个独立的疾病,也可是一类疾病的伴发疾病,肥胖患者、脂肪营养不良症患者、糖尿病患者均伴发脂肪肝。脂肪肝时肝细胞内蓄积的脂质多为甘油三酯,因此肝细胞甘油三酯代谢紊乱是脂肪肝发生最主要原因。肝细胞甘油三酯蓄积会破坏其对胰岛素敏感性,促进肝糖异生导致高血糖,也可引起肝细胞极低密度脂蛋白分泌增加,升高血脂。本文详细阐述肝细胞甘油三酯代谢途径的重要步骤,探讨这些步骤异常与脂肪肝之间的关系,为脂肪肝药物设计提供新靶点。的每条通路的各个步骤,探讨这些步骤异常与脂肪肝之间的关系,为脂肪肝药物设计提供新靶点。     

Tissue fatty acid deposition is influenced by an interaction of dietary oil source and energy intake level in rats

To investigate the net tissue fatty acid deposition in response to graded levels of energy restriction and modification of diet fatty acid composition, rats were randomly assigned into four dietary groups and fed for 10 weeks diets containing 40% as energy of either fish, safflower, or olive oil, or beef tallow, consumed ad libitum or energy restricted to 85% or 68% of ad libitum intake by reducing diet carbohydrate content. An additional eight rats were killed before the diet regimen, to provide baseline data from which fatty acid deposition rates were calculated. Body weight, and heart, liver and fat mass gains were decreased with energy restriction (P<0.001). Olive oil feeding resulted in higher body weight gain (P < 0.03) than tallow feeding, whereas fish oil feeding was associated with highest (P < 0.007) liver weight and lowest (P < 0.03) fat mass gains. Energy deficit-related differences in the deposition of stearic, linoleic, arachidonic, and docosahexaenoic acids in heart and palmitic and docosahexaenoic acids in liver were dependent on the dietary oil consumed (P < 0.03). Similarly, interactive effects of restricted food intake and dietary oil type were found in the gain of palmitic, stearic, oleic, and linoleic acids in adipose tissue (P < 0.01) when expressed in relation to the amount of each fatty acid consumed. These data suggest that energy intake level can influence the deposition pattern, as well as oxidation rate, of tissue fatty acids as a function of tissue type, fatty acid structure, and dietary fatty acid composition.     

Nrf2调控的铁死亡途径在非酒精性脂肪性肝病防治中的作用机制

非酒精性脂肪性肝病（NAFLD）是发病率很高的慢性肝病类型,与肥胖、糖尿病、高脂血症等代谢综合征密切相关,是当前重要的公共健康问题之一。其具体的发病机制尚不清楚。目前有研究认为铁死亡参与了NAFLD的发生与发展,铁死亡是一种新型程序性细胞死亡。核因子E2相关因子2 (Nrf2)是调控铁死亡过程中的重要核因子,对铁死亡过程中抗氧化、铁代谢以及脂质过氧化途径起到调控作用,并且已被报道可能通过抑制铁死亡改善NAFLD。本文通过对铁死亡与NAFLD的关系研究进行梳理,探究Nrf2调控铁死亡改善NAFLD的可能机制。最后,对存在的问题进行分析并提出未来研究展望。     

Fsp27/CIDEC is a CREB target gene induced during early fasting in liver and regulated by FA oxidation rate

FSP27 [cell death-inducing DFFA-like effector c (CIDEC) in humans] is a protein associated with lipid droplets that downregulates the fatty acid oxidation (FAO) rate when it is overexpressed. However, little is known about its physiological role in liver. Here, we show that fasting regulates liver expression of Fsp27 in a time-dependent manner. Thus, during the initial stages of fasting, a maximal induction of 800-fold was achieved, whereas during the later phase of fasting, Fsp27 expression decreased. The early response to fasting can be explained by a canonical PKA-CREB-CRTC2 signaling pathway because: i) CIDEC expression was induced by forskolin, ii) Fsp27 promoter activity was increased by CREB, and iii) Fsp27 expression was upregulated in the liver of Sirt1 knockout animals. Interestingly, pharmacological (etomoxir) or genetic (Hmgcs2 interference) inhibition of the FAO rate increases the in vivo expression of Fsp27 during fasting. Similarly, CIDEC expression was upregulated in HepG2 cells by either etomoxir or HMGCS2 interference. Our data indicate that there is a kinetic mechanism of autoregulation between short- and long-term fasting, by which free FAs delivered to the liver during early fasting are accumulated/exported by FSP27/CIDEC, whereas over longer periods of fasting, they are degraded in the mitochondria through the carnitine palmitoyl transferase system.     

Inflammation stimulates niacin receptor (GPR109A/HCA2) expression in adipose tissue and macrophages

Many of the beneficial and adverse effects of niacin are mediated via a G protein receptor, G protein-coupled receptor 109A/hydroxycarboxylic acid 2 receptor (GPR109A/HCA2), which is highly expressed in adipose tissue and macrophages. Here we demonstrate that immune activation increases GPR109A/HCA2 expression. Lipopolysaccharide (LPS), TNF, and interleukin (IL) 1 increase GPR109A/HCA2 expression 3- to 5-fold in adipose tissue. LPS also increased GPR109A/HCA2 mRNA levels 5.6-fold in spleen, a tissue rich in macrophages. In peritoneal macrophages and RAW cells, LPS increased GPR109A/HCA2 mRNA levels 20- to 80-fold. Zymosan, lipoteichoic acid, and polyinosine-polycytidylic acid, other Toll-like receptor activators, and TNF and IL-1 also increased GPR109A/HCA2 in macrophages. Inhibition of the myeloid differentiation factor 88 or TIR-domain-containing adaptor protein inducing IFNβ pathways both resulted in partial inhibition of LPS stimulation of GPR109A/HCA2, suggesting that LPS signals an increase in GPR109A/HCA2 expression by both pathways. Additionally, inhibition of NF-κB reduced the ability of LPS to increase GPR109A/HCA2 expression by ∼50% suggesting that both NF-κB and non-NF-κB pathways mediate the LPS effect. Finally, preventing the LPS-induced increase in GPR109A/HCA2 resulted in an increase in TG accumulation and the expression of enzymes that catalyze TG synthesis. These studies demonstrate that inflammation stimulates GPR109A/HCA2 and there are multiple intracellular signaling pathways that mediate this effect. The increase in GPR109A/HCA2 that accompanies macrophage activation inhibits the TG accumulation stimulated by macrophage activation.     

FA2H is responsible for the formation of 2-hydroxy galactolipids in peripheral nervous system myelin

Myelin in the mammalian nervous system has a high concentration of galactolipids [galactosylceramide (GalCer) and sulfatide] with 2-hydroxy fatty acids. We recently reported that fatty acid 2-hydroxylase (FA2H), encoded by the FA2H gene, is the major fatty acid 2-hydroxylase in the mouse brain. In this report, we show that FA2H also plays a major role in the formation of 2-hydroxy galactolipids in the peripheral nervous system. FA2H mRNA and FA2H activity in the neonatal rat sciatic nerve increased rapidly during developmental myelination. The contents of 2-hydroxy fatty acids were approximately 5% of total galactolipid fatty acids at 4 days of age and increased to 60% in GalCer and to 35% in sulfatides at 60 days of age. The chain length of galactolipid fatty acids also increased significantly during myelination. FA2H expression in cultured rat Schwann cells was highly increased in response to dibutyryl cyclic AMP, which stimulates Schwann cell differentiation and upregulates myelin genes, such as UDP-galactose:ceramide galactosyltransferase and protein zero. These observations indicate that FA2H is a myelination-associated gene. FA2H-directed RNA interference (RNAi) by short-hairpin RNA expression resulted in a reduction of cellular 2-hydroxy fatty acids and 2-hydroxy GalCer in D6P2T Schwannoma cells, providing direct evidence that FA2H-dependent fatty acid 2-hydroxylation is required for the formation of 2-hydroxy galactolipids in peripheral nerve myelin. Interestingly, FA2H-directed RNAi enhanced the migration of D6P2T cells, suggesting that, in addition to their structural role in myelin, 2-hydroxy lipids may greatly influence the migratory properties of Schwann cells.     

达格列净对2型糖尿病合并非酒精性脂肪性肝病患者血清FGF-21水平的影响

摘要 目的：分析血清成纤维细胞生长因子-21（FGF-21）与2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）患者常见指标及NAFLD纤维化评分（NFS）的相关性,进一步探讨达格列净对T2DM合并NAFLD患者血清FGF-21水平的影响。方法：选取2022年1月至2022年6月徐州医科大学附属徐州市立医院收治的80例T2DM合并NAFLD患者为研究对象（T2DM合并NAFLD组）,选择同期80例T2DM不合并NAFLD患者为T2DM组。收集腰围（WC）、身高、体重数据,计算体重指数（BMI）。测定空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-c）,低密度脂蛋白胆固醇（LDL-c）、肌酐（Cr）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST ）、白蛋白（Alb）、血小板计数（PLT）等指标,计算胰岛素抵抗指数（HOMA-IR）、NFS。采用酶联免疫吸附（ELISA）法测定FGF-21水平。比较T2DM组和T2DM合并NAFLD组各项指标的差异,探讨血清FGF-21水平与T2DM合并NAFLD患者其他指标的相关性,Logistic回归分析T2DM合并NAFLD的影响因素,受试者工作特征曲线（ROC）分析各影响因素对T2DM合并NAFLD的诊断价值。将80例T2DM合并NAFLD患者按随机数字表法随机分为二甲双胍组和达格列净组各40例,治疗前后观测各项指标变化,并密切监测不良反应。结果：T2DM合并NAFLD组患者WC、BMI、FINS、HbA1c、TG、AST、ALT、HOMA-IR、NFS及FGF-21均高于 T2DM组（P＜0.05）。相关性分析显示,FGF-21水平与T2DM合并NAFLD组患者WC、BMI、HbA1c、TG、HOMA-IR、NFS均存在正相关（P<0.05）。Logistic回归分析显示,BMI、HbA1c、FGF-21、HOMA-IR为影响T2DM患者合并NAFLD的危险因素。ROC曲线分析显示,BMI、HbA1c、FGF-21、HOMA-IR对T2DM合并NAFLD均具有一定预测价值,其中以FGF-21的预测效能最佳。治疗后,达格列净组TG、AST、ALT、NFS、FGF-21水平较二甲双胍组降低更为明显（P＜0.05）。结论：血清FGF-21水平为T2DM合并NAFLD的危险因素,参与了T2DM合并NAFLD发病及进展,且对T2DM合并NAFLD有较好的预测效能。相较于二甲双胍,达格列净可明显降低T2DM合并NAFLD患者血清FGF-21水平并改善NFS,具有一定程度的肝脏保护作用。     

饱和脂肪酸诱导肝细胞系建立代谢相关脂肪性肝病细胞损伤模型

摘要 目的：探讨不同脂肪酸对肝细胞系脂质积累、细胞损伤的影响,选择合适诱导试剂及肝细胞系建立一种具有严重细胞损伤及炎症反应的晚期代谢相关脂肪性肝病（MAFLD）体外细胞模型。方法：以油酸（OA）或棕榈酸（PA）或其混合物分别处理HepG2和LO2细胞,以CCK8检测细胞存活率;以油红O染色及甘油三酯酶法检测细胞脂质积累程度;以qRT-PCR检测凋亡相关蛋白、纤维化相关蛋白、自噬相关蛋白、炎症因子的mRNA表达水平。结果：0.25 mmol/LPA作用HepG2细胞24 h可显著诱导甘油三酯（TG）和脂质积累,但对LO2细胞无明显影响;0.25 mmol/L PA处理两种细胞系可诱导显著的细胞损伤及炎症,OA可缓解PA对细胞的损伤作用。结论：利用PA处理HepG2细胞可引起一定程度的脂质积累,诱导显著的细胞损伤及炎症,是合适的MAFLD体外细胞模型。     

Protective Effects of Platycodi radix on Alcohol-Induced Fatty Liver

The protective effects of Platycodi radix (PR), the root of Platycodon grandiflorum A. DC, on alcohol-induced fatty liver and possible mechanisms involved in this protection were investigated in rats. Administration of PR significantly prevented alcohol-induced elevation of serum and liver lipids. Furthermore, PR treatment normalized hepatic liver fatty acid binding protein (L-FABP) expression and cytochrome P450 2E1 (CYP2E1) activity in alcohol-treated rats. These results suggest that inhibition of CYP2E1 and regulation of L-FABP by PR play an important role in alcohol-induced hepatoprotection.     

Modification of lipid-related atherosclerosis risk factors by ω3 fatty acid ethyl esters in hypertriglyceridemic patients

The efficacy of ω3 fatty acid ethyl esters was evaluated in 10 mildly hypertriglyceridemic patients in this randomized, placebo-controlled, double-blind, crossover trial. Patients were given capsules (1 per 10 kg body weight) containing 640 mg/g of ω3 fatty acids or an olive oil placebo for two 4-week treatment periods separated by a 1-week washout phase. Plasma lipids, lipoproteins, and apolipoproteins: phospholipid FA composition; the susceptibility to oxidation of the apolipoprotein B-100 containing lipoproteins; and bleeding times were determined at the end of each period. Plasma triglyceride levels were reduced by 37% (P < 0.001), whereas low density lipoprotein cholesterol and the cholesterol content of subfraction 2 of high density lipoproteins increased by 23 and 56%, respectively (both P < 0.02). Changes in plasma lipid parameters and in phospholipid FA patterns occurred rapidly, usually stabilizing within 1 week, and returned to baseline levels within 10 days after stopping supplementation with ω3 fatty acids. Bleeding times were not changed. However, the susceptibility of lipoproteins to oxidation was increased during the ω3 fatty acid period. We conclude that ω3 fatty acid ethyl esters are effective hypotriglyceridemic agents, and that they impact lipoprotein metabolism very quickly. How they may alter the atherogenic process is not clear from this study because some risk factors worsened and other improved.     

Liver fatty acid binding protein enhances sterol transfer by membrane interaction

Among the large family of fatty acid binding proteins, the liver L-FABP is unique in that it not only binds fatty acids but also interacts with sterols to enhance sterol transfer between membranes. Nevertheless, the mechanism whereby L-FABP potentiates intermembrane sterol transfer is unknown. Both fluorescence and dialysis data indicate L-FABP mediated sterol transfer between L-cell fibroblast plasma membranes occurs by a direct membrane effect: First, dansylated-L-FABP (DNS-L-FABP) is bound to L-cell fibroblast plasma membranes as indicated by increased DNS-L-FABP steady state polarization and phase resolved limiting anisotropy. Second, coumarin-L-FABP (CPM-L-FABP) fluorescence lifetimes were significantly increased upon interaction with plasma membranes. Third, dialysis studies with³H-cholesterol loaded plasma membranes showed that L-FABP added to the donor compartment of the dialysis cell stimulated³H-cholesterol transfer whether or not the dialysis membrane was permeable to L-FABP. However, L-FABP mediated intermembrane sterol transfer did require a sterol binding site on L-FABP. Chemically blocking the ligand binding site also inhibited L-FABP activity in intermembrane sterol transfer. Finally, L-FABP did not act either as an aqueous carrier or in membrane fusion. The fact that L-FABP interacted with plasma membrane vesicles and required a sterol binding site was consistent with a mode of action whereby L-FABP binds to the membrane prior to releasing sterol from the bilayer.Abbreviations ³H-CHO [1,2-³H(N)]-cholesterol - ANTS 8-aminonaphthalene-1,3,6-trisulfonic acid - CF carboxyfluorescein - CHO cholesterol - CPM (coumarin maleimide) 7-diethylamino-3-(4-maleimidylphenyl)-4-methylcoumarin - cPNA cisparinaric acid - DHE (dehydroergosterol) ^5,7,9(11),22-ergostatetraen-3-ol - DMF dimethyl formamide - DMPOPOP 1,4-bis[4-methyl-5-phenyl-2-oxazolyl]benzene - DNS (dansyl chloride) 5-dimethylaminonaphthalene-1-sulfonylchloride - DPX p-xylene-bis-pyridinium bromide - FBS fetal bovine serum - fluorescamine 4-phenylspiro[furan-2(3H), 1 phthalan]-3,3-dione - L-FABP liver fatty acid binding protein - NPG p-nitrophenylglyoxal - PIPES piperazine-N,N-bis(2-ethanesulfonic acid) - POPC 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine - SUV small unilamellar vesicle(s) - TNM tetranitromethane This work was supported in part by the National Institutes of Health United States Public Health Service (GM31651 and DK41402) and the American Heart Association (Postdoctoral Fellowship to JKW). The helpful assistance of Dr. Scott M. Colles and Mr. Daniel R. Prows in isolating L-FABP was much appreciated.     

非酒精性脂肪性肝合并2型糖尿病患者血清chemerin水平变化及其相关性分析

目的:探讨非酒精性脂肪性肝(NAFLD)合并2型糖尿病患者血清chemerin水平变化及其相关性,为其临床诊治提供参考。方法:选择河北医科大学附属秦皇岛市第一医院收治的NAFLD和2型糖尿病患者作为研究对象,其中NAFLD合并2型糖尿病患者100例(A组),单纯NAFLD患者100例(B组),单纯2型糖尿病患者100例(C组),并选取同期来该院检查的100例健康人作为对照组。比较各组患者的血清chemerin、空腹血糖、胰岛素水平、肝功能、炎症因子、应激反应指标以及胰岛素抵抗指数(HOMA-IR)差异,分析血清chemerin水平与各项指标的相关性。结果:按照A组、B组、C组以及对照组的顺序,患者血清chemerin、谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、丙二醛(MDA)、空腹血糖、胰岛素及HOMA-IR水平逐渐降低,而血清超氧化物歧化酶(SOD)以及谷胱甘肽过氧化物酶(GSH)水平逐渐升高,组间比较差异具有统计学意义(P0.05)。经Pearson相关性分析,血清chemerin水平与血清ALT、AST、MDA、CRP、TNF-α、空腹血糖、胰岛素水平及HOMA-IR水平呈现正相关,与SOD、GSH水平呈现负相关(P0.05)。结论:血清chemerin水平可通过对胰岛素抵抗、应激反应以及炎症反应等机制进行调节,参与NAFLD合并2型糖尿病的发生以及发展,并具有较好的相关性,可为NAFLD合并2型糖尿病患者的临床治疗提供新的突破点。