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      Integrated lipidomic and transcriptomic analyses identify altered nerve triglycerides in mouse models of prediabetes and type 2 diabetes

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          ABSTRACT

          Peripheral neuropathy (PN) is a complication of prediabetes and type 2 diabetes (T2D). Increasing evidence suggests that factors besides hyperglycaemia contribute to PN development, including dyslipidaemia. The objective of this study was to determine differential lipid classes and altered gene expression profiles in prediabetes and T2D mouse models in order to identify the dysregulated pathways in PN. Here, we used high-fat diet (HFD)-induced prediabetes and HFD/streptozotocin (STZ)-induced T2D mouse models that develop PN. These models were compared to HFD and HFD-STZ mice that were subjected to dietary reversal. Both untargeted and targeted lipidomic profiling, and gene expression profiling were performed on sciatic nerves. Lipidomic and transcriptomic profiles were then integrated using complex correlation analyses, and biological meaning was inferred from known lipid-gene interactions in the literature. We found an increase in triglycerides (TGs) containing saturated fatty acids. In parallel, transcriptomic analysis confirmed the dysregulation of lipid pathways. Integration of lipidomic and transcriptomic analyses identified an increase in diacylglycerol acyltransferase 2 (DGAT2), the enzyme required for the last and committed step in TG synthesis. Increased DGAT2 expression was present not only in the murine models but also in sural nerve biopsies from hyperlipidaemic diabetic patients with PN. Collectively, these findings support the hypothesis that abnormal nerve-lipid signalling is an important factor in peripheral nerve dysfunction in both prediabetes and T2D.

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          Summary: Mouse models of prediabetes and type 2 diabetes that develop peripheral neuropathy display increased levels of nerve triglycerides, which return to normal upon dietary reversal, suggesting that altered lipids are involved in disease.

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          Diabetic neuropathy

          The global epidemic of prediabetes and diabetes has led to a corresponding epidemic of complications of these disorders. The most prevalent complication is neuropathy, of which distal symmetric polyneuropathy (for the purpose of this Primer, referred to as diabetic neuropathy) is very common. Diabetic neuropathy is a loss of sensory function beginning distally in the lower extremities that is also characterized by pain and substantial morbidity. Over time, at least 50% of individuals with diabetes develop diabetic neuropathy. Glucose control effectively halts the progression of diabetic neuropathy in patients with type 1 diabetes mellitus, but the effects are more modest in those with type 2 diabetes mellitus. These findings have led to new efforts to understand the aetiology of diabetic neuropathy, along with new 2017 recommendations on approaches to prevent and treat this disorder that are specific for each type of diabetes. In parallel, new guidelines for the treatment of painful diabetic neuropathy using distinct classes of drugs, with an emphasis on avoiding opioid use, have been issued. Although our understanding of the complexities of diabetic neuropathy has substantially evolved over the past decade, the distinct mechanisms underlying neuropathy in type 1 and type 2 diabetes remains unknown. Future discoveries on disease pathogenesis will be crucial to successfully address all aspects of diabetic neuropathy, from prevention to treatment.
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            Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.

            Although dietary recommendations have focused on restricting saturated fat (SF) consumption to reduce cardiovascular disease (CVD) risk, evidence from prospective studies has not supported a strong link between total SF intake and CVD events. An understanding of whether food sources of SF influence these relations may provide new insights. We investigated the association of SF consumption from different food sources and the incidence of CVD events in a multiethnic population. Participants who were 45-84 y old at baseline (n = 5209) were followed from 2000 to 2010. Diet was assessed by using a 120-item food-frequency questionnaire. CVD incidence (316 cases) was assessed during follow-up visits. After adjustment for demographics, lifestyle, and dietary confounders, a higher intake of dairy SF was associated with lower CVD risk [HR (95% CI) for +5 g/d and +5% of energy from dairy SF: 0.79 (0.68, 0.92) and 0.62 (0.47, 0.82), respectively]. In contrast, a higher intake of meat SF was associated with greater CVD risk [HR (95% CI) for +5 g/d and a +5% of energy from meat SF: 1.26 (1.02, 1.54) and 1.48 (0.98, 2.23), respectively]. The substitution of 2% of energy from meat SF with energy from dairy SF was associated with a 25% lower CVD risk [HR (95% CI): 0.75 (0.63, 0.91)]. No associations were observed between plant or butter SF and CVD risk, but ranges of intakes were narrow. Associations of SF with health may depend on food-specific fatty acids or other nutrient constituents in foods that contain SF, in addition to SF.
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              Elevated Triglycerides Correlate With Progression of Diabetic Neuropathy

              OBJECTIVE To evaluate mechanisms underlying diabetic neuropathy progression using indexes of sural nerve morphometry obtained from two identical randomized, placebo-controlled clinical trials. RESEARCH DESIGN AND METHODS Sural nerve myelinated fiber density (MFD), nerve conduction velocities (NCVs), vibration perception thresholds, clinical symptom scores, and a visual analog scale for pain were analyzed in participants with diabetic neuropathy. A loss of ≥500 fibers/mm2 in sural nerve MFD over 52 weeks was defined as progressing diabetic neuropathy, and a MFD loss of ≤100 fibers/mm2 during the same time interval as nonprogressing diabetic neuropathy. The progressing and nonprogressing cohorts were matched for baseline characteristics using an O'Brien rank-sum and baseline MFD. RESULTS At 52 weeks, the progressing cohort demonstrated a 25% decrease (P < 0.0001) from baseline in MFD, while the nonprogressing cohort remained unchanged. MFD was not affected by active drug treatment (P = 0.87), diabetes duration (P = 0.48), age (P = 0.11), or BMI (P = 0.30). Among all variables tested, elevated triglycerides and decreased peroneal motor NCV at baseline significantly correlated with loss of MFD at 52 weeks (P = 0.04). CONCLUSIONS In this cohort of participants with mild to moderate diabetic neuropathy, elevated triglycerides correlated with MFD loss independent of disease duration, age, diabetes control, or other variables. These data support the evolving concept that hyperlipidemia is instrumental in the progression of diabetic neuropathy.
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                Author and article information

                Journal
                Dis Model Mech
                Dis Model Mech
                DMM
                dmm
                Disease Models & Mechanisms
                The Company of Biologists Ltd
                1754-8403
                1754-8411
                1 February 2020
                24 January 2020
                24 January 2020
                : 13
                : 2 , Special Issue: A Guide to Using Neuromuscular Disease Models for Basic and Preclinical Studies
                : dmm042101
                Affiliations
                [1 ]Department of Neurology, University of Michigan , Ann Arbor, MI 48109-2200, USA
                [2 ]Department of Biomedical Sciences, University of North Dakota , Grand Forks, ND 58202-9037, USA
                Author notes
                [*]

                These authors contributed equally to this work

                []Author for correspondence ( efeldman@ 123456med.umich.edu )
                Author information
                http://orcid.org/0000-0002-6365-3477
                http://orcid.org/0000-0002-4651-781X
                http://orcid.org/0000-0003-3775-7544
                http://orcid.org/0000-0002-0788-3251
                http://orcid.org/0000-0002-5206-8010
                http://orcid.org/0000-0002-5601-7675
                http://orcid.org/0000-0002-0736-2149
                http://orcid.org/0000-0002-9162-2694
                Article
                DMM042101
                10.1242/dmm.042101
                6994925
                31822493
                038241eb-b435-4a2a-92ca-8075bf3e7a71
                © 2020. Published by The Company of Biologists Ltd

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed.

                History
                : 28 August 2019
                : 29 November 2019
                Funding
                Funded by: National Institutes of Health, https://dx.doi.org/10.13039/100000002;
                Award ID: 1DP3DK094292
                Award ID: 1R24DK082841
                Award ID: 1R21NS102924
                Award ID: 1F32DK112642
                Award ID: T32DK101357
                Funded by: Novo Nordisk Foundation Center for Basic Metabolic Research, http://dx.doi.org/10.13039/501100011747;
                Award ID: NNF14°C0011633
                Funded by: Nathan and Rose Milstein Research Fund;
                Funded by: Sinai Medical Staff Foundation;
                Funded by: Robert C Graham;
                Funded by: Walbridge Aldinger;
                Funded by: American Diabetes Association, http://dx.doi.org/10.13039/100000041;
                Award ID: 7-12-BS-045
                Funded by: Program for Neurology Research and Discovery;
                Funded by: A. Alfred Taubman Medical Research Institute, http://dx.doi.org/10.13039/100008456;
                Funded by: University of North Dakota, http://dx.doi.org/10.13039/100007237;
                Funded by: National Institute of Diabetes and Digestive and Kidney Diseases, http://dx.doi.org/10.13039/100000062;
                Award ID: U2CDK110768
                Award ID: DK059637
                Award ID: DK020593
                Award ID: DK059630
                Categories
                313
                303
                Research Article

                Molecular medicine
                type 2 diabetes,peripheral neuropathy,triglyceride,lipidomic,saturated fatty acid,diacylglycerol acyltransferase 2

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