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      Hepatic steatosis risk is partly driven by increased de novo lipogenesis following carbohydrate consumption

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          Abstract

          Background

          Diet is a major contributor to metabolic disease risk, but there is controversy as to whether increased incidences of diseases such as non-alcoholic fatty liver disease arise from consumption of saturated fats or free sugars. Here, we investigate whether a sub-set of triacylglycerols (TAGs) were associated with hepatic steatosis and whether they arise from de novo lipogenesis (DNL) from the consumption of carbohydrates.

          Results

          We conduct direct infusion mass spectrometry of lipids in plasma to study the association between specific TAGs and hepatic steatosis assessed by ultrasound and fatty liver index in volunteers from the UK-based Fenland Study and evaluate clustering of TAGs in the National Survey of Health and Development UK cohort. We find that TAGs containing saturated and monounsaturated fatty acids with 16–18 carbons are specifically associated with hepatic steatosis. These TAGs are additionally associated with higher consumption of carbohydrate and saturated fat, hepatic steatosis, and variations in the gene for protein phosphatase 1, regulatory subunit 3b (PPP1R3B), which in part regulates glycogen synthesis. DNL is measured in hyperphagic ob/ob mice, mice on a western diet (high in fat and free sugar) and in healthy humans using stable isotope techniques following high carbohydrate meals, demonstrating the rate of DNL correlates with increased synthesis of this cluster of TAGs. Furthermore, these TAGs are increased in plasma from patients with biopsy-confirmed steatosis.

          Conclusion

          A subset of TAGs is associated with hepatic steatosis, even when correcting for common confounding factors. We suggest that hepatic steatosis risk in western populations is in part driven by increased DNL following carbohydrate rich meals in addition to the consumption of saturated fat.

          Electronic supplementary material

          The online version of this article (10.1186/s13059-018-1439-8) contains supplementary material, which is available to authorized users.

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          Most cited references31

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          Hepatic ceramides dissociate steatosis and insulin resistance in patients with non-alcoholic fatty liver disease.

          Recent data in mice have identified de novo ceramide synthesis as the key mediator of hepatic insulin resistance (IR) that in humans characterizes increases in liver fat due to IR ('Metabolic NAFLD' but not that due to the I148M gene variant in PNPLA3 ('PNPLA3 NAFLD'). We determined which bioactive lipids co-segregate with IR in the human liver.
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            Alterations in adipose tissue and hepatic lipid kinetics in obese men and women with nonalcoholic fatty liver disease.

            Steatosis in patients with nonalcoholic fatty liver disease (NAFLD) is due to an imbalance between intrahepatic triglyceride (IHTG) production and export. The purpose of this study was to evaluate TG metabolism in adipose tissue and liver in NAFLD. Fatty acid, VLDL-TG, and VLDL-apolipoprotein B-100 (apoB100) kinetics were assessed by using stable isotope tracers in 14 nondiabetic obese subjects with NAFLD (IHTG, 22.7% +/- 2.0%) and 14 nondiabetic obese subjects with normal IHTG content (IHTG, 3.4% +/- 0.4%), matched on age, sex, body mass index, and percent body fat. Compared with the normal IHTG group, the NAFLD group had greater rates of palmitate release from adipose tissue into plasma (85.4 +/- 6.6 and 114.1 +/- 8.1 micromol/min, respectively; P = .01) and VLDL-TG secretion (11.4 +/- 1.1 and 24.3 +/- 3.1 micromol/min, respectively; P = .001); VLDL-apoB100 secretion rates were not different between groups. The increase in VLDL-TG secretion was primarily due to an increased contribution from "nonsystemic" fatty acids, presumably derived from lipolysis of intrahepatic and intra-abdominal fat and de novo lipogenesis. VLDL-TG secretion rate increased linearly with increasing IHTG content in subjects with normal IHTG but reached a plateau when IHTG content was >/=10% (r = 0.618, P < .001). Obese persons with NAFLD have marked alterations in both adipose tissue (increased lipolytic rates) and hepatic (increased VLDL-TG secretion) TG metabolism. Fatty acids derived from nonsystemic sources are responsible for the increase in VLDL-TG secretion. However, the increase in hepatic TG export is not adequate to normalize IHTG content.
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              Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects.

              Nonalcoholic fatty liver disease is associated with insulin resistance and diabetes. The purpose of this study was to determine the relationship between intrahepatic triglyceride (IHTG) content and insulin action in liver (suppression of glucose production), skeletal muscle (stimulation of glucose uptake), and adipose tissue (suppression of lipolysis) in nondiabetic obese subjects. A euglycemic-hyperinsulinemic clamp procedure and stable isotopically labeled tracer infusions were used to assess insulin action, and magnetic resonance spectroscopy was used to determine IHTG content, in 42 nondiabetic obese subjects (body mass index, 36 +/- 4 kg/m(2)) who had a wide range of IHTG content (1%-46%). Hepatic insulin sensitivity, assessed as a function of glucose production rate and plasma insulin concentration, was inversely correlated with IHTG content (r = -0.599; P < .001). The ability of insulin to suppress fatty acid release from adipose tissue and to stimulate glucose uptake by skeletal muscle were also inversely correlated with IHTG content (adipose tissue: r = -0.590, P < .001; skeletal muscle: r = -0.656, P < .001). Multivariate linear regression analyses found that IHTG content was the best predictor of insulin action in liver, skeletal muscle, and adipose tissue, independent of body mass index and percent body fat, and accounted for 34%, 42%, and 44% of the variability in these tissues, respectively (P < .001 for each model). These results show that progressive increases in IHTG content are associated with progressive impairment of insulin action in liver, skeletal muscle, and adipose tissue in nondiabetic obese subjects. Therefore, nonalcoholic fatty liver disease should be considered part of a multiorgan system derangement in insulin sensitivity.
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                Author and article information

                Contributors
                +44 (0)1223 764922 , jlg40@cam.ac.uk
                Journal
                Genome Biol
                Genome Biol
                Genome Biology
                BioMed Central (London )
                1474-7596
                1474-760X
                20 June 2018
                20 June 2018
                2018
                : 19
                : 79
                Affiliations
                [1 ]ISNI 0000 0004 0606 2472, GRID grid.415055.0, MRC Human Nutrition Research, ; Fulbourn Road, Cambridge, UK
                [2 ]ISNI 0000000121885934, GRID grid.5335.0, Department of Biochemistry and the Cambridge Systems Biology Centre, , University of Cambridge, ; The Sanger Building, 80 Tennis Court Road, Cambridge, CB2 1GA UK
                [3 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Current address: Leeds Institute of Cardiovascular and Metabolic Medicine, , University of Leeds, ; Leeds, UK
                [4 ]ISNI 0000 0004 0622 5016, GRID grid.120073.7, MRC Epidemiology, University of Cambridge, , Addenbrooke’s Hospital, ; Cambridge, UK
                [5 ]NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
                [6 ]ISNI 0000000121885934, GRID grid.5335.0, Institute of Metabolic Science, , University of Cambridge, ; Cambridge, UK
                [7 ]ISNI 0000 0004 0427 2580, GRID grid.268922.5, MRC Unit for Lifelong Health and Ageing at UCL, ; London, UK
                [8 ]ISNI 0000 0004 0383 8386, GRID grid.24029.3d, Liver Unit, Department of Medicine, Cambridge Biomedical Research Centre, , Cambridge University Hospitals NHS Foundation Trust, ; Cambridge, UK
                [9 ]ISNI 0000000121885934, GRID grid.5335.0, Department of Physiology, Development and Neuroscience, , University of Cambridge, ; Cambridge, UK
                Article
                1439
                10.1186/s13059-018-1439-8
                6009819
                29925420
                5146aeab-1bd2-42f4-8ead-7446ab86d444
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 July 2017
                : 1 May 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: MC UP A90 1006
                Award ID: MC PC 13030
                Award ID: MC UU12015/1
                Award ID: MC UU 12015/5
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004282, Evelyn Trust;
                Award ID: NA
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: 1R01ES022186-01
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Genetics
                non-alcoholic fatty liver disease,direct infusion mass spectrometry,de novo lipogenesis,triacylglycerols,triglycerides

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