TY - JOUR A1 - Püschel, Gerhard A1 - Klauder, Julia A1 - Henkel-Oberländer, Janin T1 - Macrophages, low-grade inflammation, insulin resistance and hyperinsulinemia BT - A mutual ambiguous relationship in the development of metabolic diseases JF - Journal of Clinical Medicine : open access journal N2 - Metabolic derangement with poor glycemic control accompanying overweight and obesity is associated with chronic low-grade inflammation and hyperinsulinemia. Macrophages, which present a very heterogeneous population of cells, play a key role in the maintenance of normal tissue homeostasis, but functional alterations in the resident macrophage pool as well as newly recruited monocyte-derived macrophages are important drivers in the development of low-grade inflammation. While metabolic dysfunction, insulin resistance and tissue damage may trigger or advance pro-inflammatory responses in macrophages, the inflammation itself contributes to the development of insulin resistance and the resulting hyperinsulinemia. Macrophages express insulin receptors whose downstream signaling networks share a number of knots with the signaling pathways of pattern recognition and cytokine receptors, which shape macrophage polarity. The shared knots allow insulin to enhance or attenuate both pro-inflammatory and anti-inflammatory macrophage responses. This supposedly physiological function may be impaired by hyperinsulinemia or insulin resistance in macrophages. This review discusses the mutual ambiguous relationship of low-grade inflammation, insulin resistance, hyperinsulinemia and the insulin-dependent modulation of macrophage activity with a focus on adipose tissue and liver. KW - NAFLD/MAFLD KW - type 2 diabetes KW - obesity KW - vicious cycle KW - TLR signaling KW - M1/M2 differentiation KW - Akt pathway Y1 - 2022 U6 - https://doi.org/10.3390/jcm11154358 SN - 2077-0383 VL - 11 IS - 15 SP - 1 EP - 30 PB - MDPI CY - Basel, Schweiz ER - TY - JOUR A1 - Aga-Barfknecht, Heja A1 - Hallahan, Nicole A1 - Gottmann, Pascal A1 - Jähnert, Markus A1 - Osburg, Sophie A1 - Schulze, Gunnar A1 - Kamitz, Anne A1 - Arends, Danny A1 - Brockmann, Gudrun A1 - Schallschmidt, Tanja A1 - Lebek, Sandra A1 - Chadt, Alexandra A1 - Al-Hasani, Hadi A1 - Joost, Hans-Georg A1 - Schürmann, Annette A1 - Vogel, Heike T1 - Identification of novel potential type 2 diabetes genes mediating beta-cell loss and hyperglycemia using positional cloning JF - Frontiers in genetics N2 - Type 2 diabetes (T2D) is a complex metabolic disease regulated by an interaction of genetic predisposition and environmental factors. To understand the genetic contribution in the development of diabetes, mice varying in their disease susceptibility were crossed with the obese and diabetes-prone New Zealand obese (NZO) mouse. Subsequent whole-genome sequence scans revealed one major quantitative trait loci (QTL),Nidd/DBAon chromosome 4, linked to elevated blood glucose and reduced plasma insulin and low levels of pancreatic insulin. Phenotypical characterization of congenic mice carrying 13.6 Mbp of the critical fragment of DBA mice displayed severe hyperglycemia and impaired glucose clearance at week 10, decreased glucose response in week 13, and loss of beta-cells and pancreatic insulin in week 16. To identify the responsible gene variant(s), further congenic mice were generated and phenotyped, which resulted in a fragment of 3.3 Mbp that was sufficient to induce hyperglycemia. By combining transcriptome analysis and haplotype mapping, the number of putative responsible variant(s) was narrowed from initial 284 to 18 genes, including gene models and non-coding RNAs. Consideration of haplotype blocks reduced the number of candidate genes to four (Kti12,Osbpl9,Ttc39a, andCalr4) as potential T2D candidates as they display a differential expression in pancreatic islets and/or sequence variation. In conclusion, the integration of comparative analysis of multiple inbred populations such as haplotype mapping, transcriptomics, and sequence data substantially improved the mapping resolution of the diabetes QTLNidd/DBA. Future studies are necessary to understand the exact role of the different candidates in beta-cell function and their contribution in maintaining glycemic control. KW - type 2 diabetes KW - beta-cell loss KW - insulin KW - positional cloning KW - transcriptomics KW - haplotype Y1 - 2020 U6 - https://doi.org/10.3389/fgene.2020.567191 SN - 1664-8021 VL - 11 PB - Frontiers Media CY - Lausanne ER - TY - THES A1 - Saussenthaler, Sophie T1 - The impact of DNA methylation on susceptibility to typ 2 diabetes in NZO mice N2 - The development of type 2 diabetes (T2D) is driven by genetic as well as life style factors. However, even genetically identical female NZO mice on a high-fat diet show a broad variation in T2D onset. The main objective of this study was to elucidate and investigate early epigenetic determinants of type 2 diabetes. Prior to other experiments, early fat content of the liver (<55.2 HU) in combination with blood glucose concentrations (>8.8 mM) were evaluated as best predictors of diabetes in NZO females. Then, DNA methylome and transcriptome were profiled to identify molecular pathophysiological changes in the liver before diabetes onset. The major finding of this thesis is that alterations in the hepatic DNA methylome precede diabetes onset. Of particular interest were 702 differentially methylated regions (DMRs), of which 506 DMRs had genic localization. These inter-individual DMRs were enriched by fivefold in the KEGG pathway type 2 diabetes mellitus, independent of the level of gene expression, demonstrating an epigenetic predisposition toward diabetes. Interestingly, among the list of hepatic DMRs, eleven DMRs were associated with known imprinted genes in the mouse genome. Thereby, six DMRs (Nap1l5, Mest, Plagl1, Gnas, Grb10 and Slc38a4) localized to imprinting control regions, including five iDMRs that exhibited hypermethylation in livers of diabetes-prone mice. This suggests that gain of DNA methylation in multiple loci of the paternal alleles has unfavourable metabolic consequences for the offspring. Further, the comparative liver transcriptome analysis demonstrated differences in expression levels of 1492 genes related to metabolically relevant pathways, such as citrate cycle and fatty acid metabolism. The integration of hepatic transcriptome and DNA methylome indicated that 449 differentially expressed genes were potentially regulated by DNA methylation, including genes implicated in insulin signaling. In addition, liver transcriptomic profiling of diabetes-resistant and diabetes-prone mice revealed a potential transcriptional dysregulation of 17 hepatokines, in particular Hamp. The hepatic expression of Hamp was decreased by 52% in diabetes-prone mice, on account of an increase in DNA methylation of promoter CpG-118. Hence, HAMP protein levels were lower in mice prone to develop diabetes, which correlated to higher liver triglyceride levels.. In sum, the identified DNA methylation changes appear to collectively favor the initiation and progression of diabetes in female NZO mice. In near future, epigenetic biomarkers are likely to contribute to improved diagnosis for T2D. KW - epigenetics KW - DNA methylation KW - RNAseq KW - fatty liver KW - type 2 diabetes KW - HAMP Y1 - 2021 ER - TY - JOUR A1 - Willmann, Caroline A1 - Heni, Martin A1 - Linder, Katarzyna A1 - Wagner, Robert A1 - Stefan, Norbert A1 - Machann, Jürgen A1 - Schulze, Matthias Bernd A1 - Joost, Hans-Georg A1 - Haring, Hans-Ulrich A1 - Fritsche, Andreas T1 - Potential effects of reduced red meat compared with increased fiber intake on glucose metabolism and liver fat content BT - a randomized and controlled dietary intervention study JF - The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc. N2 - Background: Epidemiological studies suggest that an increased red meat intake is associated with a higher risk of type 2 diabetes, whereas an increased fiber intake is associated with a lower risk. Objectives: We conducted an intervention study to investigate the effects of these nutritional factors on glucose and lipid metabolism, body-fat distribution, and liver fat content in subjects at increased risk of type 2 diabetes. Methods: This prospective, randomized, and controlled dietary intervention study was performed over 6 mo. All groups decreased their daily caloric intake by 400 kcal. The "control" group (N = 40) only had this requirement. The "no red meat" group (N = 48) in addition aimed to avoid the intake of red meat, and the "fiber" group (N = 44) increased intake of fibers to 40 g/d. Anthropometric parameters and frequently sampled oral glucose tolerance tests were performed before and after intervention. Body-fat mass and distribution, liver fat, and liver iron content were assessed by MRI and single voxel proton magnetic resonance spectroscopy. Results: Participants in all groups lost weight (mean 3.3 +/- 0.5 kg, P < 0.0001). Glucose tolerance and insulin sensitivity improved (P < 0.001), and body and visceral fat mass decreased in all groups (P < 0.001). These changes did not differ between groups. Liver fat content decreased significantly (P < 0.001) with no differences between the groups. The decrease in liver fat correlated with the decrease in ferritin during intervention (r(2) = 0.08, P = 0.0021). This association was confirmed in an independent lifestyle intervention study (Tuebingen Lifestyle Intervention Program, N = 229, P = 0.0084). Conclusions: Our data indicate that caloric restriction leads to a marked improvement in glucose metabolism and body-fat composition, including liver-fat content. The marked reduction in liver fat might be mediated via changes in ferritin levels. In the context of caloric restriction, there seems to be no additional beneficial impact of reduced red meat intake and increased fiber intake on the improvement in cardiometabolic risk parameters. This trial was registered at clinicaltrials.gov as NCT03231839. KW - type 2 diabetes KW - prevention KW - randomized controlled intervention study KW - nutritional factors KW - fiber KW - red meat Y1 - 2019 U6 - https://doi.org/10.1093/ajcn/nqy307 SN - 0002-9165 SN - 1938-3207 VL - 109 IS - 2 SP - 288 EP - 296 PB - Oxford Univ. Press CY - Oxford ER - TY - THES A1 - Laeger, Thomas T1 - Protein-dependent regulation of feeding, metabolism, and development of type 2 diabetes T1 - Proteinabhängige Regulation der Nahrungsaufnahme und des Metabolismus sowie Entstehung des Typ-2-Diabetes BT - FGF21’s biological role BT - die Rolle von FGF21 N2 - Food intake is driven by the need for energy but also by the demand for essential nutrients such as protein. Whereas it was well known how diets high in protein mediate satiety, it remained unclear how diets low in protein induce appetite. Therefore, this thesis aims to contribute to the research area of the detection of restricted dietary protein and adaptive responses. This thesis provides clear evidence that the liver-derived hormone fibroblast growth factor 21 (FGF21) is an endocrine signal of a dietary protein restriction, with the cellular amino acid sensor general control nonderepressible 2 (GCN2) kinase acting as an upstream regulator of FGF21 during protein restriction. In the brain, FGF21 is mediating the protein-restricted metabolic responses, e.g. increased energy expenditure, food intake, insulin sensitivity, and improved glucose homeostasis. Furthermore, endogenous FGF21 induced by dietary protein or methionine restriction is preventing the onset of type 2 diabetes in the New Zealand Obese mouse. Overall, FGF21 plays an important role in the detection of protein restriction and macronutrient imbalance in rodents and humans, and mediates both the behavioral and metabolic responses to dietary protein restriction. This makes FGF21 a critical physiological signal of dietary protein restriction, highlighting the important but often overlooked impact of dietary protein on metabolism and eating behavior, independent of dietary energy content. N2 - Die Nahrungsaufnahme wird nicht nur durch den Bedarf an Energie, sondern auch durch den Bedarf an essenziellen Nährstoffen wie z. B. Protein bestimmt. Es war zwar bekannt, wie proteinreiche Nahrung eine Sättigung vermittelt, jedoch war unklar, wie eine proteinarme Ernährung den Appetit anregt. Ziel dieser Arbeit ist es daher, zu untersuchen, wie Nahrung mit einem niedrigen Proteingehalt detektiert wird und die Anpassung des Organismus im Hinblick auf den Metabolismus und das Ernährungsverhalten erfolgt. Diese Arbeit liefert klare Beweise dafür, dass das aus der Leber stammende Hormon Fibroblast growth factor 21 (FGF21) ein endokrines Signal einer Nahrungsproteinrestriktion ist, wobei der zelluläre Aminosäuresensor general control nonderepressible 2 kinase (GCN2) als Regulator von FGF21 während der Proteinrestriktion fungiert. Im Gehirn vermittelt FGF21 die durch Proteinrestriktion induzierten Stoffwechselreaktionen, z.B. den Anstieg des Energieverbrauches, die Erhöhung der Nahrungsaufnahme und eine Verbesserung der Insulinsensitivität sowie der Glukosehomöostase. Darüber hinaus schützt das durch eine protein- oder methioninarme Diät induzierte FGF21 New Zealand Obese (NZO)-Mäuse, einem Tiermodell für den humanen Typ-2-Diabetes, vor einer Diabetesentstehung. FGF21 spielt bei Nagetieren und Menschen eine wichtige Rolle hinsichtlich der Detektion einer diätetischen Proteinrestriktion sowie eines Ungleichgewichtes der Makronährstoffe zueinander und vermittelt die adaptiven Verhaltens- und Stoffwechselreaktionen. Dies macht FGF21 zu einem kritischen physiologischen Signal der Nahrungsproteinrestriktion und unterstreicht den wichtigen, aber oft übersehenen Einfluss der Nahrungsproteine auf den Stoffwechsel und das Nahrungsaufnahmeverhalten, unabhängig vom Energiegehalt der Nahrung. KW - protein restriction KW - autophagy KW - thermogenesis KW - appetite KW - hyperglycemia KW - methionine restriction KW - bone KW - FGF21 KW - energy expenditure KW - GCN2 KW - metabolism KW - food choice KW - type 2 diabetes Y1 - 2021 ER - TY - JOUR A1 - Manowsky, Julia A1 - Camargo, Rodolfo Gonzalez A1 - Kipp, Anna Patricia A1 - Henkel, Janin A1 - Püschel, Gerhard Paul T1 - Insulin-induced cytokine production in macrophages causes insulin resistance in hepatocytes JF - American journal of physiology : Endocrinology and metabolism N2 - Overweight and obesity are associated with hyperinsulinemia, insulin resistance, and a low-grade inflammation. Although hyperinsulinemia is generally thought to result from an attempt of the beta-cell to compensate for insulin resistance, there is evidence that hyperinsulinaemia itself may contribute to the development of insulin resistance and possibly the low-grade inflammation. To test this hypothesis, U937 macrophages were exposed to insulin. In these cells, insulin induced expression of the proinflammatory cytokines IL-1 beta, IL-8, CCL2, and OSM. The insulin-elicited induction of IL-1 beta was independent of the presence of endotoxin and most likely mediated by an insulin-dependent activation of NF-kappa B. Supernatants of the insulin-treated U937 macrophages rendered primary cultures of rat hepatocytes insulin resistant; they attenuated the insulin-dependent induction of glucokinase by 50%. The cytokines contained in the supernatants of insulin-treated U937 macrophages activated ERK1/2 and IKK beta, resulting in an inhibitory serine phosphorylation of the insulin receptor substrate. In addition, STAT3 was activated and SOCS3 induced, further contributing to the interruption of the insulin receptor signal chain in hepatocytes. These results indicate that hyperinsulinemia per se might contribute to the low-grade inflammation prevailing in overweight and obese patients and thereby promote the development of insulin resistance particularly in the liver, because the insulin concentration in the portal circulation is much higher than in all other tissues. KW - metabolic syndrome KW - type 2 diabetes KW - inflammation KW - macrophage KW - insulin KW - cytokines Y1 - 2016 U6 - https://doi.org/10.1152/ajpendo.00427.2015 SN - 0193-1849 SN - 1522-1555 VL - 310 SP - E938 EP - E946 PB - American Chemical Society CY - Bethesda ER - TY - JOUR A1 - Danquah, Ina A1 - Dobrucky, C. Lydia A1 - Frank, Laura K. A1 - Henze, Andrea A1 - Amoako, Yaw A. A1 - Bedu-Addo, George A1 - Raila, Jens A1 - Schulze, Matthias Bernd A1 - Mockenhaupt, Frank P. A1 - Schweigert, Florian J. T1 - Vitamin A: potential misclassification of vitamin A status among patients with type 2 diabetes and hypertension in urban Ghana JF - The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc. N2 - Background: Sub-Saharan Africa is facing a double burden of malnutrition: vitamin A deficiency (VAD) prevails, whereas the nutrition-related chronic conditions type 2 diabetes (T2D) and hypertension are emerging. Serum retinol a VAD marker increases in kidney disease and decreases in inflammation, which can partly be attributed to alterations in the vitamin A transport proteins retinol-binding protein 4 (RBP4) and prealbumin. Kidney dysfunction and inflammation commonly accompany T2D and hypertension. Objective: Among urban Ghanaians, we investigated the associations of T2D and hypertension with serum retinol as well as the importance of kidney function and inflammation in this regard. Design: A hospital-based, case-control study in individuals for risk factors of T2D, hypertension, or both was conducted in Kumasi, Ghana (328 controls, 197 with T2D, 354 with hypertension, and 340 with T2D plus hypertension). In 1219 blood samples, serum retinol, RBP4, and prealbumin were measured. Urinary albumin and estimated glomerular filtration rate (eGFR) defined kidney function. C-reactive protein (CRP) >5 mg/L indicated inflammation. We identified associations of T2D and hypertension with retinol by linear regression and calculated the contribution of RBP4, prealbumin, urinary albumin, eGFR, and CRP to these associations as the percentages of the explained variance of retinol. Results: VAD (retinol <1.05 mu mol/L) was present in 10% of this predominantly female, middle-aged, overweight, and deprived population. Hypertension, but not T2D, was positively associated with retinol (beta: 0.12; 95% CI: 0.08, 0,17), adjusted for age, sex, socioeconomic factors, anthropometric measurements, and lifestyle. In addition to RBP4 (72%) and prealbumin (22%), the effect of increased retinol on individuals with hypertension was mainly attributed to impaired kidney function (eGFR: 30%; urinary albumin: 5%) but not to inflammation. Conclusions: In patients with hypertension, VAD might be underestimated because of increased serum retinol in the context of kidney dysfunction. Thus, the interpretation of serum retinol in sub-Saharan Africa should account for hypertension status. KW - hypertension KW - inflammation KW - kidney dysfunction KW - type 2 diabetes KW - vitamin A deficiency Y1 - 2015 U6 - https://doi.org/10.3945/ajcn.114.101345 SN - 0002-9165 SN - 1938-3207 VL - 102 IS - 1 SP - 207 EP - 214 PB - American Society for Nutrition, Inc. CY - Bethesda ER - TY - JOUR A1 - Groop, Per-Henrik A1 - Cooper, Mark E. A1 - Perkovic, Vlado A1 - Sharma, Kumar A1 - Schernthaner, Guntram A1 - Haneda, Masakazu A1 - Hocher, Berthold A1 - Gordat, Maud A1 - Cescutti, Jessica A1 - Woerle, Hans-Juergen A1 - von Eynatten, Maximilian T1 - Dipeptidyl peptidase-4 inhibition with linagliptin and effects on hyperglycaemia and albuminuria in patients with type 2 diabetes and renal dysfunction: Rationale and design of the MARLINA-T2D trial JF - Diabetes & vascular disease research : official journal of the International Society of Diabetes and Vascular Disease N2 - Efficacy, Safety & Modification of Albuminuria in Type 2 Diabetes Subjects with Renal Disease with LINAgliptin (MARLINA-T2D), a multicentre, multinational, randomized, double-blind, placebo-controlled, parallel-group, phase 3b clinical trial, aims to further define the potential renal effects of dipeptidyl peptidase-4 inhibition beyond glycaemic control. A total of 350 eligible individuals with inadequately controlled type 2 diabetes and evidence of renal disease are planned to be randomized in a 1:1 ratio to receive either linagliptin 5mg or placebo in addition to their stable glucose-lowering background therapy for 24weeks. Two predefined main endpoints will be tested in a hierarchical manner: (1) change from baseline in glycated haemoglobin and (2) time-weighted average of percentage change from baseline in urinary albumin-to-creatinine ratio. Both endpoints are sufficiently powered to test for superiority versus placebo after 24weeks with =0.05. MARLINA-T2D is the first of its class to prospectively explore both the glucose- and albuminuria-lowering potential of a dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes and evidence of renal disease. KW - Dipeptidyl peptidase-4 inhibition KW - linagliptin KW - type 2 diabetes KW - chronic kidney disease KW - glycaemic control KW - albuminuria Y1 - 2015 U6 - https://doi.org/10.1177/1479164115579002 SN - 1479-1641 SN - 1752-8984 VL - 12 IS - 6 SP - 455 EP - 462 PB - Sage Publ. CY - London ER -