fatty acid metabolism

脂肪酸代谢
  • 文章类型: Journal Article
    脂肪组织(AT),主要由脂肪细胞组成,在血脂控制中起着至关重要的作用,新陈代谢,和能量储存。一旦被认为是代谢惰性的,AT现在被认为是调节食物摄入的动态内分泌器官,能量稳态,胰岛素敏感性,体温调节,和免疫反应。这篇综述探讨了脂联素的多方面作用,AT释放的主要脂肪因子,在葡萄糖和脂肪酸代谢中。我们探索脂联素的调节机制,其生理效应及其作为2型糖尿病等代谢性疾病治疗靶点的潜力,心血管疾病和脂肪肝疾病。此外,我们分析了各种膳食模式的影响,特定的营养素,和身体活动对脂联素水平的影响,强调改善代谢健康的策略。我们的全面综述提供了有关脂联素的关键功能及其在维持全身代谢稳态中的重要性的见解。
    Adipose tissue (AT), composed mainly of adipocytes, plays a critical role in lipid control, metabolism, and energy storage. Once considered metabolically inert, AT is now recognized as a dynamic endocrine organ that regulates food intake, energy homeostasis, insulin sensitivity, thermoregulation, and immune responses. This review examines the multifaceted role of adiponectin, a predominant adipokine released by AT, in glucose and fatty acid metabolism. We explore the regulatory mechanisms of adiponectin, its physiological effects and its potential as a therapeutic target for metabolic diseases such as type 2 diabetes, cardiovascular disease and fatty liver disease. Furthermore, we analyze the impact of various dietary patterns, specific nutrients, and physical activities on adiponectin levels, highlighting strategies to improve metabolic health. Our comprehensive review provides insights into the critical functions of adiponectin and its importance in maintaining systemic metabolic homeostasis.
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  • 文章类型: Journal Article
    全球,肥胖和糖尿病的患病率增加,心脏病是他们死亡的主要原因。传统上,肥胖和糖尿病的管理主要集中在减轻体重和控制高血糖。不幸的是,尽管做出了这些努力,不良的药物管理使这些患者容易出现心力衰竭.心力衰竭发展的一个煽动者是心脏组织如何利用不同的能量燃料来源。在这方面,心脏从使用各种基质转变,主要使用脂肪酸(FA)。这种使用FA作为唯一能量来源的转变在疾病的初始阶段是有帮助的。然而,在糖尿病的进展中,这具有严重的最终结果。这是因为过度使用FA会产生有毒的副产品,削弱心脏功能(心脏病)。脂蛋白脂肪酶(LPL)负责调节FA向心脏的输送,其在糖尿病期间的功能尚未完全揭示。在这次审查中,将讨论LPL在控制条件下和糖尿病后调节心脏燃料利用的机制,以试图确定治疗干预的新目标。目前,因为直接针对糖尿病性心脏病的治疗选择很少,LPL的研究可能有助于药物开发,专门针对心脏的燃料利用和巨噬细胞中的脂质积累,以帮助延迟,防止,或者治疗心力衰竭,并在糖尿病期间提供这种情况的长期管理。
    Worldwide, the prevalence of obesity and diabetes have increased, with heart disease being their leading cause of death. Traditionally, the management of obesity and diabetes has focused mainly on weight reduction and controlling high blood glucose. Unfortunately, despite these efforts, poor medication management predisposes these patients to heart failure. One instigator for the development of heart failure is how cardiac tissue utilizes different sources of fuel for energy. In this regard, the heart switches from using various substrates, to predominantly using fatty acids (FA). This transformation to using FA as an exclusive source of energy is helpful in the initial stages of the disease. However, over the progression of diabetes this has grave end results. This is because toxic by-products are produced by overuse of FA, which weaken heart function (heart disease). Lipoprotein lipase (LPL) is responsible for regulating FA delivery to the heart, and its function during diabetes has not been completely revealed. In this review, the mechanisms by which LPL regulates fuel utilization by the heart in control conditions and following diabetes will be discussed in an attempt to identify new targets for therapeutic intervention. Currently, as treatment options to directly target diabetic heart disease are scarce, research on LPL may assist in drug development that exclusively targets fuel utilization by the heart and lipid accumulation in macrophages to help delay, prevent, or treat cardiac failure, and provide long-term management of this condition during diabetes.
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  • 文章类型: Journal Article
    结肠直肠癌(CRC)对公共卫生构成挑战,其特征是发病率高。本研究探讨了CRC患者肿瘤微环境(TME)中铁死亡与脂肪酸代谢之间的关系,以确定这些相互作用如何影响免疫治疗的预后和有效性。关注患者预后和预测治疗反应的潜力。
    使用来自多个队列的数据集,包括癌症基因组图谱(TCGA)和基因表达综合(GEO),我们进行了一项深入的多组学研究,以揭示铁凋亡调节因子与CRC脂肪酸代谢之间的关系.通过无监督聚类,我们发现了将铁死亡和脂肪酸代谢联系起来的独特模式,并在免疫细胞浸润和途径分析的背景下进一步研究了它们。我们开发了FeFAMscore,使用机器学习算法的组合创建的预后模型,并评估其对患者预后和治疗反应性的预测能力。使用RT-PCR确认FeFAMscore签名表达水平,ACAA2在癌症中的进展得到进一步证实。
    这项研究揭示了铁凋亡调节因子和脂肪酸代谢相关基因在肿瘤进展方面的显著相关性。确定了具有不同预后和免疫细胞浸润的三个不同患者群。FeFAMscore显示出比现有模型更高的预后准确性,训练队列的C指数为0.689,四个独立验证队列的值范围为0.648至0.720。它也对免疫疗法和化疗有反应,表明特殊疗法的敏感反应(例如,抗PD-1,抗CTLA4,奥希替尼)在高FeFAM评分患者中。
    铁凋亡调节因子和脂肪酸代谢相关基因不仅增强免疫激活,但也有助于免疫逃逸。因此,FeFAMscore,一种新的预后工具,对于预测CRC患者的免疫治疗策略的预后和疗效是有希望的。
    UNASSIGNED: Colorectal cancer (CRC) poses a challenge to public health and is characterized by a high incidence rate. This study explored the relationship between ferroptosis and fatty acid metabolism in the tumor microenvironment (TME) of patients with CRC to identify how these interactions impact the prognosis and effectiveness of immunotherapy, focusing on patient outcomes and the potential for predicting treatment response.
    UNASSIGNED: Using datasets from multiple cohorts, including The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), we conducted an in-depth multi-omics study to uncover the relationship between ferroptosis regulators and fatty acid metabolism in CRC. Through unsupervised clustering, we discovered unique patterns that link ferroptosis and fatty acid metabolism, and further investigated them in the context of immune cell infiltration and pathway analysis. We developed the FeFAMscore, a prognostic model created using a combination of machine learning algorithms, and assessed its predictive power for patient outcomes and responsiveness to treatment. The FeFAMscore signature expression level was confirmed using RT-PCR, and ACAA2 progression in cancer was further verified.
    UNASSIGNED: This study revealed significant correlations between ferroptosis regulators and fatty acid metabolism-related genes with respect to tumor progression. Three distinct patient clusters with varied prognoses and immune cell infiltration were identified. The FeFAMscore demonstrated superior prognostic accuracy over existing models, with a C-index of 0.689 in the training cohort and values ranging from 0.648 to 0.720 in four independent validation cohorts. It also responses to immunotherapy and chemotherapy, indicating a sensitive response of special therapies (e.g., anti-PD-1, anti-CTLA4, osimertinib) in high FeFAMscore patients.
    UNASSIGNED: Ferroptosis regulators and fatty acid metabolism-related genes not only enhance immune activation, but also contribute to immune escape. Thus, the FeFAMscore, a novel prognostic tool, is promising for predicting both the prognosis and efficacy of immunotherapeutic strategies in patients with CRC.
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  • 文章类型: Journal Article
    [123I]β-甲基-对-碘苯基-十五烷酸([123I]BMIPP),用于心肌脂肪酸代谢的核医学成像,积聚在癌细胞中。然而,积累的机制仍然未知。因此,本研究旨在阐明[123I]BMIPP在癌细胞中的积累和积累机制。我们比较了[123I]BMIPP在癌细胞中的积累与[18F]FDG的积累,发现[123I]BMIPP的积累比[18F]FDG高得多。在存在磺基琥珀酰亚胺油酸酯(SSO)的情况下评估[123I]BMIPP的积累,CD36抑制剂,和lipofermata,脂肪酸转运蛋白(FATP)抑制剂,在低温条件下,在依托莫西的存在下,肉碱棕榈酰转移酶I(CPT1)抑制剂。结果表明,在H441,LS180和DLD-1细胞中,[123I]BMIPP积累在SSO和脂质铁的存在下减少,提示FATPs和CD36参与[123I]BMIPP在癌细胞中的摄取。[123I]在所有癌细胞系中的BMIPP积累在4°C下与37°C下相比显着降低,并且在所有癌细胞系中存在依托莫昔尔时增加,表明[123I]BMIPP在癌细胞中的积累是代谢依赖性的。在使用移植有LS180细胞的荷瘤小鼠进行的生物分布研究中,[123I]BMIPP不仅在LS180细胞中而且在正常组织和器官(包括血液和肌肉)中高度积累。[123I]BMIPP的肿瘤与肠或大肠比率与[18F]FDG相似,在体内研究中,[123I]BMIPP给药后30分钟内,肿瘤与大肠的比率超过1.0。[123I]BMIPP通过CD36和FATP被癌细胞吸收,并通过CPT1掺入线粒体。因此,[123I]BMIPP可能对脂肪酸代谢激活的癌症成像有用,比如结肠癌。然而,需要开发基于[123I]BMIPP化学结构类似物的新型成像放射性示踪剂。
    [123I]β-methyl-p-iodophenyl-pentadecanoic acid ([123I]BMIPP), which is used for nuclear medicine imaging of myocardial fatty acid metabolism, accumulates in cancer cells. However, the mechanism of accumulation remains unknown. Therefore, this study aimed to elucidate the accumulation and accumulation mechanism of [123I]BMIPP in cancer cells. We compared the accumulation of [123I]BMIPP in cancer cells with that of [18F]FDG and found that [123I]BMIPP was a much higher accumulation than [18F]FDG. The accumulation of [123I]BMIPP was evaluated in the presence of sulfosuccinimidyl oleate (SSO), a CD36 inhibitor, and lipofermata, a fatty acid transport protein (FATP) inhibitor, under low-temperature conditions and in the presence of etomoxir, a carnitine palmitoyl transferase I (CPT1) inhibitor. The results showed that [123I]BMIPP accumulation was decreased in the presence of SSO and lipofermata in H441, LS180, and DLD-1 cells, suggesting that FATPs and CD36 are involved in [123I]BMIPP uptake in cancer cells. [123I]BMIPP accumulation in all cancer cell lines was significantly decreased at 4 °C compared to that at 37 °C and increased in the presence of etomoxir in all cancer cell lines, suggesting that the accumulation of [123I]BMIPP in cancer cells is metabolically dependent. In a biological distribution study conducted using tumor-bearing mice transplanted with LS180 cells, [123I]BMIPP highly accumulated in not only LS180 cells but also normal tissues and organs (including blood and muscle). The tumor-to-intestine or large intestine ratios of [123I]BMIPP were similar to those of [18F]FDG, and the tumor-to-large-intestine ratios exceeded 1.0 during 30 min after [123I]BMIPP administration in the in vivo study. [123I]BMIPP is taken up by cancer cells via CD36 and FATP and incorporated into mitochondria via CPT1. Therefore, [123I]BMIPP may be useful for imaging cancers with activated fatty acid metabolism, such as colon cancer. However, the development of novel imaging radiotracers based on the chemical structure analog of [123I]BMIPP is needed.
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  • 文章类型: Journal Article
    细胞色素P450(CYP450)是一组在I期代谢中起重要作用的酶,有57个功能基因,在人类基因组中分为18个家族,其中CYP1、CYP2和CYP3家族突出。除了药物代谢,CYP酶代谢内源性化合物,如脂质,蛋白质,和激素来维持生理稳态。因此,CYP450酶的失调可导致不同的内分泌失调。此外,CYP450酶显著有助于脂肪酸代谢,胆固醇合成,和胆汁酸生物合成,影响细胞生理学和疾病发病机理。它们的不同功能强调了它们在治疗高胆固醇血症和神经退行性疾病方面的治疗潜力。此外,CYP450酶与癌症等疾病的发生和发展有关,影响化疗结果。评估CYP450酶的表达和活性有助于评估肝脏健康状况和区分肝脏疾病,指导治疗决策,优化药物疗效。了解CYP450酶的作用及其遗传多态性的临床效果对于开发个性化治疗策略和增强不同患者人群的药物反应至关重要。
    Cytochrome P450 (CYP450) is a group of enzymes that play an essential role in Phase I metabolism, with 57 functional genes classified into 18 families in the human genome, of which the CYP1, CYP2, and CYP3 families are prominent. Beyond drug metabolism, CYP enzymes metabolize endogenous compounds such as lipids, proteins, and hormones to maintain physiological homeostasis. Thus, dysregulation of CYP450 enzymes can lead to different endocrine disorders. Moreover, CYP450 enzymes significantly contribute to fatty acid metabolism, cholesterol synthesis, and bile acid biosynthesis, impacting cellular physiology and disease pathogenesis. Their diverse functions emphasize their therapeutic potential in managing hypercholesterolemia and neurodegenerative diseases. Additionally, CYP450 enzymes are implicated in the onset and development of illnesses such as cancer, influencing chemotherapy outcomes. Assessment of CYP450 enzyme expression and activity aids in evaluating liver health state and differentiating between liver diseases, guiding therapeutic decisions, and optimizing drug efficacy. Understanding the roles of CYP450 enzymes and the clinical effect of their genetic polymorphisms is crucial for developing personalized therapeutic strategies and enhancing drug responses in diverse patient populations.
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  • 文章类型: Journal Article
    胍基乙酸(GAA)通过刺激肌酸的生物合成,可以有效地改善能量和蛋白质的代谢。我们提出了一项研究,探讨了GAA对生产性能的影响,血清生物化学,湖羊的肉品质和瘤胃发酵。将144只断奶雄性湖羊(体重16.91±3.1kg)随机分为4组,每组3只,每组12只。饮食中添加了0(CON),500(GAA-1),750(GAA-2)和1000mg/kg(GAA-3)的GAA(饲料重量),分别。经过90天的全面实验,我们发现补充GAA对各种肌肉参数有显著影响。具体来说,显着提高了动物的平均日生长(ADG),并改善了肌肉的剪切力和纤维直径,同时还减少了滴水损失和肌肉纤维密度。此外,在饲料中添加GAA显着升高了高密度脂蛋白胆固醇(HDL-C)的血清浓度,总蛋白(TP)和球蛋白(GLB),以及超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的酶活性。同时,血清中甘油三酯(TG)和丙二醛(MDA)水平降低。此外,GAA降低了pH值和乙酸盐与丙酸盐的比率,并增加了瘤胃液的总挥发性脂肪酸(TVFA)和氨态氮(NH3-N)水平。此外,GAA上调湖羊肌肉中乙酰辅酶A羧化酶(ACC)基因的表达。总之,我们的研究结果表明,补充GAA不仅可以提高肌肉质量,而且可以积极影响血清生化和瘤胃代谢,使其成为改善湖羊整体健康和性能的潜在候选人。
    Guanidinoacetic acid (GAA) can effectively improve the metabolism of energy and proteins by stimulating creatine biosynthesis. We present a study exploring the impact of GAA on production performance, serum biochemistry, meat quality and rumen fermentation in Hu sheep. A total of 144 weaned male Hu sheep (body weight 16.91 ± 3.1 kg) were randomly assigned to four groups with three replicates of twelve sheep in each group. The diets were supplemented with 0 (CON), 500 (GAA-1), 750 (GAA-2) and 1000 mg/kg (GAA-3) of GAA (weight of feed), respectively. After a comprehensive 90-day experimental period, we discovered that the supplementation of GAA had a remarkable impact on various muscle parameters. Specifically, it significantly enhanced the average daily growth (ADG) of the animals and improved the shear force and fiber diameter of the muscle, while also reducing the drip loss and muscle fiber density. Furthermore, the addition of GAA to the feed notably elevated the serum concentrations of high-density lipoprotein cholesterol (HDL-C), total protein (TP) and globulin (GLB), as well as the enzyme activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Concurrently, there was a decrease in the levels of triglycerides (TG) and malondialdehyde (MDA) in the serum. In addition, GAA decreased the pH and the acetate-to-propionate ratio and increased the total volatile fatty acids (TVFA) and ammoniacal nitrogen (NH3-N) levels of rumen fluid. Additionally, GAA upregulated acetyl-CoA carboxylase (ACC) gene expression in the Hu sheep\'s muscles. In conclusion, our findings suggest that GAA supplementation not only enhances muscle quality but also positively affects serum biochemistry and ruminal metabolism, making it a potential candidate for improving the overall health and performance of Hu sheep.
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  • 文章类型: Journal Article
    生物学和转录组水平的异质性在定义和分型低级别神经胶质瘤(LGG)方面提出了挑战,导致对特定分子特征以增强诊断的关键需求,治疗,和LGG的预后评估。本研究以脂肪酸代谢(FAM)相关基因和预后特征为基础,探讨LGG细胞转移和侵袭的机制和治疗策略。通过筛选158个FAM相关基因,并将512个LGG样品聚类为两个亚型(C1和C2),差异基因表达分析和功能富集。比较两种亚型的免疫细胞评分和预后,C1显示较差的结果和较高的免疫评分。四基因签名(PHEX,SHANK2,HOPX,和LGALS1)在不同的数据集中进行了识别和验证,表现出稳定的预测效果。细胞实验证实了LGALS1和HOPX在促进肿瘤细胞增殖中的作用,迁移,和入侵,而SHANK2表现出抑制作用。这种基于FAM相关基因的四基因签名为了解LGG的发病机理和临床管理提供了有价值的见解。
    Heterogeneity at biological and transcriptomic levels poses a challenge in defining and typing low-grade glioma (LGG), leading to a critical need for specific molecular signatures to enhance diagnosis, therapy, and prognostic evaluation of LGG. This study focused on fatty acid metabolism (FAM) related genes and prognostic features to investigate the mechanisms and treatment strategies for LGG cell metastasis and invasion. By screening 158 FAM-related genes and clustering 512 LGG samples into two subtypes (C1 and C2), differential gene expression analysis and functional enrichment were performed. The immune cell scores and prognosis were compared between the two subtypes, with C1 showing poorer outcomes and higher immune scores. A four-gene signature (PHEX, SHANK2, HOPX, and LGALS1) was identified and validated across different datasets, demonstrating a stable predictive effect. Cellular experiments confirmed the roles of LGALS1 and HOPX in promoting tumor cell proliferation, migration, and invasion, while SHANK2 exhibited a suppressive effect. This four-gene signature based on FAM-related genes offers valuable insights for understanding the pathogenesis and clinical management of LGG.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨MDSCs在CRC免疫抑制中的关键作用。专注于CSF1R和JAK/STAT3信令轴。此外,它评估了LNCs@CSF1RsiRNA和抗PD-1联合治疗的疗效。
    方法:来自CRC和邻近正常组织的单细胞转录组测序数据鉴定了MDSC相关的差异表达基因。RNA-seq分析全面分析小鼠CRC肿瘤中的MDSC基因表达。LNCs@CSF1RsiRNA纳米载体有效靶向并抑制CSF1R。流式细胞术定量CSF1R抑制后MDSC表面标志物的变化。RNA-seq和途径富集分析揭示了CSF1R对MDSC代谢和信号传导的影响。使用Colivelin和代谢评估来验证CSF1R抑制对JAK/STAT3信号传导轴的影响。通过基于荧光的流式细胞术测量葡萄糖和脂肪酸摄取。LNCs@CSF1RsiRNA和抗PD-1的疗效,单独和联合,在具有广泛肿瘤切片分析的小鼠CRC模型中进行评估。
    结果:CSF1R在MDSC介导的免疫抑制中起重要作用。LNCs@CSF1RsiRNA纳米载体有效靶向MDSCs并抑制CSF1R。CSF1R通过JAK/STAT3信号轴调节MDSC脂肪酸代谢和免疫抑制。抑制CSF1R降低了STAT3的激活和靶基因的表达,是Colivelin救的.用LNC@CSF1RsiRNA和抗PD-1联合治疗显著减缓肿瘤生长并降低CRC肿瘤内的MDSC丰度。
    结论:CSF1R通过JAK/STAT3轴关键调节MDSCs,特别是脂肪酸代谢和免疫抑制。LNCs@CSF1RsiRNA和抗PD-1联合治疗可增强小鼠CRC模型的疗效,为未来的临床应用奠定了坚实的基础。
    OBJECTIVE: This study aimed to investigate the critical role of MDSCs in CRC immune suppression, focusing on the CSF1R and JAK/STAT3 signaling axis. Additionally, it assessed the therapeutic efficacy of LNCs@CSF1R siRNA and anti-PD-1 in combination.
    METHODS: Single-cell transcriptome sequencing data from CRC and adjacent normal tissues identified MDSC-related differentially expressed genes. RNA-seq analysis comprehensively profiled MDSC gene expression in murine CRC tumors. LNCs@CSF1R siRNA nanocarriers effectively targeted and inhibited CSF1R. Flow cytometry quantified changes in MDSC surface markers post-CSF1R inhibition. RNA-seq and pathway enrichment analyses revealed the impact of CSF1R on MDSC metabolism and signaling. The effect of CSF1R inhibition on the JAK/STAT3 signaling axis was validated using Colivelin and metabolic assessments. Glucose and fatty acid uptake were measured via fluorescence-based flow cytometry. The efficacy of LNCs@CSF1R siRNA and anti-PD-1, alone and in combination, was evaluated in a murine CRC model with extensive tumor section analyses.
    RESULTS: CSF1R played a significant role in MDSC-mediated immune suppression. LNCs@CSF1R siRNA nanocarriers effectively targeted MDSCs and inhibited CSF1R. CSF1R regulated MDSC fatty acid metabolism and immune suppression through the JAK/STAT3 signaling axis. Inhibition of CSF1R reduced STAT3 activation and target gene expression, which was rescued by Colivelin. Combined treatment with LNCs@CSF1R siRNA and anti-PD-1 significantly slowed tumor growth and reduced MDSC abundance within CRC tumors.
    CONCLUSIONS: CSF1R via the JAK/STAT3 axis critically regulates MDSCs, particularly in fatty acid metabolism and immune suppression. Combined therapy with LNCs@CSF1R siRNA and anti-PD-1 enhances therapeutic efficacy in a murine CRC model, providing a strong foundation for future clinical applications.
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  • 文章类型: Journal Article
    背景:神经性厌食症患者继发性肉碱缺乏的报道很少。这项研究旨在调查严重营养不良的饮食失调患者在重新喂养期间肉碱缺乏的发生情况,并评估其对治疗结果的潜在不利影响。
    方法:在2010年3月至2020年12月在一家医院进行的56名饮食失调女性住院患者的队列研究中,我们测量了血浆游离肉碱(FC)水平,并与健康对照组(n=35)进行了比较。根据FC水平将患者分为三组:FC缺乏症(FC<20µmol/L),FC预缺乏(20µmol/L≤FC<36µmol/L),和FC正常(36μmol/L≤FC)。
    结果:入院时,患者的中位年龄为26岁(四分位间距[IQR]:21~35),中位体重指数(BMI)为13.8kg/m2(IQR:12.8~14.8).在57%的患者中发现了肉碱缺乏或预缺乏。低肉碱血症与再喂养期间血红蛋白水平下降相关(比值比[OR]:0.445;95%置信区间[CI]:0.214-0.926,p=0.03),入院时的BMI(OR:0.478;95%CI:0.217-0.874,p=0.014),入院时中度或更严重的肝功能损害(OR:6.385;95%CI:1.170-40.833,p=0.032)。
    结论:低肉碱血症,特别是在严重营养不良的情况下(入院时BMI<13kg/m2),在严重营养不良的患者中观察到,关键的代谢过渡阶段.入院时中度或重度肝功能损害被认为是低肉碱血症的潜在指标。尽管低肉碱血症与除再喂养期间贫血以外的任何明显不良事件无关,不能否认,在身体状态变化相关的能量需求突然增加时,肉碱缺乏可能是导致更严重并发症的危险因素.有必要进一步研究严重营养不良的饮食失调患者的低肉碱血症的临床意义。
    肉碱是一种氨基酸衍生物,在促进和调节脂肪酸代谢中起重要作用,和肉碱缺乏假设与慢性饥饿相关的神经性厌食症患者,但是关于这个问题的报道很少。这项研究代表了严重营养不良的饮食失调患者的低肉碱血症的初步文献,包括神经性厌食症.低肉碱血症,特别是在严重营养不良(BMI<13kg/m2)的情况下,关键的代谢过渡阶段.中度或重度肝功能损害被认为是低肉碱血症的潜在指标。尽管没有发现与再喂养期间贫血以外的不良事件的明显关联,当能量需求的突然增加加上患者组身体状况的变化时,可能会出现低肉碱血症的临床表现。需要进一步研究以确定低肉碱血症的临床意义。
    BACKGROUND: Secondary carnitine deficiency in patients with anorexia nervosa has been rarely reported. This study aimed to investigate the occurrence of carnitine deficiency in severely malnourished patients with eating disorders during refeeding and assess its potential adverse effects on treatment outcomes.
    METHODS: In a cohort study of 56 female inpatients with eating disorders at a single hospital from March 2010 to December 2020, we measured plasma free carnitine (FC) levels and compared to those of a healthy control group (n = 35). The patients were categorized into three groups based on FC levels: FC deficiency (FC< 20 µmol/L), FC pre-deficiency (20 µmol/L ≤ FC< 36 µmol/L), and FC normal (36 µmol/L ≤ FC).
    RESULTS: Upon admission, the patients had a median age of 26 years (interquartile range [IQR]: 21-35) and a median body mass index (BMI) of 13.8 kg/m2 (IQR: 12.8-14.8). Carnitine deficiency or pre-deficiency was identified in 57% of the patients. Hypocarnitinemia was associated with a decline in hemoglobin levels during refeeding (odds ratio [OR]: 0.445; 95% confidence interval [CI]: 0.214-0.926, p = 0.03), BMI at admission (OR: 0.478; 95% CI: 0.217-0.874, p = 0.014), and moderate or greater hepatic impairment at admission (OR: 6.385; 95% CI: 1.170-40.833, p = 0.032).
    CONCLUSIONS: Hypocarnitinemia, particularly in cases of severe undernutrition (BMI< 13 kg/m2 at admission) was observed in severely malnourished patients with eating disorders during refeeding, a critical metabolic transition phase. Moderate or severe hepatic impairment at admission was considered a potential indicator of hypocarnitinemia. Although hypocarnitinemia was not associated with any apparent adverse events other than anemia during refeeding, the possibility that carnitine deficiency may be a risk factor for more serious complications during sudden increases in energy requirements associated with changes in physical status cannot be denied. Further research on the clinical significance of hypocarnitinemia in severely malnourished patients with eating disorders is warranted.
    Carnitine is an amino acid derivative that plays an important role in the promotion and regulation of fatty acid metabolism, and carnitine deficiency is assumed in patients with anorexia nervosa associated with chronic starvation, but there are few reports on this issue. This study represents the inaugural documentation of hypocarnitinemia in severely malnourished patients with eating disorders, including anorexia nervosa. Hypocarnitinemia, particularly in cases of severe undernutrition (BMI < 13 kg/m2) was observed during refeeding, a critical metabolic transition phase. Moderate or severe hepatic impairment was considered a potential indicator of hypocarnitinemia. Although no apparent association with adverse events other than anemia during refeeding was identified, clinical manifestations of hypocarnitinemia may occur when a sudden increase in energy demand is added to a change in the physical condition of the patient group. Further investigation is required to determine the clinical significance of hypocarnitinemia.
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  • 文章类型: Journal Article
    在肿瘤发生中对应激的促存活代谢适应仍然不太明确。我们发现多发性骨髓瘤(MM)在基础和应激条件下都出乎意料地依赖于长链脂肪酸(FA)的β-氧化。然而,在应力条件下,需要第二个促存活信号来维持FA氧化(FAO)。我们先前发现CD28在MM细胞上表达并转导显著的促存活/化疗抗性信号。我们现在发现CD28信号调节自噬/脂质吞噬,涉及Ca2→AMPK→ULK1轴的激活,并通过HuR调节ATG5的翻译,导致持续的吸脂性,增加粮农组织,增强MM生存。相反,阻断自噬/吸脂性使MM对体内化疗敏感。我们的发现将促生存信号与FA可用性联系起来,以维持在压力条件下癌细胞生存所需的FAO,并确定了吸脂性作为克服MMs治疗抵抗的治疗靶标。
    Pro-survival metabolic adaptations to stress in tumorigenesis remain less well defined. We find that multiple myeloma (MM) is unexpectedly dependent on beta-oxidation of long-chain fatty acids (FAs) for survival under both basal and stress conditions. However, under stress conditions, a second pro-survival signal is required to sustain FA oxidation (FAO). We previously found that CD28 is expressed on MM cells and transduces a significant pro-survival/chemotherapy resistance signal. We now find that CD28 signaling regulates autophagy/lipophagy that involves activation of the Ca2+→AMPK→ULK1 axis and regulates the translation of ATG5 through HuR, resulting in sustained lipophagy, increased FAO, and enhanced MM survival. Conversely, blocking autophagy/lipophagy sensitizes MM to chemotherapy in vivo. Our findings link a pro-survival signal to FA availability needed to sustain the FAO required for cancer cell survival under stress conditions and identify lipophagy as a therapeutic target to overcome treatment resistance in MM.
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