1. Hepatic glucose production rises with the histological severity of metabolic dysfunction-associated steatohepatitis.
- Author
-
Sabatini S, Sen P, Carli F, Pezzica S, Rosso C, Lembo E, Verrastro O, Daly A, Govaere O, Cockell S, Hyötyläinen T, Mingrone G, Bugianesi E, Anstee QM, Orešič M, and Gastaldelli A
- Subjects
- Humans, Male, Diabetes Mellitus, Type 2 metabolism, Diabetes Mellitus, Type 2 pathology, Diabetes Mellitus, Type 2 genetics, Diabetes Mellitus, Type 2 complications, Gluconeogenesis genetics, Female, Middle Aged, Liver Cirrhosis pathology, Liver Cirrhosis metabolism, Liver Cirrhosis genetics, Hyperglycemia metabolism, Hyperglycemia pathology, Insulin Receptor Substrate Proteins metabolism, Insulin Receptor Substrate Proteins genetics, Insulin metabolism, Glucose metabolism, Liver pathology, Liver metabolism, Insulin Resistance, Fatty Liver pathology, Fatty Liver metabolism, Fatty Liver genetics, Lipolysis
- Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) are associated with a high prevalence of type 2 diabetes (T2D). Individuals with MASLD exhibit insulin resistance (IR) and hyperglycemia, but it is unclear whether hepatic glucose production (HGP) is increased with MASLD severity. We evaluated HGP in a cohort of histologically characterized individuals with MASL/MASH using stable isotope infusion (6,6-
2 H2 -glucose, U-2 H5 -glycerol) and liver-specific genome-scale metabolic models (GEMs). Tracer-measured HGP is increased with liver fibrosis and inflammation, but not steatosis, and is associated with lipolysis and IR. The GEM-derived gluconeogenesis is elevated due to high glucogenic/energy metabolite uptakes (lactate, glycerol, and free fatty acid [FFA]), and the expression of insulin action genes (IRS1, IRS2, and AKT2) is reduced in MASH with fibrosis F2-F4, with/without T2D, suggesting these as putative mechanisms for increased fasting HGP and hyperglycemia. In conclusion, elevated HGP, lipolysis, and IR help to explain the mechanisms for the increased risk of hyperglycemia and T2D in MASH., Competing Interests: Declaration of interests G.M. reports consulting fees from Novo Nordisk, Fractyl Inc, and Recor Inc. She is also scientific advisor of Metadeq Inc, Keyron Ltd, GHP Scientific Ltd, and Jemyll Ltd. G.M. reports receiving research grants from Metadeq Inc and Fractyl Inc. A.G. has served as a consultant for: Boehringer Ingelheim, Eli Lilly and Company, Metadeq Diagnostics, and Fractyl Health; has participated in advisory boards for Boehringer Ingelheim, Merck Sharp & Dohme, Novo Nordisk, Metadeq Diagnostics, and Pfizer; and has received speaker’s honorarium and other fees from Eli Lilly and Company, Merck Sharp & Dohme, and Novo Nordisk. Q.M.A. reports grants and/or personal fees from Allergan/Tobira, E3Bio, Eli Lilly & Company Ltd, Galmed, Genfit SA, Gilead, Grunthal, Imperial Innovations, Intercept Pharma Europe Ltd, Inventiva, Janssen, Kenes, MedImmune, NewGene, Pfizer Ltd, Raptor Pharma, Novartis Pharma AG, AbbVie, BMS, GSK, NGMBio, Madrigal, Servier, EcoR1, 89Bio, Altimmune, AstraZeneca, Axcella, Blade, BNN Cardio, Celgene, Cirius, CymaBay, Genentech, HistoIndex, Indalo, IQVIA,Metacrine, North Sea Therapeutics, Novo Nordisk, Poxel, Terns, Viking Therapeutics, Glympse Bio, and PathAI, outside the submitted work., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
- Full Text
- View/download PDF