Made available in DSpace on 2014-06-11T19:32:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-06-15Bitstream added on 2014-06-13T20:03:20Z : No. of bitstreams: 1 nascimento_af_dr_botfm.pdf: 1541050 bytes, checksum: 9fae4f69a9aa734a76ae03632e1bca64 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Acúmulo de lipídeo no citoplasma do miócito é associado com disfunção e morte celular, um processo conhecido como lipotoxicidade cardíaca. Leptina, um hormônio produzido no tecido adiposo, atua como reguladora do metabolismo lipídico e desempenha um papel anti-esteatose; em contraste, resistência à leptina tem sido associada com lipotoxicidade. É incerto se resistência à leptina pode ser um fator de risco para lipotoxicidade cardíaca com o desenvolvimento de obesidade induzida por dieta. O objetivo deste estudo foi avaliar a relação entre diferentes períodos de exposição à obesidade induzida por dieta e lipotoxicidade cardíaca via alteração do eixo OB-R/AMPK/ACC/Malonil CoA. Ratos Wistar machos foram alimentados com dieta normocalórica (12% calorias provenientes da gordura) ou hipercalórica (49% calorias provenientes da gordura), durante 15 ou 45 semanas. O índice de adiposidade, peso corporal e co-morbidades foram avaliados. A lipotoxicidade cardíaca foi avaliada por meio da análise da função cardíaca em associação as alterações na morfologia e conteúdo cardíaco de triacilglicerol, ceramida e hidroperóxido de lipídeo. A apoptose cardíaca também foi avaliada; a técnica utilizada foi a de TUNEL. A função da leptina sobre o tecido cardíaco foi determinada pela expressão gênica e proteíca cardíaca dos receptores de leptina, proteína quinase ativada por adenosina monofosfato e acetil CoA carboxilase, em associação ao nível sérico do hormônio. Os resultados mostraram que a obesidade induzida por dieta, nos dois momentos experimentais, foi caracterizada por aumentos nos índice de adiposidade, peso corporal e níveis séricos de letpina. Não houve diferença nos níveis de triacilglicerol e hidroperóxido de lipídeo cardíacos. Interessantemente, o conteúdo miocárdico de ceramida foi diminuído nos animais obesos em relação aos controles... / Lipid accumulation in the cytoplasm of the myocyte has been associated with cellular dysfunction and death, a phenomenon known as cardiac lipotoxicity. Leptin, a hormone derived from adipose tissue, acts as a regulator of lipid metabolism and plays an anti-steatosis role; however, leptin resistance has been related with myocardial lipotoxicity. Whether leptin resistance is a risk factor associated with cardiac lipotoxicity on diet-induced obesity is unclear. The objective of this study was to evaluate the relationship between diet-induced obesity and cardiac lipotoxicity via the alteration of the OB-R/AMPK/ACC/Malonyl-CoA axis at different time points. Male Wistar rats were fed with a normal chow diet (12% calories from fat) or a high-fat diet (49% calories from fat), for 15 or 45 weeks, respectively. The adiposity index, body weight and co-morbidities were evaluated. Lipotoxicity on the heart was assessed by analyzing cardiac function and morphologic changes, cardiac triglyceride, ceramide and lipid hydroperoxide accumulation. The cardiac apoptosis was examined by TUNEL’s method. The leptin function was determined by examining plasma leptin levels, cardiac expression of leptin receptor and its related phosphorylations of AMPactivated kinase protein (AMPK) and Acetyl CoA carboxilase (ACC). Result showed that obesity promoted by a high-fat diet in rats was characterized by an increase in adiposity index, body weight and high leptin levels at both 15 and 45 weeks. There was no difference in cardiac triglyceride and lipid hydroperoxide. Interestingly, ceramide levels decreased in obese animals in both experimental periods, when compared with the control group. The cardiac morphological and functional parameters were not altered. Although down-regulation of cardiac leptin receptor has occurred in chronic obesity, it does not adversely affect AMPK and ACC phosphorylations. The result... (Complete abstract click electronic access below)

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Orientador: Antonio Carlos Cicogna / Banca: Ana Lúcia dos Anjos Ferreira / Banca: Marina Politi Okoshi / Banca: Alessandra Medeiros / Banca: Edilamar Menezes de Oliveira / Resumo: Acúmulo de lipídeo no citoplasma do miócito é associado com disfunção e morte celular, um processo conhecido como lipotoxicidade cardíaca. Leptina, um hormônio produzido no tecido adiposo, atua como reguladora do metabolismo lipídico e desempenha um papel anti-esteatose; em contraste, resistência à leptina tem sido associada com lipotoxicidade. É incerto se resistência à leptina pode ser um fator de risco para lipotoxicidade cardíaca com o desenvolvimento de obesidade induzida por dieta. O objetivo deste estudo foi avaliar a relação entre diferentes períodos de exposição à obesidade induzida por dieta e lipotoxicidade cardíaca via alteração do eixo OB-R/AMPK/ACC/Malonil CoA. Ratos Wistar machos foram alimentados com dieta normocalórica (12% calorias provenientes da gordura) ou hipercalórica (49% calorias provenientes da gordura), durante 15 ou 45 semanas. O índice de adiposidade, peso corporal e co-morbidades foram avaliados. A lipotoxicidade cardíaca foi avaliada por meio da análise da função cardíaca em associação as alterações na morfologia e conteúdo cardíaco de triacilglicerol, ceramida e hidroperóxido de lipídeo. A apoptose cardíaca também foi avaliada; a técnica utilizada foi a de TUNEL. A função da leptina sobre o tecido cardíaco foi determinada pela expressão gênica e proteíca cardíaca dos receptores de leptina, proteína quinase ativada por adenosina monofosfato e acetil CoA carboxilase, em associação ao nível sérico do hormônio. Os resultados mostraram que a obesidade induzida por dieta, nos dois momentos experimentais, foi caracterizada por aumentos nos índice de adiposidade, peso corporal e níveis séricos de letpina. Não houve diferença nos níveis de triacilglicerol e hidroperóxido de lipídeo cardíacos. Interessantemente, o conteúdo miocárdico de ceramida foi diminuído nos animais obesos em relação aos controles... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Lipid accumulation in the cytoplasm of the myocyte has been associated with cellular dysfunction and death, a phenomenon known as cardiac lipotoxicity. Leptin, a hormone derived from adipose tissue, acts as a regulator of lipid metabolism and plays an anti-steatosis role; however, leptin resistance has been related with myocardial lipotoxicity. Whether leptin resistance is a risk factor associated with cardiac lipotoxicity on diet-induced obesity is unclear. The objective of this study was to evaluate the relationship between diet-induced obesity and cardiac lipotoxicity via the alteration of the OB-R/AMPK/ACC/Malonyl-CoA axis at different time points. Male Wistar rats were fed with a normal chow diet (12% calories from fat) or a high-fat diet (49% calories from fat), for 15 or 45 weeks, respectively. The adiposity index, body weight and co-morbidities were evaluated. Lipotoxicity on the heart was assessed by analyzing cardiac function and morphologic changes, cardiac triglyceride, ceramide and lipid hydroperoxide accumulation. The cardiac apoptosis was examined by TUNEL's method. The leptin function was determined by examining plasma leptin levels, cardiac expression of leptin receptor and its related phosphorylations of AMPactivated kinase protein (AMPK) and Acetyl CoA carboxilase (ACC). Result showed that obesity promoted by a high-fat diet in rats was characterized by an increase in adiposity index, body weight and high leptin levels at both 15 and 45 weeks. There was no difference in cardiac triglyceride and lipid hydroperoxide. Interestingly, ceramide levels decreased in obese animals in both experimental periods, when compared with the control group. The cardiac morphological and functional parameters were not altered. Although down-regulation of cardiac leptin receptor has occurred in chronic obesity, it does not adversely affect AMPK and ACC phosphorylations. The result... (Complete abstract click electronic access below) / Doutor

Des études montrent que l’accumulation de lipides dans l’hypothalamus serait responsable de l’installation d’une lipotoxicité centrale : phénomène qui pourrait jouer un rôle dans l’apparition d’une insulino-résistance périphérique et du diabète de type II en dérégulant le contrôle nerveux de l’homéostasie glucidique. Il est connu que l'accumulation des céramides est impliquée dans le développement d’une lipotoxicité des tissus périphériques. L’objectif de cette étude est de déterminer le rôle du métabolisme des céramides au niveau hypothalamique dans l’installation d’une insulino-résistance centrale et d'en étudier les mécanismes impliqués. Nous avons également déterminé le rôle du métabolisme des céramides hypothalamiques dans la dérégulation de l’homéostasie glucidique induite par l’obésité.L’installation d'une insulino-résistance centrale est étudiée à l'aide d'approches in vitro, en utilisant des cellules hypothalamiques de souris GT1-7 traitées avec du palmitate pendant 24h. L'action de l’insuline est mesurée par la quantification d’Akt phosphorylée (western blot). Les céramides sont quantifiées par lipidomique, l'expression d’ARNm des gènes codant pour les enzymes de la voie de synthèse de novo des céramides par qRT-PCR. Des rats Zucker obèses sont perfusés avec la myriocine (inhibiteur de la synthèse de novo des céramides) en ICV pendant 21 jours. Des tests de sensibilité à l'insuline et de tolérance au glucose sont réalisés. A la fin du traitement, ils reçoivent une injection ICV d'insuline, la sensibilité à l’insuline ainsi que les taux de céramides sont quantifiés dans l’hypothalamus. Les îlots de Langerhans sont isolés pour des tests de sécrétion d'insuline.Nous avons mis en évidence une insulino-résistance dans la lignée hypothalamique GT1-7 traitées avec le palmitate qui s’accompagne d’une accumulation de céramides. En présence de myriocine, les céramides ne sont plus accumulés et le l’insulino-résistance induite par le palmitate est contre-carrée. En utilisant un inhibiteur de la PKCζ et un adénovirus codant pour un dominant-négatif de la PKCζ, nous avons montré que le palmitate n'est plus capable d'induire une insulino-résistance et ce malgré la présence d'une accumulation de céramides. Chez le rat Zucker obèse, nous avons mis en évidence une accumulation de céramides hypothalamiques qui est contre-carrée par la myriocine. Ceci est associé avec une amélioration de la sensibilité à l’insuline dans l’hypothalamus. De façon, intéressante, ces animaux améliorent leur tolérance au glucose qui est associée à une augmentation du tonus parasympathique conduisant à une augmentation de la sécrétion d’insuline. Les îlots de Langerhans isolés à partir de ces rats présentent une capacité sécrétoire augmentée lors du traitement avec la myriocine.Au final, notre étude révèle que la lipotoxicité hypothalamique est associée à une accumulation de céramides dans cette structure, responsable de l’installation d’une insulino-résistance. Ces résultats mettent également en évidence le rôle clé du métabolisme des céramides au niveau de l’hypothalamus dans la dérégulation du contrôle nerveux de l’homéostasie glucidique induit par l’obésité / Studies show that hypothalamic lipid accumulation is responsible for the development of central lipotoxicity, a phenomenon that could play a role in the installation of peripheral insulin resistance and type II diabetes by deregulating the nervous control of glucose homeostasis. It is known that the accumulation of ceramides is involved in the development of lipotoxicity of peripheral tissues. The objective of this study is to determine the role of the hypothalamic ceramide metabolism on the installation of a central insulin resistance and to study the mechanisms involved on this phenomenon. We also determined the role of hypothalamic ceramide metabolism in the deregulation of obesity-induced glucose homeostasis.The installation of a central insulin resistance is studied using in vitro approaches using hypothalamic GT1-7 mouse cells treated with palmitate for 24 hours. The action of insulin is measured by the quantification of phosphorylated Akt (western blot). The ceramides are quantified by lipidomic assay, mRNA expression of genes encoding enzymes of de novo synthesis pathway of ceramides by qRT-PCR. Obese Zucker rats were perfused with myriocin (an inhibitor of de novo synthesis of ceramides) in ICV for 21 days. Insulin sensitivity and glucose tolerance tests are performed. At the end of treatment, they receive an ICV injection of insulin, insulin sensitivity and ceramide levels are quantified in the hypothalamus. Islets of Langerhans are isolated for insulin secretion tests.We have demonstrated that palmitate is able to induce insulin resistance in the hypothalamic GT1-7, which is accompanied by an accumulation of ceramides. In the presence of myriocin, ceramides are no longer accumulated and the insulin resistance induced by palmitate is counteract. Using an inhibitor of PKCζ and an adenovirus encoding a dominant-negative of PKCζ, we have shown that palmitate is no longer able to induce insulin resistance despite the presence of an accumulation of ceramides. In the obese Zucker rat, we have demonstrated an accumulation of hypothalamic ceramides which is counteract by myriocin. This is associated with an improvement in insulin sensitivity in the hypothalamus. Interestingly, these animals improve their glucose tolerance which is associated with an increase in parasympathetic tone leading to an increase in insulin secretion. Islets of Langerhans isolated from these rats have increased secretory capacity when treated with myriocin.In conclusion, our study reveals that hypothalamic lipotoxicity is associated with an accumulation of ceramides in this structure, responsible for the installation of insulin resistance. These results also highlight the key role of ceramide metabolism at the hypothalamus level in the deregulation of nervous control of obesity-induced carbohydrate homeostasis

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第12816号 / 論医博第2078号 / 新制||医||1004(附属図書館) / 31303 / 京都大学大学院医学研究科医学専攻 / (主査)教授 岩井 一宏, 教授 長田 重一, 教授 川口 義弥 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DGAM

Résumé : Le syndrome des ovaires polykystiques (SOPK) affecte 6-10% des femmes en âge de procréer et est la principale cause d’infertilité anovulatoire. Cette condition est principalement caractérisée par une hyperandrogénie provenant des ovaires et des glandes surrénales. De plus en plus d’études, à la fois in vivo et in vitro, indiquent qu’une surexposition ovarienne en gras, de même que les mécanismes lipotoxiques subséquents pourraient causer l’hyperandrogénie chez ces femmes. Ainsi, cette étude vise à 1) évaluer l’implication des gras et de l’inflammation folliculaire dans la production des androgènes ovariens par une étude de corrélation; et 2) comparer les niveaux folliculaires de gras, métabolites lipidiques et marqueurs inflammatoires entre les femmes SOPK et non-SOPK. Cette étude transversale a recruté 80 femmes en cours de fécondation in vitro. Treize étaient SOPK, 58 étaient non-SOPK et 9 avaient un diagnostic incertain. Les participantes au projet avaient un âge moyen de 33 ± 4 ans. Tout groupe confondus, les niveaux folliculaires de testostérone corrélaient avec les gras (r=0,381; P=0,001; indépendamment de l’IL-6), les acylcarnitines (r≥0,255; tout P=0,008; non indépendamment des gras) et l’IL-6 (r=0,300; P=0,009; indépendamment des gras). De plus, les niveaux folliculaires de gras corrélaient avec les acylcarnitines (r≥0,594; tout P<0,001). Lorsque comparées aux femmes non-SOPK, les femmes SOPK étaient plus obèses (BMI: 31,2 vs. 25,1 kg/m2; P=0,009) et avaient des niveaux folliculaires plus élevés de testostérone (12,9 vs. 0,29 nM; P=0,001), de gras (P=0,001), d’acylcarnitines (tout P=0,001) et du marqueur inflammatoire IL-6 (13,0 vs. 8.6 pg/mL; P=0,018), le tout indépendamment de l’IMC. Les résultats suggèrent qu’une exposition intra-ovarienne en gras pourrait contribuer à une augmentation de la production des androgènes. Les mécanismes pourraient inclure une β-oxydation insuffisante, illustré par des acylcarnitines élevés, menant à l’accumulation de métabolites lipidiques toxiques, et une inflammation ovarienne, possiblement suite à une infiltration de macrophages. Ces deux mécanismes semblent être indépendants. De plus, l’environnement ovarien des femmes SOPK est caractérisé par une élévation des gras, de métabolites lipidiques et de marqueurs inflammatoires. Il peut donc être proposer que l’hyperandrogénie caractéristique du SOPK soit causée en partie par la lipotoxicité. // Abstract : Polycystic ovary syndrome (PCOS) affects 6-10% of the women of childbearing age and is the main cause of anovulatory infertility. It is mainly characterised by hyperandrogenism that can originate from the adrenal gland and the ovaries. A growing number of evidences, either in vivo or in vitro, points toward an overexposition to fat and lipotoxic mechanisms (lipid induced cellular toxicity) as the cause of PCOS hyperandrogenesis. Therefore, we aimed to: 1) evaluate the implication of follicular fluid (FF) levels of fat and inflammation markers in the ovarian production of androgens through a correlation analysis; and 2) compare FF levels of lipids, lipid metabolite levels and inflammation markers between PCOS and non-PCOS women. This cross-sectional controlled study was performed with 80 women undergoing an IVF procedure. Among them, 13 were PCOS, 58 were non-PCOS and 9 had an uncertain diagnosis. Participants were aged 33 ± 4 years old and had an average body mass index (BMI) of 25.7 ± 6.2. When analysing all women, follicular levels of testosterone correlated significantly with fat (NEFA + triglycerides) (r=0.381; P=0.001; independently of l’IL-6), acylcarnitines (r≥0.255; all P=0.008; not independently of fat) and l’IL-6 (r=0.300; P=0.009; independently of fat). Moreover, follicular levels of fat significantly correlated with acylcarnitines (r≥0.594; all P<0.001). When compared to non-PCOS women, PCOS women were significantly more obese (BMI: 31.2 vs. 25.1 kg/m2, P=0.009) and had significantly higher follicular levels of testosterone (12.9 vs. 0.29 nM, P=0.001), fat (P=0.001), acylcarnitines (all P=0.001) and inflammatory marker IL-6 (13.0 vs. 8.6 pg/mL, P=0.018), everything independently of BMI. Our results suggest that intra-ovarian exposure to fat may be responsible for the increased production of androgens. Mechanisms are likely to include an insufficient β-oxidation, leading to the accumulation of toxic lipid metabolites, and ovarian inflammation, possibly through macrophage infiltration. Both these mechanisms seem independent of one another. Also, intra-ovarian environment of PCOS women are characterized by increased levels of fat, acylcarnitines and inflammatory marker. It can thus be proposed that lipotoxic mechanisms are responsible for the increased production of androgen that is characteristic of PCOS women.

Prevalence of type 2 diabetes mellitus (T2DM) is still rising and even so in the juvenile population. Obesity is highly associated with increased risk for developing T2DM. The development has been related to elevated fasting concentrations of the pancreatic islet hormones insulin and glucagon as well as to an increase in plasma lipids that occurs during obesity. Specifically, research has indicated that chronic exposure to high levels of saturated free fatty acids cause dysfunction in islet alpha- and beta-cells. Fatty acids can affect islet cells by various mechanisms one of which is the G-protein coupled receptor FFAR1/GPR40. The role of the receptor in the effects of fatty acids on pancreatic islet-cell function is not clear. The aim of this thesis was to clarify the role of FFAR1 in how fatty acids, and more specifically the long-chain saturated fatty acid palmitate, affect insulin and glucagon secretion. In children and adolescents with obesity elevated fasting levels of insulin and glucagon were positively correlated with lipid parameters. Specifically, plasma triglycerides and free fatty acids were positively correlated with insulin and glucagon at fasting as well as with visceral adipose tissue volume. Elevated glucagon levels at fasting were associated with worsening of glucose tolerance in the same population. In in vitro studies of isolated human islets palmitate stimulated basal insulin and glucagon secretion as well as mitochondrial respiration at fasting glucose levels. The effect was mediated by FFAR1 and fatty acid beta-oxidation. At higher glucose concentrations the receptor was involved in the potentiation of insulin secretion from isolated human islets and insulin-secreting MIN6 cells. Furthermore, we found that the effects of palmitate on hormone secretion were associated with enhanced mitochondrial respiration mediated by FFAR1 Gαq signaling and PKC activity as well as increased intracellular metabolism induced by the fatty acid. When islets were exposed to palmitate for long time periods and in the presence of FFAR1 antagonist, normalized insulin and glucagon secretion during culture and insulin response to glucose after culture were observed. In MIN6 cells chronic palmitate treatment increased mitochondrial uncoupling irrespective of FFAR1 involvement. However, FFAR1 antagonism during palmitate exposure resulted in elevated respiration and reduced apoptosis. In conclusion, children and adolescents with obesity have elevated fasting concentrations of insulin and glucagon that correlate with free fatty acids and fatty acid sources. High glucagon levels are linked to worsening of glucose tolerance in these subjects. In vitro the combination or synergy of FFAR1 activation and intracellular metabolism caused by palmitate is decisive for both the short-term enhancement effects and the negative chronic effects on insulin and glucagon secretion.

Résumé : Une dysrégulation de la lipolyse des tissus adipeux peut conduire à une surexposition des tissus non-adipeux aux acides gras non-estérifiés (AGNE), qui peut mener à un certain degré de lipotoxicité dans ces tissus. La lipotoxicité constitue, par ailleurs, l’une des causes majeures du développement de la résistance à l’insuline et du diabète de type 2. En plus de ses fonctions glucorégulatrices, l’insuline a pour fonction d’inhiber la lipolyse et donc de diminuer les niveaux d’AGNE en circulation, prévenant ainsi la lipotoxicité. Il n’y a pas d’étalon d’or pour mesurer la sensibilité de la lipolyse à l’insuline. Le clamp euglycémique hyperinsulinémique constitue la méthode étalon d’or pour évaluer la sensibilité du glucose à l’insuline mais il est aussi utilisé pour mesurer la suppression de la lipolyse par l’insuline. Par contre, cette méthode est couteuse et laborieuse, et ne peut pas s’appliquer à de grandes populations. Il existe aussi des indices pour estimer la fonction antilipolytique de l’insuline dérivés de l’hyperglycémie provoquée par voie orale (HGPO), un test moins dispendieux et plus simple à effectuer à grande échelle. Cette étude vise donc à : 1) Étudier la relation entre les indices de suppressibilité des AGNE par l’insuline dérivés du clamp et ceux dérivés de l’HGPO; et 2) Déterminer laquelle de ces mesures corrèle le mieux avec les facteurs connus comme étant reliés à la dysfonction adipeuse : paramètres anthropométriques et indices de dysfonction métabolique. Les résultats montrent que dans le groupe de sujets étudiés (n=29 femmes, 15 témoins saines et 14 femmes avec résistance à l’insuline car atteintes du syndrome des ovaires polykystiques), certains indices de sensibilité à l’insuline pour la lipolyse dérivés de l’HGPO corrèlent bien avec ceux dérivés du clamp euglycémique hyperinsulinémique. Parmi ces indices, celui qui corrèle le mieux avec les indices du clamp et les paramètres anthropométriques et de dysfonction adipeuse est le T50[indice inférieur AGNE] (temps nécessaire pour diminuer de 50% le taux de base – à jeun – des AGNE). Nos résultats suggèrent donc que l’HGPO, facile à réaliser, peut être utilisée pour évaluer la sensibilité de la lipolyse à l’insuline. Nous pensons que la lipo-résistance à l’insuline peut être facilement quantifiée en clinique humaine. / Abstract : It has been shown that a dysfunctional regulation of adipose-tissue lipolysis could conduct to non-adipose tissues overexpos ure to non exterified fatty acids (NEFA), leading to lipotoxicity. Lipotoxicity is considered as a key factor in the development of insulin resistance and type 2 diabetes. Insulin regulates glucose metabolism but also NEFA storage and release. To our knowledge, there is no gold standard for evaluating insulin sensitivity for lipolysis. The gold standard to measure insulin sensitivity for glucose is the euglycemic-hyperinsulinemic clamp. This method is simple to interpret because it achieves static levels of metabolic parameters at the end of each step of the clamp. The major limit of the clamp is that it is time-consuming, expensive and cannot be used on large population. On the other hand, the oral glucose tolerance test (OGTT) consists in a dynamic test also used to estimate insulin mediated glucose disappearance after ingestion of 75 g of glucose. Since the OGTT is easier to use, less expensive and can be suggested in large cohort studies, its potential use has been suggested to estimate insulin sensitivity for lipolysis, as well. T his work is the first to validate the use of simple indices derived from OGTT to estimate insulin sensitivity for lipolysis against the euglycemic clamp and adipose-tissue dysfunction in women. The results of this study clearly show in a group of 29 women (15 normal and 14 with polycystic ovary syndrome, who are used to increase the range of insulin resistance) that T50[subscript NEFA] (time to suppress 50% of NEFA baseline levels) during OGTT is the best index associated with glucose insulin clamp indices and clinical markers related to adipose tissue dysfunction and metabolic parameters. T50[subscript NEFA] (OGTT) was also better associated with central adiposity and metabolic parameters than clamp-derived indices. Since the OGTT is much easier to perform and is less expensive than the clamp technique, the use of OGTT to calculate T50[subscript NEFA] seems to be a valid method to assess antilipolytic action of insulin in large cohorts.

La stéatose hépatique non-alcoolique consiste en une accumulation de lipides dans le cytoplasme des hépatocytes. Longtemps considérée comme une pathologie bénigne, elle peut être à l’origine du développement d’un stade plus sévère : la stéatohépatite non alcoolique (NASH). La NASH s’accompagne de lésions sévères du foie liées à la genèse d’un stress oxydant, d’une inflammation et de la mort cellulaire. Le rôle de la mitochondrie est au centre de cette maladie, bien que les connaissances sur la dysfonction mitochondriale et ses conséquences sur l’apoptose soient encore insuffisantes. En effet, la mitochondrie est responsable de la dégradation des lipides par -oxydation et elle agit comme un centre intégrateur des signaux apoptotiques en déclenchant une perméabilisation des membranes mitochondriales (PMM) aboutissant à la libération de facteurs apoptogènes. Ce processus est considéré comme le point de non-retour de la voie mitochondriale de l’apoptose. Nos travaux ont porté sur la compréhension des mécanismes moléculaires liant l’apoptose hépatocytaire mitochondriale et la stéatose. La combinaison de quatre modèles expérimentaux de stéatose (biopsies de patients, mitochondries isolées de souris obèses ob/ob ou recevant un régime hypercalorique, et lignées cellulaires) a permis de montrer, dans le foie stéatosique, une sensibilité accrue à l’induction de la PMM et une augmentation de la perméabilité de VDAC (voltage-dependent anion channel), protéine formant un canal dans la membrane externe mitochondriale. Ces observations sont associées à une diminution de la phosphorylation de VDAC sur un résidu thréonine et sa perte d’interaction avec la protéine anti-apoptotique Bcl-XL et la kinase GSK3, révélant ainsi une nouvelle voie de signalisation par les lipides. Cette découverte s’est notamment appuyée sur l’utilisation de tests fonctionnels en mitochondries isolées que nous avions développés et validés dans plusieurs études aux stratégies expérimentales variées. En conclusion, notre étude permet de mieux comprendre la fragilité mitochondriale lipo-induite, stade précédant l’apoptose hépatocytaire, et ouvre des perspectives à visée biomédicale. / Non-alcoholic steatosis is a liver disease characterized by lipid accumulation in the cytoplasm of hepatocytes. For a long time, it has been considered as a benign condition. Now it is known that it can precede the development of a severe stage, non-alcoholic steatohepatitis (NASH). NASH is accompanied by severe dammages of the liver linked to the genesis of oxidative stress, inflammation and cell death. Mitochondrion is a central player of this disease; however, the knowledge of mitochondrial dysfunction and its consequences on apoptosis is still insufficient. Indeed, mitochondria are responsible for lipid degradation by -oxidation. Mitochondria act as a central integrator of apoptotic signals by triggering the mitochondrial membrane permeabilization (MMP) leading to the release of apoptogenic factors. This process is considered as the point of no return of the mitochondrial pathway of apoptosis. We aimed to better understand the molecular mechanisms linking mitochondrial liver apoptosis and steatosis. Combination of four experimental models of steatosis (human biopsies, isolated mitochondria from ob/ob obese mice, high fat diet-fed mice or hepatic cell lines) displayed, in steatotic livers, increased sensitivity to MMP induction and permeability of VDAC (Voltage dependent anion channel), a protein which forms a channel in the outer mitochondrial membrane. These findings are associated with the hypo-phosphorylation of VDAC on a threonine residue and the loss of its interaction with the anti-apoptotic Bcl-XL and GSK3 kinase, thus revealing a new lipid-induced signaling pathway. Our work is based on the use of functional assays on isolated mitochondria that we have developed and validated in several studies involving various strategies. To conclude, our study increases the knowledge on the lipid-induced mitochondrial weakness preceding hepatic apoptosis and opens perspectives in biomedical applications

An important mechanism involved in the pathogenesis of type 2 diabetes is elevation of plasma free fatty acids which induce insulin resistance and may impair both β-cell function and mass (β-cell lipotoxicity). The objective of my thesis was to investigate the role of oxidative stress in β-cell lipotoxicity, using in vivo, ex vivo, and in vitro models. I used in vivo models of 48h i.v. oleate or olive oil infusion in Wistar rats followed by hyperglycemic clamps, or islet secretion studies ex vivo, and in vitro models of 48h exposure to oleate in isolated islets. My first study showed that 48h oleate infusion decreased the insulin response to a hyperglycemic clamp, an effect prevented by coinfusion of the antioxidants N-acetylcysteine and taurine. Similar to the findings in vivo, 48h infusion of oleate decreased glucose stimulated insulin secretion (GSIS) ex vivo, and induced oxidative stress in isolated islets, effects prevented by coinfusion of the antioxidants N-acetylcysteine, taurine, or tempol. Islets exposed to oleate or palmitate showed a decreased insulin response to high glucose and increased levels of oxidative stress, effects prevented by taurine. Therefore, my data are the first demonstration that oxidative stress plays a role in the decrease in β-cell secretory function induced by prolonged exposure to FFA, in vitro and in vivo. My second study addressed downstream effects of oxidative stress involving inflammation. A 48h infusion of oleate or olive oil decreased β-cell function during a hyperglycemic clamp, an effect prevented by coinfusion of the IKKβ inhibitor salicylate. GSIS in isolated islets was impaired by olive oil or oleate and restored by salicylate. These results suggest a potential role for both oxidative stress and inflammation in lipid-induced β-cell dysfunction. My third study addressed downstream effects of oxidative stress involving β-cell insulin signalling. A 48h infusion of oleate or olive oil decreased β-cell function during a hyperglycemic clamp, an effect prevented by coinfusion of the tyrosine phosphatase inhibitor bisperoxovanadate. GSIS in isolated islets was impaired by olive oil or oleate and restored by bisperoxovanadate, suggesting a role of FFA in decreasing β-cell function by induction of β-cell insulin resistance.