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| Name | Class |
|---|---|
| Danish Council for Independent Research | OTHER |
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The investigators propose that the sensitivity to glucagon in hepatic lipid metabolism is impaired in subjects with non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH). Moreover, they propose a dys-coordinated, reduced glucagon sensitivity in hepatic lipid metabolism and endogen glucose production in patients with NAFLD and NASH compared with healthy subjects and patients with simple steatosis. This reduced sensitivity may be the basis of a more severe dyslipidemia and the production of increased concentrations of toxic lipid intermediates in plasma and muscle tissue. The study will include healthy subjects with obesity and subjects with simple steatosis and NASH, tested at basal glucagonemia and moderate hyperglucagonemia to mimic insulin resistant levels during simultaneous somatostatin infusion and replacement doses of insulin and growth hormone. Infusion of palmitate, VLDL-triglyceride and glucose tracers in combination with indirect calorimetry as well as skeletal and adipose tissue biopsies will be employed to assess free fatty acid and VLDL-triglyceride kinetics (turnover, and oxidation) and hepatic fatty acid-esterification.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy overweight subjects | Active Comparator | MR spectroscopy verified no steatosis |
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| Subjects with non-alcoholic fatty liver disease | Active Comparator | MR spectroscopy verified steatosis, no steatohepatitis on liver biopsy |
|
| Subjects with non-alcoholic steatohepatitis | Active Comparator | MR spectroscopy verified steatosis, steatohepatitis on liver biopsy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| glucagon | Other | Infusion of low dose glucagon and high dose glucagon during simultaneous somatostatin infusion and replacement doses of insulin and growth hormone. Infusion of palmitate, VLDL-triglyceride and glucose tracers. |
| Measure | Description | Time Frame |
|---|---|---|
| VLDL-triglyceride kinetics (appearance rate (µmol/min) and oxidation (µmol/min)) | Ex vivo labeled VLDL [14C]-triolein tracer technique. Oxidation is measured by specific activity in exhaled air. | 30 minutes at steady-state |
| Endogen glucose production (mmol/kg/min) | 3-3H glucose tracer technique | 30 minutes at steady-state |
| Measure | Description | Time Frame |
|---|---|---|
| LPL-activity (lipoprotein lipase, µmol/h) | Measured by the 'glycerol-stabilized substrate' method | 30 minutes at steady-state |
| VLDL-triglyceride-fatty acid uptake in muscle and fatty tissue (%) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sara Heebøll | Aarhus University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aarhus University Hospital | Aarhus | Danmark | 8200 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39291967 | Derived | Heeboll S, Wegener G, Gronbaek H, Nielsen S. Comparable glucagon-stimulated amino acid suppression in individuals with and without hepatic steatosis or steatohepatitis. Am J Physiol Endocrinol Metab. 2024 Dec 1;327(6):E679-E685. doi: 10.1152/ajpendo.00187.2024. Epub 2024 Sep 18. | |
| 36001750 | Derived | Heeboll S, Risikesan J, Ringgaard S, Kumarathas I, Sandahl TD, Gronbaek H, Sondergaard E, Nielsen S. Impaired Glucagon-Mediated Suppression of VLDL-Triglyceride Secretion in Individuals With Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD). Diabetes. 2022 Nov 1;71(11):2402-2411. doi: 10.2337/db22-0313. |
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| ID | Term |
|---|---|
| D065626 | Non-alcoholic Fatty Liver Disease |
| D044882 | Glucose Metabolism Disorders |
| ID | Term |
|---|---|
| D005234 | Fatty Liver |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D008659 | Metabolic Diseases |
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| ID | Term |
|---|---|
| D005934 | Glucagon |
| ID | Term |
|---|---|
| D052336 | Proglucagon |
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
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Measurement of fatty acid concentration and specific activity in muscle- and adipose tissue biopsies
| 30 minutes at steady-state |
| Expression of relevant genes in tissues | PCR in muscle- and adipose tissue biopsies | 30 minutes at steady-state |
| Fatty acid turnover (µmol/min) | Infusion af [9,10-3H] palmitate and measurement of specific activity in muscle and adipose tissue | 30 minutesat steady-state |
| D009750 |
| Nutritional and Metabolic Diseases |
| D006730 |
| Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |