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      Fasting hepatic de novo lipogenesis is not reliably assessed using circulating fatty acid markers

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          ABSTRACT

          Background

          Observational studies often infer hepatic de novo lipogenesis (DNL) by measuring circulating fatty acid (FA) markers; however, it remains to be elucidated whether these markers accurately reflect hepatic DNL.

          Objectives

          We investigated associations between fasting hepatic DNL and proposed FA markers of DNL in subjects consuming their habitual diet.

          Methods

          Fasting hepatic DNL was assessed using 2H 2O (deuterated water) in 149 nondiabetic men and women and measuring the synthesis of very low-density lipoprotein triglyceride (VLDL-TG) palmitate. FA markers of blood lipid fractions were determined by gas chromatography.

          Results

          Neither the lipogenic index (16:0/18:2n–6) nor the SCD index (16:1n–7/16:0) in VLDL-TG was associated with isotopically assessed DNL ( r = 0.13, P = 0.1 and r = −0.08, P = 0.35, respectively). The relative abundances (mol%) of 14:0, 16:0, and 18:0 in VLDL-TG were weakly ( r ≤ 0.35) associated with DNL, whereas the abundances of 16:1n–7, 18:1n–7, and 18:1n–9 were not associated. When the cohort was split by median DNL, only the abundances of 14:0 and 18:0 in VLDL-TG could discriminate between subjects having high (11.5%) and low (3.8%) fasting hepatic DNL. Based on a subgroup, FA markers in total plasma TG, plasma cholesteryl esters, plasma phospholipids, and red blood cell phospholipids were generally not associated with DNL.

          Conclusions

          The usefulness of circulating FAs as markers of hepatic DNL in healthy individuals consuming their habitual diet is limited due to their inability to discriminate clearly between individuals with low and high fasting hepatic DNL.

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          Most cited references37

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          Contribution of hepatic de novo lipogenesis and reesterification of plasma non esterified fatty acids to plasma triglyceride synthesis during non-alcoholic fatty liver disease.

          Non-alcoholic fatty liver disease (NAFLD) is frequently observed in insulin-resistant subjects and can lead to liver fibrosis and cirrhosis. The abnormalities of lipid metabolism behind this development of excess hepatic TG stores are poorly understood. To clarify these mechanisms we measured triglyceride secretion rate and the contributions of hepatic lipogenesis and reesterification of non-esterified fatty acids (NEFA) to this secretion in healthy subjects and in patients with clear evidence of NAFLD. All subjects were studied in the post-absorptive state. Hepatic lipogenesis was measured with deuterated water. NEFA turnover rate, triglyceride secretion rate and the contribution of NEFA reesterification to this secretion were determined with [1-(13)C] palmitate infusion. NAFLD patients had higher NEFA concentrations (p<0.05) but normal NEFA turnover rates (5.23 +/- 0.80 vs 5.91 +/- 0.97 micromol.kg(-1).min(-1) in control subjects, ns). Despite a trend for higher plasma triglyceride levels in patients (p<0.10), triglyceride turnover rates were not increased (0.11 +/- 0.01 micromol.kg(-1).min(-1) in patients vs 0.14 +/- 0.01 in controls, ns). However the contribution of hepatic lipogenesis to triglyceride secretion was largely increased in patients (14.9 +/- 2.7 vs 4.6 +/- 1.1% p<0.01) while that of NEFA reesterification was reduced (25.1 +/- 2.9 vs 52.8 +/- 6.2% p<0.01). Enhanced lipogenesis appears as a major abnormality of hepatic fatty metabolism in subjects with NAFLD. Therapeutic measures aimed at decreasing hepatic lipogenesis would therefore be the most appropriate in order to reduce hepatic TG synthesis and content in such patients.
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            Human fatty acid synthesis is stimulated by a eucaloric low fat, high carbohydrate diet.

            A new experimental approach was used to determine whether a eucaloric, low fat, high carbohydrate diet increases fatty acid synthesis. Normally volunteers consumed low fat liquid formula diets (10% of calories as fat and 75% as glucose polymers, n = 7) or high fat diets (40% of calories as fat and 45% as glucose polymers, n = 3) for 25 d. The fatty acid composition of each diet was matched to the composition of each subject's adipose tissue and compared with the composition of VLDL triglyceride. By day 10, VLDL triglyceride was markedly enriched in palmitate and deficient in linoleate in all subjects on the low fat diet. Newly synthesized fatty acids accounted for 44 +/- 10% of the VLDL triglyceride. Mass isotopomer distribution analysis of palmitate labeled with intravenously infused 13C-acetate confirmed that increased palmitate synthesis was the likely cause for the accumulation of triglyceride palmitate and "dilution" of linoleate. In contrast, there was minimal fatty acid synthesis on the high diet. Thus, the dietary substitution of carbohydrate for fat stimulated fatty acid synthesis and the plasma accumulation of palmitate-enriched, linoleate-deficient triglyceride. Such changes could have adverse effects on the cardiovascular system.
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              Regulation of hepatic de novo lipogenesis in humans.

              The enzymatic pathway for synthesis of fatty acids from acetyl-coenzyme A, or de novo lipogenesis (DNL), is present in human liver and, to a lesser extent, in adipose tissue. Although the molecular and enzymatic regulation of the components for DNL are well characterized, the quantitative importance of the assembled pathway and its physiologic functions have remained uncertain. We review methods that have been used for measuring DNL in vivo, their limitations and the conclusions based on them. Two new methods for direct measurement of DNL in humans are discussed-mass isotopomer distribution analysis (MIDA), a mass spectrometric technique based on combinatorial probabilities, and 2H2O incorporation. Recent findings with these methods in a variety of dietary and hormonal settings are reviewed. In particular, we focus on the question of whether or not surplus carbohydrate energy is converted to fat by the liver in humans. A somewhat surprising model of the response to carbohydrate over-feeding emerges from these studies, with a number of implications for metabolic regulation in health and disease. We close by speculating on potential functions of DNL in physiology and pathophysiology if storage of surplus carbohydrate energy is not an important function of DNL. The availability of techniques for quantifying DNL in vivo should make it possible to resolve these uncertainties regarding its functions and regulation in humans.
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                Author and article information

                Journal
                Am J Clin Nutr
                Am. J. Clin. Nutr
                ajcn
                The American Journal of Clinical Nutrition
                Oxford University Press
                0002-9165
                1938-3207
                February 2019
                05 February 2019
                05 February 2019
                : 109
                : 2
                : 260-268
                Affiliations
                [1 ]Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
                [2 ]Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
                [3 ]Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden
                [4 ]Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
                [5 ]Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, United Kingdom
                Author notes
                Address correspondence to LH (e-mail: leanne.hodson@ 123456ocdem.ox.ac.uk ).
                Author information
                http://orcid.org/0000-0002-2648-6526
                Article
                nqy304
                10.1093/ajcn/nqy304
                6367991
                30721918
                0d1742ff-bba9-4895-a644-79e19649b542
                Copyright © American Society for Nutrition.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 August 2018
                : 03 October 2018
                Page count
                Pages: 9
                Funding
                Funded by: British Heart Foundation 10.13039/501100000274
                Award ID: FS/11/18/28633
                Award ID: FS/15/56/31645
                Award ID: PG/09/003
                Funded by: Biotechnology and Biological Sciences Research Council 10.13039/501100000268
                Award ID: BB/N005600/1
                Award ID: BB/N015665/1
                Categories
                Original Research Communications

                Nutrition & Dietetics
                de novo lipogenesis,fatty acids,metabolism,human,triglycerides,lipogenic index,scd,palmitoleic acid

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