Impaired hepatic mitochondrial capacity in nonalcoholic steatohepatitis associated with type 2 diabetes
S Gancheva, S Kahl, D Pesta, L Mastrototaro… - Diabetes …, 2022 - Am Diabetes Assoc
S Gancheva, S Kahl, D Pesta, L Mastrototaro, B Dewidar, K Strassburger, E Sabah…
Diabetes Care, 2022•Am Diabetes AssocOBJECTIVE Individuals with type 2 diabetes are at higher risk of progression of nonalcoholic
fatty liver (steatosis) to steatohepatitis (NASH), fibrosis, and cirrhosis. The hepatic
metabolism of obese individuals adapts by upregulation of mitochondrial capacity, which
may be lost during the progression of steatosis. However, the role of type 2 diabetes with
regard to hepatic mitochondrial function in NASH remains unclear. RESEARCH DESIGN
AND METHODS We therefore examined obese individuals with histologically proven NASH …
fatty liver (steatosis) to steatohepatitis (NASH), fibrosis, and cirrhosis. The hepatic
metabolism of obese individuals adapts by upregulation of mitochondrial capacity, which
may be lost during the progression of steatosis. However, the role of type 2 diabetes with
regard to hepatic mitochondrial function in NASH remains unclear. RESEARCH DESIGN
AND METHODS We therefore examined obese individuals with histologically proven NASH …
OBJECTIVE
Individuals with type 2 diabetes are at higher risk of progression of nonalcoholic fatty liver (steatosis) to steatohepatitis (NASH), fibrosis, and cirrhosis. The hepatic metabolism of obese individuals adapts by upregulation of mitochondrial capacity, which may be lost during the progression of steatosis. However, the role of type 2 diabetes with regard to hepatic mitochondrial function in NASH remains unclear.
RESEARCH DESIGN AND METHODS
We therefore examined obese individuals with histologically proven NASH without (OBE) (n = 30; BMI 52 ± 9 kg/m2) or with type 2 diabetes (T2D) (n = 15; 51 ± 7 kg/m2) as well as healthy individuals without liver disease (CON) (n = 14; 25 ± 2 kg/m2). Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamps with d-[6,6-2H2]glucose. Liver biopsies were used for assessing mitochondrial capacity by high-resolution respirometry and protein expression.
RESULTS
T2D and OBE had comparable hepatic fat content, lobular inflammation, and fibrosis. Oxidative capacity in liver tissue normalized for citrate synthase activity was 59% greater in OBE than in CON, whereas T2D presented with 33% lower complex II–linked oxidative capacity than OBE and higher H2O2 production than CON. Interestingly, those with NASH and hepatic fibrosis score ≥1 had lower oxidative capacity and antioxidant defense than those without fibrosis.
CONCLUSIONS
Loss of hepatic mitochondrial adaptation characterizes NASH and type 2 diabetes or hepatic fibrosis and may thereby favor accelerated disease progression.
Am Diabetes Assoc