The processes causing increased hepatic triglycerides (TGs) in mouse models of hepatic steatosis (HS) due to high fat diet (HFD)-induced obesity (DIO), EtOH consumption, or obesity mutations () are uncertain. This report summarizes two studies. Study 1 focused on regulation by five transcription factors (TFs) (NfKb, Srebp-lc, AMPK, PPARα, PPARγ) of seven, much-studied hepatic long-chain fatty acid (LCFA) transporters (FABPpm, CD36, FATPl, FATP2, FATP4, FATP5, & Caveolin-1 [CAV-1]), and expression of genes for enzymes of LCFA synthesis (SCD-1, FASN) in mice with HS from various causes. Study 2 examined the effects of spexin, a novel adipokine, on obesity, type 2 diabetes mellitus (T2DM), and HS in these mice. Study 1 showed that: (1) processes underlying HS differed in mice with normal leptin signaling (DIO, EtoH-fed) versus those without it (). Increased hepatocellular LCFA uptake was the principal cause of HS in the former, but increased hepatocellular LCFA synthesis predominated in the latter. (2) Expression of individual transporters was variable in the HS models studied, but strong correlations between TF expression and mean expression of four transporter genes across multiple HS models suggested regulatory interaction, and support the postulate that complexes of several different transporters mediate hepatic LCFA uptake. Study 2 indicated (1) that obese DIO mice often also have T2DM and/or nonalcoholic fatty liver disease (NAFLD); (2) confirmed that spexin treatment caused weight loss in DIO mice; (3) in DIO mice with T2DM, spexin also improved glucose tolerance, decreasing insulin resistance and HbAlc. Incubation with spexin directly inhibited LCFA uptake by hepatocytes isolated from DIO mice with HS/NAFLD by ≤70%. Spexin treatment in vivo for 4 weeks reduced hepatic lipids by 60%, and reduced serum alanine and aspartate aminotransferases. These studies in mice with DIO, T2DM, and HS/NAFLD suggest spexin may be an effective treatment for all three conditions.

ObjectiveThis study examined whether changes in adipocyte LCFA uptake kinetics explain the weight regain increasingly observed post bariatric surgery.DesignThree groups (10 patients each) were studied: patients who were not obese (NO: BMI 24.2±2.3 kg/m2); patients with obesity (O: BMI 49.8±11.9); and patients classified as super obese (SO: BMI 62.6±2.8). NO patients underwent omental & subcutaneous fat biopsies during clinically indicated abdominal surgeries; O were biopsied during bariatric surgery, and SO during both a sleeve gastrectomy and at another bariatric operation 16±2 months later, after losing 113±13 lbs. Adipocyte sizes & [3H]-LCFA uptake kinetics were determined in all biopsies.ResultsVmax for facilitated LCFA uptake by omental adipocytes increased exponentially from 5.1±0.95 to 21.3±3.20 to 68.7±9.45 pmol/sec/50,000 cells in NO, O, and SO patients, respectively, correlating with BMI (r = 0.99, p < 0.001). Subcutaneous results were virtually identical. By the 2nd operation, the mean BMI (SO patients) fell significantly (p<0.01) to 44.4±2.4 kg/m2, similar to the O group. However, Vmax (40.6±11.5) in this weight-reduced group remained ~2X that predicted from the BMI:Vmax regression among NO, O, & SO patients.ConclusionsFacilitated adipocyte LCFA uptake remains significantly up-regulated ≥1 year after bariatric surgery, possibly contributing to weight re-gain.