Research Article Details

Article ID: A35316
PMID: 21119028
Source: Am J Physiol Endocrinol Metab
Title: Metabolic pathways promoting intrahepatic fatty acid accumulation in methionine and choline deficiency: implications for the pathogenesis of steatohepatitis.
Abstract: The pathological mechanisms that distinguish simple steatosis from steatohepatitis (or NASH, with consequent risk of cirrhosis and hepatocellular cancer) remain incompletely defined. Whereas both a methionine- and choline-deficient diet (MCDD) and a choline-deficient diet (CDD) lead to hepatic triglyceride accumulation, MCDD alone is associated with hepatic insulin resistance and inflammation (steatohepatitis). We used metabolic tracer techniques, including stable isotope ([&#185;&#179;C&#8324;]palmitate) dilution and mass isotopomer distribution analysis (MIDA) of [&#185;&#179;C&#8322;]acetate, to define differences in intrahepatic fatty acid metabolism that could explain the contrasting effect of MCDD and CDD on NASH in C57Bl6 mice. Compared with control-supplemented (CS) diet, liver triglyceride pool sizes were similarly elevated in CDD and MCDD groups (24.37 &#177; 2.4, 45.94 &#177; 3.9, and 43.30 &#177; 3.5 &#956;mol/liver for CS, CDD, and MCDD, respectively), but intrahepatic neutrophil infiltration and plasma alanine aminotransferase (31 &#177; 3, 48 &#177; 4, 231 &#177; 79 U/l, P < 0.05) were elevated only in MCDD mice. However, despite loss of peripheral fat in MCDD mice, neither the rate of appearance of palmitate (27.2 &#177; 3.5, 26.3 &#177; 2.3, and 28.3 &#177; 3.5 &#956;mol&#183;kg&#8315;&#185;&#183;min&#8315;&#185;) nor the contribution of circulating fatty acids to the liver triglyceride pool differed between groups. Unlike CDD, MCDD had a defect in hepatic triglyceride export that was confirmed using intravenous tyloxapol (142 &#177; 21, 122 &#177; 15, and 80 &#177; 7 mg&#183;kg&#8315;&#185;&#183;h&#8315;&#185;, P < 0.05). Moreover, hepatic de novo lipogenesis was significantly elevated in the MCDD group only (1.4 &#177; 0.3, 2.3 &#177; 0.4, and 3.4 &#177; 0.4 &#956;mol/day, P < 0.01). These findings suggest that important alterations in hepatic fatty acid metabolism may promote the development of steatohepatitis. Similar mechanisms may predispose to hepatocyte damage in human NASH.
DOI: 10.1152/ajpendo.00331.2010