Accuracy of bioimpedance equations for measuring body composition in a cohort of 2134 patients with obesity.

INTRODUCTION: Measuring body composition is an important issue to phenotype patients with obesity and to follow the nutritional care efficiency. Bioelectrical Impedance Analysis (BIA) is a simple and rapid technique. However, validity of BIA in patients with obesity remains controversial. Thus, we aimed to evaluate the validity of several BIA equations to assess body composition in a large cohort of patients with obesity by using dual X ray absorptiometry (DXA) as reference. METHODS: Seven BIA equations have been retrospectively applied on electrical data measured by BIA in patients with obesity with BMI equal or higher than 30 kg/m2 and results were compared to DXA-derived fat mass (FM) and fat-free mass (FFM). BIA and DXA were done the same day after an overnight fasting. Results were compared with Bland-Altman method and Pearson correlation. We also calculated the accuracy defined as the percentage of patients with DXA-BIA difference within ± 10% of DXA measures for FFM and FM. RESULTS: Data from 2134 patients with class I and II obesity (ob1/2, n = 1452, 47.4 ± 14.2 y; 35.0 ± 2.7 kg.m-2) and class III obesity (ob3, n = 682, 48.2 ± 13.9 y; 44.1 ± 3.5 kg.m-2) were analyzed. The best results to evaluate FFM both in ob1/2 and ob3 groups were obtained with Roubenoff's equation: Bland Altman bias at -1.96 and -0.82 kg, Pearson correlation r at 0.93 and 0.87, accuracy at 75.7% and 83.3%, respectively. However, limits of agreements at 95% were high: [-9.42; 5.49 kg] and [-8.16; 6.52 kg]. For FM evaluation, Roubenoff's equation also showed best results for ob1/2 group (bias at -1.17 kg; correlation r at 0.89 and accuracy at 79.1%) but not for ob3 group. In this latter group, Deurenberg's equation exhibited the best results (bias at 2.09 kg; correlation r at 0.81 and accuracy at 76.8%). However, limits of agreements remained high. CONCLUSION: In patients with obesity, Roubenoff BIA equation should be recommended to assess fat free mass, even if limits of agreements remain high.

Gut microbiota depletion affects nutritional and behavioral responses to activity-based anorexia model in a sex-dependent manner.

BACKGROUND & AIMS: In the last decade, the role of the microbiota-gut-brain axis in eating behavior and anxiety-depressive disorders has gained increasing attention. Although a gut microbiota dysbiosis has been reported in anorectic patients, its pathophysiological role remains poorly understood. Thus, we aimed to characterize the potential role of gut microbiota by evaluating the effects of its depletion in the Activity-Based Anorexia (ABA) mouse model both in male and female mice. METHODS: Male and female C57Bl/6 mice were submitted (ABA group) or not (CT group) to the ABA protocol, which combines access to a running wheel with a progressive limited food access. Gut microbiota was previously depleted or not by a cocktail of antibiotics (ATB) delivered by oral gavages. We monitored body composition, anxiety-like behavior, leptin and adiponectin plasma levels, hypothalamic and hippocampal neuropeptides mRNA levels, as well as dopamine (DRD) and serotonin (5HT1 and 4) receptors mRNA expression. RESULTS: In response to the ABA model, the body weight loss was less pronounced in ATB-treated ABA compared to untreated ABA, while food intake remained unaffected by ATB treatment. ATB-treated ABA exhibited increased fat mass and decreased lean mass compared to untreated ABA both in male and female mice, whereas but plasma adipokine concentrations were affected in a sex-dependent manner. Only male ABA mice showed a reduced anticipatory physical activity in response to ATB treatment. Similarly, anxiety-like behavior was mainly affected in ATB-treated ABA male mice compared to ATB-treated ABA female mice, which was associated with male-specific alterations of hypothalamic CRH mRNA and hippocampal DRD and 5-HT1A mRNA levels. CONCLUSIONS: Our study provides evidence that ATB-induced gut microbiota depletion triggers alterations of nutritional and behavioral responses to the activity-based anorexia model in a sex-dependent manner.

Gut microbiota alteration in a mouse model of Anorexia Nervosa.

BACKGROUND & AIMS: Anorexia Nervosa is a severe disease depending on both biological, psychological and environmental factors. The gut microbiota has recently been proposed as one of the biological factors potentially involved in the onset or maintenance of Anorexia Nervosa. To unravel the potential role of the gut microbiota in this disease, we characterized the dysbiosis occurring in a mouse model of Anorexia and correlated bacteria level changes with different physiological parameters such as body weight, food intake or levels of hypothalamic neuropeptides. METHODS: We used the Activity-Based Anorexia (ABA) mouse model, which combines food restriction and physical activity, and which mimics core features of Anorexia Nervosa. We characterized the gut microbiota alteration in ABA mice by combining 16S rRNA gene sequencing and quantitative PCR analyses of targeted genera or species. RESULTS: We identified 68 amplicon sequence variants (ASVs) with decreased levels and 8 ASVs with increased levels in the cecal content of ABA mice compared to control mice. We observed in particular in ABA mice increases in the abundance of Clostridium cocleatum and several Lactobacillus species and a decrease in the abundance of Burkholderiales compared to control mice. Interestingly, we show that most of the observed gut microbiota alterations are due to food restriction and are not affected by physical activity. In addition, we identified several bacterial groups that correlate with mice body weight, food intake, lean and fat masses as well as with hypothalamic mRNA levels of NPY (Neuropeptide Y) and POMC (Pro-opiomelanocortin). CONCLUSIONS: Our study provides a comprehensive characterization of the gut microbiota dysbiosis occurring in the Activity-Based Anorexia mouse model. These data constitute a valuable resource to further decipher the role of the gut microbiota in the different facets of anorexia pathophysiology, such as functional gastrointestinal disorders, appetite regulation and mood disorders.

Influence of Glutamine and Branched-Chain Amino Acids Supplementation during Refeeding in Activity-Based Anorectic Mice.

BACKGROUND: Optimizing the refeeding of patients with anorexia nervosa remains important to limit somatic complications of malnutrition, as well as to avoid disease relapses by targeting persistent mood and intestinal disorders. We aimed to evaluate the effects of glutamine (Gln) and branched-chain amino acids (BCAA) supplementation during refeeding in activity-based anorectic (ABA) mice. METHOD: Male C57Bl/6 mice were randomized in control and ABA groups. Once ABA-induced malnutrition was established, mice were progressively refed or not. Refed mice had free access to drinking water supplemented or not with 1% Gln or 2.5% BCAA for 10 days. RESULTS: A progressive refeeding was associated with a partial restoration of body weight and lean mass, while a fat mass rebound was observed. In addition, refeeding restored glucose and leptin. Gln did not affect these parameters, while BCAA tended to increase body weight, fat mass, and glycaemia. In the colon, refeeding improved total protein synthesis and restored the LC3II/LC3I ratio, a marker of autophagy. Gln supplementation enhanced colonic protein synthesis, which was associated with an increased p-p70S6kinase/p70S6kinase ratio, whereas these effects were blunted by BCCA supplementation. CONCLUSIONS: In ABA mice, Gln and BCAA supplementations during a progressive refeeding fail to restore body weight and lean mass. However, Gln supplementation improves total colonic protein synthesis conversely to BCAA. Further studies are needed to decipher the underlying mechanisms involved in these opposite results.

Stress-induced intestinal barrier dysfunction is exacerbated during diet-induced obesity.

Obesity and irritable bowel syndrome (IBS) are two major public health issues. Interestingly previous data report a marked increase of IBS prevalence in morbid obese subjects compared with non-obese subjects but underlying mechanisms remain unknown. Obesity and IBS share common intestinal pathophysiological mechanisms such as gut dysbiosis, intestinal hyperpermeability and low-grade inflammatory response. We thus aimed to evaluate the link between obesity and IBS using different animal models. Male C57Bl/6 mice received high fat diet (HFD) for 12 weeks and were then submitted to water avoidance stress (WAS). In response to WAS, HFD mice exhibited higher intestinal permeability and plasma corticosterone concentration than non-obese mice. We were not able to reproduce a similar response both in ob/ob mice and in leptin-treated non-obese mice. In addition, metformin, a hypoglycemic agent, limited fasting glycaemia both in unstressed and WAS diet-induced obese mice but only partially restored colonic permeability in unstressed HFD mice. Metformin failed to improve intestinal permeability in WAS HFD mice. Finally, cecal microbiota transplantation from HFD mice in antibiotics-treated recipient mice did not reproduce the effects observed in stressed HFD mice. In conclusion, stress induced a more marked intestinal barrier dysfunction in diet-induced obese mice compared with non-obese mice that seems to be independent of leptin, glycaemia and gut microbiota. These data should be further confirmed and the role of the dietary composition should be studied.

Glutamine, but not Branched-Chain Amino Acids, Restores Intestinal Barrier Function during Activity-Based Anorexia.

BACKGROUND: During activity-based anorexia (ABA) in mice, enhanced paracellular permeability and reduced protein synthesis have been shown in the colon while the gut-brain axis has received increasing attention in the regulation of intestinal and mood disorders that frequently occur during anorexia nervosa, a severe eating disorder for which there is no specific treatment. In the present study, we assessed the effects of oral glutamine (Gln) or branched-chain amino acids (BCAA) supplementation during ABA to target intestinal functions, body composition and feeding behavior. METHODS: C57BL/6 male mice were randomized in Control (CTRL) and ABA groups. After ABA induction, mice received, or not, either 1% Gln or 2.5% BCAA (Leu, Ile, Val) for one week in drinking water. RESULTS: Neither Gln nor BCAA supplementation affected body weight and body composition, while only Gln supplementation slightly increased food intake. ABA mice exhibited increased paracellular permeability and reduced protein synthesis in the colonic mucosa. Oral Gln restored colonic paracellular permeability and protein synthesis and increased the mucin-2 mRNA level, whereas BCAA did not affect colonic parameters. CONCLUSION: In conclusion, oral Gln specifically improves colonic response during ABA. These data should be further confirmed in AN patients.

Colonic Mucosal Proteome Signature Reveals Reduced Energy Metabolism and Protein Synthesis but Activated Autophagy during Anorexia-Induced Malnutrition in Mice.

Anorexia nervosa is an eating disorder often associated with intestinal disorders. To explore the underlying mechanisms of these disorders, the colonic proteome was evaluated during activity-based anorexia. Female C57Bl/6 mice were randomized into three groups: Control, Limited Food Access (LFA) and Activity-Based Anorexia (ABA). LFA and ABA mice had a progressive limited access to food but only ABA mice had access to an activity wheel. On colonic mucosal protein extracts, a 2D PAGE-based comparative proteomic analysis was then performed and differentially expressed proteins were identified by LC-ESI-MS/MS. Twenty-seven nonredundant proteins that were differentially expressed between Control, LFA, and ABA groups were identified. ABA mice exhibited alteration of several mitochondrial proteins involved in energy metabolism such as dihydrolipoyl dehydrogenase and 3-mercaptopyruvate sulfurtransferase. In addition, a downregulation of mammalian target of rapamycin (mTOR) pathway was observed leading, on the one hand, to the inhibition of protein synthesis, evaluated by puromycin incorporation and mediated by the increased phosphorylation of eukaryotic elongation factor 2, and on the other hand, to the activation of autophagy, assessed by the increase of the marker of autophagy, form LC3-phosphatidylethanolamine conjugate/Cytosolic form of Microtubule-associated protein 1A/1B light chain 3 (LC3II/LC3I) ratio. Colonic mucosal proteome is altered during ABA suggesting a downregulation of energy metabolism. A decrease of protein synthesis and an activation of autophagy were also observed mediated by mTOR pathway.

Simultaneous characterization of metabolic, cardiac, vascular and renal phenotypes of lean and obese SHHF rats.

Individuals with metabolic syndrome (MetS) are prone to develop heart failure (HF). However, the deleterious effects of MetS on the continuum of events leading to cardiac remodeling and subsequently to HF are not fully understood. This study characterized simultaneously MetS and cardiac, vascular and renal phenotypes in aging Spontaneously Hypertensive Heart Failure lean (SHHF(+/?) regrouping (+/+) and (+/cp) rats) and obese (SHHF(cp/cp), "cp" defective mutant allele of the leptin receptor gene) rats. We aimed to refine the milestones and their onset during the progression from MetS to HF in this experimental model. We found that SHHF(cp/cp )but not SHHF(+/?) rats developed dyslipidemia, as early as 1.5 months of age. This early alteration in the lipidic profile was detectable concomitantly to impaired renal function (polyuria, proteinuria but no glycosuria) and reduced carotid distensibility as compared to SHHF(+/?) rats. By 3 months of age SHHFcp/cp animals developed severe obesity associated with dislipidemia and hypertension defining the onset of MetS. From 6 months of age, SHHF(+/?) rats developed concentric left ventricular hypertrophy (LVH) while SHHF(cp/cp) rats developed eccentric LVH apparent from progressive dilation of the LV dimensions. By 14 months of age only SHHF(cp/cp) rats showed significantly higher central systolic blood pressure and a reduced ejection fraction resulting in systolic dysfunction as compared to SHHF(+/?). In summary, the metabolic and hemodynamic mechanisms participating in the faster decline of cardiac functions in SHHF(cp/cp) rats are established long before their physiological consequences are detectable. Our results suggest that the molecular mechanisms triggered within the first three months after birth of SHHF(cp/cp) rats should be targeted preferentially by therapeutic interventions in order to mitigate the later HF development.