Abstract

BackgroundAlthough dietary ketogenic essential amino acid (KAA) content modifies accumulation of hepatic lipids, the molecular interactions between KAAs and lipid metabolism are yet to be fully elucidated.Methodology/Principal FindingsWe designed a diet with a high ratio (E/N) of essential amino acids (EAAs) to non-EAAs by partially replacing dietary protein with 5 major free KAAs (Leu, Ile, Val, Lys and Thr) without altering carbohydrate and fat content. This high-KAA diet was assessed for its preventive effects on diet-induced hepatic steatosis and whole-animal insulin resistance. C57B6 mice were fed with a high-fat diet, and hyperinsulinemic ob/ob mice were fed with a high-fat or high-sucrose diet. The high-KAA diet improved hepatic steatosis with decreased de novo lipogensis (DNL) fluxes as well as reduced expressions of lipogenic genes. In C57B6 mice, the high-KAA diet lowered postprandial insulin secretion and improved glucose tolerance, in association with restored expression of muscle insulin signaling proteins repressed by the high-fat diet. Lipotoxic metabolites and their synthetic fluxes were also evaluated with reference to insulin resistance. The high-KAA diet lowered muscle and liver ceramides, both by reducing dietary lipid incorporation into muscular ceramides and preventing incorporation of DNL-derived fatty acids into hepatic ceramides.ConclusionOur results indicate that dietary KAA intake improves hepatic steatosis and insulin resistance by modulating lipid synthetic pathways.

Highlights

  • Non-alcoholic fatty liver disease (NAFLD) caused by persistent hepatic steatosis affects up to one-third of the US population [1,2]

  • Our results indicate that dietary ketogenic essential amino acid (KAA) intake improves hepatic steatosis and insulin resistance by modulating lipid synthetic pathways

  • Because NAFLD is associated with hepatic insulin resistance and can further progress to non-alcoholic steatohepatitis (NASH), there is a critical need to elucidate the molecular pathogenesis of NAFLD so that nutritional strategies can be developed for its prevention and treatment [1,3]

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Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) caused by persistent hepatic steatosis affects up to one-third of the US population [1,2]. Because NAFLD is associated with hepatic insulin resistance and can further progress to non-alcoholic steatohepatitis (NASH), there is a critical need to elucidate the molecular pathogenesis of NAFLD so that nutritional strategies can be developed for its prevention and treatment [1,3]. Previous studies have shown that dietary withdrawal of the ketogenic amino acid (KAA) lysine or threonine induces severe hepatic steatosis in rodents [6,7]. Continuous infusion of amino acids has been shown to induce insulin resistance in human muscle through activation of the mTOR pathway [12]. The combination of dietary branched-chain amino acids (BCAAs) and fat over-intake was shown to induce insulin resistance in rats [13]. Dietary ketogenic essential amino acid (KAA) content modifies accumulation of hepatic lipids, the molecular interactions between KAAs and lipid metabolism are yet to be fully elucidated

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