Publications by authors named "Yen Koay"

Article Synopsis
  • * A study was conducted using mass spectrometry to analyze the differences in metabolome (metabolism) and proteome (proteins) between healthy left and right ventricles, revealing significant metabolic changes.
  • * In advanced heart conditions like dilated and ischemic cardiomyopathy, the distinct metabolic pathways between the ventricles become less pronounced, but the left ventricle shows more adverse changes related to heart failure.
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There is an unmet need for a biomarker of liver fat. We identified dimethylguanidino valeric acid (DMGV) as a circulating biomarker of liver fat. Here, we assess its two isoforms-symmetric (SDGV) and asymmetric (ADGV)-as biomarkers of steatosis.

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  • Pregnancy causes significant changes in a woman’s heart and vascular system, but some women can develop a heart condition called peripartum cardiomyopathy (PPCM) during or after pregnancy which can lead to heart failure.
  • A study used mass spectrometry to compare protein and metabolite profiles from heart tissue of patients with end-stage PPCM against those with dilated cardiomyopathy (DCM) and non-failing heart donors, aiming to understand the molecular differences.
  • Findings revealed two specific proteins (SBSPON and TNS3) were downregulated in PPCM, disrupting tissue remodeling, while certain metabolites showed abnormal levels indicating altered metabolic functions; both PPCM and DCM shared some inflammatory pathways but differed significantly in thyroid
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Article Synopsis
  • Metabolic inflexibility and substrate constraints in heart failure have been studied for years, but their exact role is still debated, which challenges traditional beliefs about how the heart uses energy.
  • The rise of SGLT2i therapy as a key treatment for heart failure is prompting researchers to re-examine metabolism as an important factor in heart health and a target for new therapies.
  • Advances in technologies like metabolomics and isotopic analysis, alongside discoveries in epigenetics and microbiome interactions, are expected to deepen our understanding of heart metabolism and inform the development of innovative treatment strategies.
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Heart failure (HF) with left ventricular diastolic dysfunction is a growing global concern. This study evaluated myocardial oxidized nicotinamide adenine dinucleotide (NAD) levels in human systolic and diastolic HF and in a murine model of HF with preserved ejection fraction, exploring NAD repletion as therapy. We quantified myocardial NAD and nicotinamide phosphoribosyltransferase levels, assessing restoration with nicotinamide riboside (NR).

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Article Synopsis
  • * Participants followed either a mostly plant diet (70% plant and 30% animal) or a balanced diet (50% plant and 50% animal) for 4 weeks, with specific foods provided.
  • * Results showed that those on the pro-vegetarian diet had lower blood pressure, cholesterol, and glucose, and overall better health, suggesting that a diet with more fruits and vegetables can help older adults feel healthier!
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Article Synopsis
  • The study compared cardiac metabolite and lipid usage between healthy individuals and those with heart failure with preserved ejection fraction (HFpEF).
  • Findings indicated that hearts with HFpEF use fatty acids less efficiently and that hemodynamic factors, like pulmonary pressures, impact lipid extraction.
  • Additionally, there were notable differences in energy substrate use based on sex, with variations observed between female and male hearts.
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Background: Heart failure with preserved ejection fraction (HFpEF) is a common but poorly understood form of heart failure, characterized by impaired diastolic function. It is highly heterogeneous with multiple comorbidities, including obesity and diabetes, making human studies difficult.

Methods: Metabolomic analyses in a mouse model of HFpEF showed that levels of indole-3-propionic acid (IPA), a metabolite produced by gut bacteria from tryptophan, were reduced in the plasma and heart tissue of HFpEF mice as compared with controls.

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The ability of ultraviolet radiation to suppress the immune system is thought to be central to both its beneficial (protection from autoimmunity) and detrimental (carcinogenic) effects. Previous work revealed a key role for lipids particularly platelet-activating factor and sphingosine-1-phosphate in mediating UV-induced immune suppression. We therefore hypothesized that there may be other UV-induced lipids that have immune regulatory roles.

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Article Synopsis
  • The liver, skeletal muscle, and adipose tissue play crucial roles in insulin regulation and glucose balance, with varied insulin resistance (IR) phenotypes linked to diabetes risk in individuals.
  • This study examined metabolic profiles in a group of obese individuals without diabetes to find specific metabolites and lipids associated with different IR types in muscle, liver, and fat tissues.
  • Results showed unique plasma signatures for distinct IR phenotypes and differentiated between types of abdominal fat, offering potential for more personalized treatments for those with obesity.
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Diet, exercise and the gut microbiome are all factors recognised to be significant contributors to cardiometabolic health. However, diet and exercise interventions to modify the gut microbiota to improve health are limited by poor understanding of the interactions between them. In this pilot study, we explored diet-exercise-microbiome dynamics in bodybuilders as they represent a distinctive group that typically employ well-defined dietary strategies and exercise regimes to alter their body composition.

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Aims: To identify biomarkers of cardiomyopathy in patients with type 2 diabetes mellitus (T2DM) using cardiovascular magnetic resonance (CMR) and to identify associations between functional status, metabolomic profile and myocardial fibrosis.

Methods: In this prospective case control study, patients (n = 49) with T2DM without significant coronary artery disease, and matched controls (n = 18) underwent CMR, cardiopulmonary exercise testing, and plasma metabolomic analyses.

Results: Patients with T2DM (n = 49, median [interquartile range] age 61 [56-63] years, 61% male, diabetes duration 11 [7-20] years), historical HbA1c 7.

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Asymmetric dimethylguanidino valeric acid (ADGV), asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are three arginine metabolites which have utility in the assessment of cardiovascular disease, renal disease and non-alcoholic fatty liver disease (NAFLD). Translation of these research metabolomic markers into routine clinical use requires the development of robust assays with appropriately assessed preanalytical variables and traceable clinical reference intervals. A hydrophilic interaction liquid chromatography (HILIC) tandem mass spectrometry (LC-MS/MS) method for the simultaneous quantification of ADGV, ADMA and SDMA was developed.

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Skeletal muscle weakness is linked to many adverse health outcomes. Current research to identify new drugs has often been inconclusive due to lack of adequate cellular models. We previously developed a scalable monolayer system to differentiate human embryonic stem cells (hESCs) into mature skeletal muscle cells (SkMCs) within 26 days without cell sorting or genetic manipulation.

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The incidence of type 2 diabetes (T2D) is increasing globally, with long-term implications for human health and longevity. Heart disease is the leading cause of death in T2D patients, who display an elevated risk of an acute cardiovascular event and worse outcomes following such an insult. The underlying mechanisms that predispose the diabetic heart to this poor prognosis remain to be defined.

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Aims: Sleep apnoea and congestive heart failure (CHF) commonly co-exist, but their interaction is unclear. Metabolomics may clarify their interaction and relationships to outcome.

Methods And Results: We assayed 372 circulating metabolites and lipids in 1919 and 1524 participants of the Framingham Heart Study (FHS) (mean age 54 ± 10 years, 53% women) and Women's Health Initiative (WHI) (mean age 67 ± 7 years), respectively.

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Liquid chromatography-mass spectrometry-based metabolomics studies are increasingly applied to large population cohorts, which run for several weeks or even years in data acquisition. This inevitably introduces unwanted intra- and inter-batch variations over time that can overshadow true biological signals and thus hinder potential biological discoveries. To date, normalisation approaches have struggled to mitigate the variability introduced by technical factors whilst preserving biological variance, especially for protracted acquisitions.

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Reduced protein intake, through dilution with carbohydrate, extends lifespan and improves mid-life metabolic health in animal models. However, with transition to industrialised food systems, reduced dietary protein is associated with poor health outcomes in humans. Here we systematically interrogate the impact of carbohydrate quality in diets with varying carbohydrate and protein content.

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Despite effective prevention programs targeting cardiovascular risk factors, coronary artery disease (CAD) remains the leading cause of death. Novel biomarkers are needed for improved risk stratification and primary prevention. To assess for independent associations between plasma metabolites and specific CAD plaque phenotypes we performed liquid chromatography mass-spectrometry on plasma from 1002 patients in the BioHEART-CT study.

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Key Points: Acute nicotinamide riboside (NR) supplementation does not alter substrate metabolism at rest, during or in recovery from endurance exercise. NR does not alter NAD -sensitive signalling pathways in human skeletal muscle. NR supplementation and acute exercise influence the NAD metabolome.

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The gut microbiota is reported to modulate the immune response in hepatocellular carcinoma (HCC). Here, we employ metagenomic and metabolomic studies to characterise gut microbiota in patients with non-alcoholic fatty liver disease (NAFLD) related cirrhosis, with or without HCC, and evaluate its effect on the peripheral immune response in an ex vivo model. We find that dysbiosis characterises the microbiota of patients with NAFLD-cirrhosis, with compositional and functional shifts occurring with HCC development.

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There is an unmet need and urgency to find safe and effective anti-obesity interventions. Our recent study in mice fed on obesogenic diet found that treatment with the alcohol aversive drug disulfiram reduced feeding efficiency and led to a decrease in body weight and an increase in energy expenditure. The intervention with disulfiram improved glucose tolerance and insulin sensitivity, and mitigated metabolic dysfunctions in various organs through poorly defined mechanisms.

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Article Synopsis
  • Dimethylguanidino valeric acid (DMGV) is linked to multiple health issues such as fatty liver disease, heart disease, and diabetes, and its levels relate to diet, particularly sugary drinks and low fruit/vegetable intake.
  • In a validation study involving the Framingham Heart Study, it was found that diets high in sugar significantly increased DMGV levels, while high-fat diets affected its metabolism differently by producing both DMGV and citrulline.
  • Interestingly, switching to high-fiber-resistant starch diets raised another marker (ADMA) without affecting DMGV levels, suggesting that dietary choices significantly influence DMGV and insulin resistance markers in both humans and mice.
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Poor access to human left ventricular myocardium is a significant limitation in the study of heart failure (HF). Here, we utilise a carefully procured large human heart biobank of cryopreserved left ventricular myocardium to obtain direct molecular insights into ischaemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM), the most common causes of HF worldwide. We perform unbiased, deep proteomic and metabolomic analyses of 51 left ventricular (LV) samples from 44 cryopreserved human ICM and DCM hearts, compared to age-, gender-, and BMI-matched, histopathologically normal, donor controls.

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Obesity is a top public health concern, and a molecule that safely treats obesity is urgently needed. Disulfiram (known commercially as Antabuse), an FDA-approved treatment for chronic alcohol addiction, exhibits anti-inflammatory properties and helps protect against certain types of cancer. Here, we show that in mice disulfiram treatment prevented body weight gain and abrogated the adverse impact of an obesogenic diet on insulin responsiveness while mitigating liver steatosis and pancreatic islet hypertrophy.

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