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Hunger and appetite are associated with fluctuations in glucose levels through mechanisms that remain incompletely understood. Hunger elicits epigastric sensations (“hunger pain”) that coincide with rhythmic gastric contractions, which intensify during hypoglycemia. These observations led to the glucostatic hypothesis, which proposed that glucose availability and utilization regulate food intake. Subsequent studies demonstrated that dynamic changes in blood glucose levels precede meal initiation and influence feeding behavior. Together, these findings provided early evidence for a physiological link between glycemia and appetite regulation.

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The conjugation-resistant bile acid norUDCA cures liver fibrosis but impairs systemic energy metabolism

Ioannis Evangelakos, Esther Verkade, Julia K. Rohde, Alex Zaufel, ... Joerg Heeren

The conjugation-resistant bile acid norUDCA cures liver fibrosis but impairs systemic energy metabolism

Bile acids (BAs) play an important role in systemic metabolic improvements following bariatric surgery. In this study, we found that orally administered norursodeoxycholic acid (norUDCA), a conjugation-resistant C23 derivative of naturally occurring UDCA, accumulated in peripheral organs including heart and brown adipose tissue (BAT). Moreover, norUDCA decreased systemic levels of endogenous conjugated BAs, while increasing unconjugated BAs. Notably, in addition to beneficial effects in a cholestatic liver disease model, norUDCA also lowered plasma glucose and fat mass in mice, suggesting that this BA derivative could be repurposed for treating obesity-associated cardiometabolic diseases. Metabolic energy expenditure studies, however, revealed that norUDCA-treated mice have impaired BAT capacity and developed intolerance to cold stress, a phenotype exacerbated in mice lacking adipose ATGL-dependent lipolysis. Transcriptomic and metabolic analyses demonstrated tissue remodeling in heart and BAT that involved pronounced changes in energy substrate utilization, including enhanced cardiac glucose uptake and higher ketone body utilization in BAT. Importantly, co-administration of a low-carb diet prevented cold stress-induced metabolic deficits. Mechanistic studies in human engineered heart tissue indicated that norUDCA compromised contractile function. In conclusion, these data suggest that conjugation-resistant BA derivatives like norUDCA impair myocardial and BAT energetics by altering glucose, lipid, and energy metabolism, particularly during catabolic cold stress conditions.

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The conjugation-resistant bile acid norUDCA cures liver fibrosis but impairs systemic energy metabolism

Ioannis Evangelakos, Esther Verkade, Julia K. Rohde, Alex Zaufel, ... Joerg Heeren

The conjugation-resistant bile acid norUDCA cures liver fibrosis but impairs systemic energy metabolism

Bile acids (BAs) play an important role in systemic metabolic improvements following bariatric surgery. In this study, we found that orally administered norursodeoxycholic acid (norUDCA), a conjugation-resistant C23 derivative of naturally occurring UDCA, accumulated in peripheral organs including heart and brown adipose tissue (BAT). Moreover, norUDCA decreased systemic levels of endogenous conjugated BAs, while increasing unconjugated BAs. Notably, in addition to beneficial effects in a cholestatic liver disease model, norUDCA also lowered plasma glucose and fat mass in mice, suggesting that this BA derivative could be repurposed for treating obesity-associated cardiometabolic diseases. Metabolic energy expenditure studies, however, revealed that norUDCA-treated mice have impaired BAT capacity and developed intolerance to cold stress, a phenotype exacerbated in mice lacking adipose ATGL-dependent lipolysis. Transcriptomic and metabolic analyses demonstrated tissue remodeling in heart and BAT that involved pronounced changes in energy substrate utilization, including enhanced cardiac glucose uptake and higher ketone body utilization in BAT. Importantly, co-administration of a low-carb diet prevented cold stress-induced metabolic deficits. Mechanistic studies in human engineered heart tissue indicated that norUDCA compromised contractile function. In conclusion, these data suggest that conjugation-resistant BA derivatives like norUDCA impair myocardial and BAT energetics by altering glucose, lipid, and energy metabolism, particularly during catabolic cold stress conditions.

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13th
Helmholtz Diabetes Conference 

Munich, 21-23. Sep 2026                                                                                                                             

2024 impact factor: 6.6

You are what you eat

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