Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver

The earliest defect in developing type 2 diabetes is insulin resistance, characterized by decreased glucose transport and metabolism in muscle and adipocytes. The glucose transporter GLUT4 mediates insulin-stimulated glucose uptake in adipocytes and muscle by rapidly moving from intracellular storage sites to the plasma membrane. In insulin-resistant states such as obesity and type 2 diabetes, GLUT4 expression is decreased in adipose tissue but preserved in muscle. Because skeletal muscle is the main site of insulin-stimulated glucose uptake, the role of adipose tissue GLUT4 downregulation in the pathogenesis of insulin resistance and diabetes is unclear. To determine the role of adipose GLUT4 in glucose homeostasis, we used Cre/loxP DNA recombination to generate mice with adipose-selective reduction of GLUT4 (G4A-/-). Here we show that these mice have normal growth and adipose mass despite markedly impaired insulin-stimulated glucose uptake in adipocytes. Although GLUT4 expression is preserved in muscle, these mice develop insulin resistance in muscle and liver, manifested by decreased biological responses and impaired activation of phosphoinositide-3-OH kinase. G4A-/- mice develop glucose intolerance and hyperinsulinaemia. Thus, downregulation of GLUT4 and glucose transport selectively in adipose tissue can cause insulin resistance and thereby increase the risk of developing diabetes.     

Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes

In obesity and type 2 diabetes, expression of the GLUT4 glucose transporter is decreased selectively in adipocytes. Adipose-specific Glut4 (also known as Slc2a4) knockout (adipose-Glut4(-/-)) mice show insulin resistance secondarily in muscle and liver. Here we show, using DNA arrays, that expression of retinol binding protein-4 (RBP4) is elevated in adipose tissue of adipose-Glut4(-/-) mice. We show that serum RBP4 levels are elevated in insulin-resistant mice and humans with obesity and type 2 diabetes. RBP4 levels are normalized by rosiglitazone, an insulin-sensitizing drug. Transgenic overexpression of human RBP4 or injection of recombinant RBP4 in normal mice causes insulin resistance. Conversely, genetic deletion of Rbp4 enhances insulin sensitivity. Fenretinide, a synthetic retinoid that increases urinary excretion of RBP4, normalizes serum RBP4 levels and improves insulin resistance and glucose intolerance in mice with obesity induced by a high-fat diet. Increasing serum RBP4 induces hepatic expression of the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) and impairs insulin signalling in muscle. Thus, RBP4 is an adipocyte-derived 'signal' that may contribute to the pathogenesis of type 2 diabetes. Lowering RBP4 could be a new strategy for treating type 2 diabetes.     

不同时间电刺激对C2C12肌管糖代谢的影响及其机制研究

以小鼠骨骼肌母细胞（C2C12）肌管为研究对象,测定不同时间电刺激对其AMPK、HK-Ⅱ、GS-1基因表达、以及GLUT4基因及蛋白表达等糖转运和代谢相关指标的变化,探讨不同收缩时间对骨骼肌细胞糖代谢的影响,以及这种影响的机制. 骨骼肌细胞的肌糖原消耗随刺激时间延长而增加,为了保证骨骼肌细胞糖消耗的需要,通过AMPK信号通路的调控,其膜对胞外糖转运的能力会随收缩时间增加而增强;骨骼肌细胞内糖原合成酶的合成则由于肌糖原储量的持续下降而增加.     

AMPK-α表达变化在糖尿病患者骨骼肌脂肪酸代谢和胰岛素抵抗中的作用

目的探讨腺苷酸活化蛋白激酶α(AMPK-α)表达变化在糖尿病患者骨骼肌脂肪酸代谢和胰岛素抵抗中的作用.方法在骨科行髋关节和下肢手术的患者中选取Ⅱ型糖尿病病程≤5 a的患者20例为研究组,另选取行骨科手术的非糖尿病患者20例为对照组.抽取空腹静脉血检测血生化指标;骨科术中留取骨骼肌组织,测定骨骼肌TG、长链脂酰辅酶A(LCACo A)水平;RT-PCR法检测骨骼肌AMPK-α1,AMPK-α2 mRNA水平;Western blotting法检测骨骼肌AMPK-α1,AMPK-α2和磷酸化AMPK-α蛋白水平.结果研究组空腹血糖、糖化血红蛋白、胰岛素、TG、FFA水平均明显高于对照组,ISI明显低于对照组,差异具有统计学意义(P0.05);研究组骨骼肌TG,LCACo A含量均明显高于对照组,差异具有统计学意义(P0.05).研究组和对照组AMPK-α1 mRNA拷贝数之间差异无统计学意义(P0.05);研究组AMPK-α1 mRNA拷贝数明显低于对照组,差异具有统计学意义(P0.05).研究组和对照组AMPK-α1蛋白表达量之间差异无统计学意义(P0.05);研究组AMPK-α2和磷酸化AMPK-α蛋白水平明显低于对照组,差异具有统计学意义(P0.05).结论Ⅱ型糖尿病患者易发生脂肪酸代谢异常和胰岛素抵抗,AMPK-α2表达和AMPK-α活性改变在骨骼肌脂质堆积和胰岛素抵抗中发挥关键作用.     

New drug targets for type 2 diabetes and the metabolic syndrome.

An insidious increase in features of the 'metabolic syndrome' - obesity, insulin resistance and dyslipidaemia -- has conspired to produce a worldwide epidemic of type 2 insulin-resistant diabetes mellitus. Most current therapies for this disease were developed in the absence of defined molecular targets or an understanding of disease pathogenesis. Emerging knowledge of key pathogenic mechanisms, such as the impairment of glucose-stimulated insulin secretion and the role of 'lipotoxicity' as a probable cause of hepatic and muscle resistance to insulin's effects on glucose metabolism, has led to a host of new molecular drug targets. Several have been validated through genetic engineering in mice or the preliminary use of lead compounds and therapeutic agents in animals and humans.     

Molecular cloning and characterization of an insulin-regulatable glucose transporter

A major mechanism by which insulin stimulates glucose transport in muscle and fat is the translocation of glucose transporters from an intracellular membrane pool to the cell surface. The existence of a distinct insulin-regulatable glucose transporter was suggested by the poor cross-reactivity between antibodies specific for either the HepG2 or rat brain glucose transporters and the rat adipocyte glucose transporter. More direct evidence was provided by the production of a monoclonal antibody (mAb 1F8) specific for the rat adipocyte glucose transporter that immunolabels a species of relative molecular mass 43,000 (43K) present only in tissues that exhibit insulin-dependent glucose transport, suggesting that this protein may be encoded by a different gene from the previously described mammalian glucose transporters. This antibody has been used to immunoprecipitate a 43K protein that was photoaffinity-labelled with cytochalasin B in a glucose displaceable way, and to immunolabel a protein in the plasma membrane of rat adipocytes, whose concentration was increased at least fivefold after cellular insulin exposure. Here we describe the cloning and sequencing of cDNAs isolated from both rat adipocyte and heart libraries that encode a protein recognized by mAb 1F8, and which has 65% sequence identity to the human HepG2 glucose transporter. This cDNA hybridizes to an mRNA present only in skeletal muscle, heart and adipose tissue. Our data indicate that this cDNA encodes a membrane protein with the characteristics of the translocatable glucose transporter expressed in insulin-responsive tissues.     

Effect of dehydroepiandrosterone on insulin action and development of insulin-induced resistance in C2C12 muscle cells

Dehydroepiandrosterone (DHEA), a precursor of androgens and estrogens, has been demonstrated to have effect of preventing insulin resistance and development of diabetes mellitus. Administration of testosterone appears to induce a marked insulin resistance. How these two hormones affect insulin resistance through regulation of sensitivity of tissues to insulin deserves further studies. Here, the effects of DHEA and testosterone on response to insulin in C2C12 muscle cells are analyzed. After 24 h of DHEA (10-6 mol/L) treatment, C2C12 cells showed an increased insulin- stimulated glucose uptake and enhanced activities of glycogen synthase (GS), phosphofructokinase (PFK) and pyruvate dehydrogenase (PDH), whereas testosterone gave the opposite effects. Incubation of C2C12 cells with high-dose insulin (5×10-7 mol/L) for 24 hours decreased their sensitivity to insulin and led to a state of resistance as assessed on insulin-stimulated glucose uptake and activities of GS, PFK and PDH. Addition of DHEA to insulin-resistant C2C12 cells could reverse the response of these cells to high-dose insulin, but testosterone could further impair insulin sensitivity in insulin-resistant C2C12 cells. These results suggest that the two hormones may influence the development or inhibition of insulin-resistance in type 2 diabetes through regulating glucose uptake, glycogenesis and glycolysis to some extent.     

Exercise-induced BCL2-regulated autophagy is required for muscle glucose homeostasis

Exercise has beneficial effects on human health, including protection against metabolic disorders such as diabetes. However, the cellular mechanisms underlying these effects are incompletely understood. The lysosomal degradation pathway, autophagy, is an intracellular recycling system that functions during basal conditions in organelle and protein quality control. During stress, increased levels of autophagy permit cells to adapt to changing nutritional and energy demands through protein catabolism. Moreover, in animal models, autophagy protects against diseases such as cancer, neurodegenerative disorders, infections, inflammatory diseases, ageing and insulin resistance. Here we show that acute exercise induces autophagy in skeletal and cardiac muscle of fed mice. To investigate the role of exercise-mediated autophagy in vivo, we generated mutant mice that show normal levels of basal autophagy but are deficient in stimulus (exercise- or starvation)-induced autophagy. These mice (termed BCL2 AAA mice) contain knock-in mutations in BCL2 phosphorylation sites (Thr69Ala, Ser70Ala and Ser84Ala) that prevent stimulus-induced disruption of the BCL2-beclin-1 complex and autophagy activation. BCL2 AAA mice show decreased endurance and altered glucose metabolism during acute exercise, as well as impaired chronic exercise-mediated protection against high-fat-diet-induced glucose intolerance. Thus, exercise induces autophagy, BCL2 is a crucial regulator of exercise- (and starvation)-induced autophagy in vivo, and autophagy induction may contribute to the beneficial metabolic effects of exercise.     

Decreased expression of the insulin-responsive glucose transporter in diabetes and fasting

Cellular resistance to insulin caused by a reduction in insulin-mediated glucose uptake can be produced in rats by chemically inducing diabetes with streptozotocin and by fasting. Two glucose transporter isoforms are expressed in fat cells: (1) the insulin-responsive species which is found only in fat and muscle, and (2) a species corresponding to the erythrocyte/Hep G2/rat brain transporter. We show here that fat cells isolated from streptozotocin diabetic rats and from fasted rats show a significant (60-80%) decrease in the amount of immunologically detectable insulin-sensitive glucose transporter and no change in the level of the Hep G2/rat brain transporter. Administration of insulin and refeeding, respectively, result in a return of the insulin-sensitive glucose transporter to levels that are normal or slightly above normal. Thus, peripheral tissue insulin resistance could be due to the specific reduction in the amount of insulin-sensitive glucose transporter.     

Small molecule activators of SIRT1 as therapeutics for the treatment of type 2 diabetes

Calorie restriction extends lifespan and produces a metabolic profile desirable for treating diseases of ageing such as type 2 diabetes. SIRT1, an NAD+-dependent deacetylase, is a principal modulator of pathways downstream of calorie restriction that produce beneficial effects on glucose homeostasis and insulin sensitivity. Resveratrol, a polyphenolic SIRT1 activator, mimics the anti-ageing effects of calorie restriction in lower organisms and in mice fed a high-fat diet ameliorates insulin resistance, increases mitochondrial content, and prolongs survival. Here we describe the identification and characterization of small molecule activators of SIRT1 that are structurally unrelated to, and 1,000-fold more potent than, resveratrol. These compounds bind to the SIRT1 enzyme-peptide substrate complex at an allosteric site amino-terminal to the catalytic domain and lower the Michaelis constant for acetylated substrates. In diet-induced obese and genetically obese mice, these compounds improve insulin sensitivity, lower plasma glucose, and increase mitochondrial capacity. In Zucker fa/fa rats, hyperinsulinaemic-euglycaemic clamp studies demonstrate that SIRT1 activators improve whole-body glucose homeostasis and insulin sensitivity in adipose tissue, skeletal muscle and liver. Thus, SIRT1 activation is a promising new therapeutic approach for treating diseases of ageing such as type 2 diabetes.     

The lipid phosphatase SHIP2 controls insulin sensitivity

Insulin is the primary hormone involved in glucose homeostasis, and impairment of insulin action and/or secretion has a critical role in the pathogenesis of diabetes mellitus. Type-II SH2-domain-containing inositol 5-phosphatase, or 'SHIP2', is a member of the inositol polyphosphate 5-phosphatase family. In vitro studies have shown that SHIP2, in response to stimulation by numerous growth factors and insulin, is closely linked to signalling events mediated by both phosphoinositide-3-OH kinase and Ras/mitogen-activated protein kinase. Here we report the generation of mice lacking the SHIP2 gene. Loss of SHIP2 leads to increased sensitivity to insulin, which is characterized by severe neonatal hypoglycaemia, deregulated expression of the genes involved in gluconeogenesis, and perinatal death. Adult mice that are heterozygous for the SHIP2 mutation have increased glucose tolerance and insulin sensitivity associated with an increased recruitment of the GLUT4 glucose transporter and increased glycogen synthesis in skeletal muscles. Our results show that SHIP2 is a potent negative regulator of insulin signalling and insulin sensitivity in vivo.     

Cloning of adiponectin receptors that mediate antidiabetic metabolic effects

Adiponectin (also known as 30-kDa adipocyte complement-related protein; Acrp30) is a hormone secreted by adipocytes that acts as an antidiabetic and anti-atherogenic adipokine. Levels of adiponectin in the blood are decreased under conditions of obesity, insulin resistance and type 2 diabetes. Administration of adiponectin causes glucose-lowering effects and ameliorates insulin resistance in mice. Conversely, adiponectin-deficient mice exhibit insulin resistance and diabetes. This insulin-sensitizing effect of adiponectin seems to be mediated by an increase in fatty-acid oxidation through activation of AMP kinase and PPAR-alpha. Here we report the cloning of complementary DNAs encoding adiponectin receptors 1 and 2 (AdipoR1 and AdipoR2) by expression cloning. AdipoR1 is abundantly expressed in skeletal muscle, whereas AdipoR2 is predominantly expressed in the liver. These two adiponectin receptors are predicted to contain seven transmembrane domains, but to be structurally and functionally distinct from G-protein-coupled receptors. Expression of AdipoR1/R2 or suppression of AdipoR1/R2 expression by small-interfering RNA supports our conclusion that they serve as receptors for globular and full-length adiponectin, and that they mediate increased AMP kinase and PPAR-alpha ligand activities, as well as fatty-acid oxidation and glucose uptake by adiponectin.     

SIRT1与糖脂代谢及在运动医学领域的研究展望

SIRT1(silent mating type information regulation 2 homolog1),哺乳动物sir2同系物,一种NAD+依赖的组蛋白脱乙酰化酶。越来越多的证据表明SIRT1通过其脱乙酰化酶活性参与糖脂代谢,其对胰岛β细胞功能和胰岛素信号通路起着正性调节作用,对改善胰岛素的敏感性和维持糖脂代谢稳态具有重要作用。运动疗法是防治2型糖尿病、非酒精性脂肪肝和动脉粥样硬化等慢性疾病主要方法之一,但运动改善慢性疾病的机理还未完全阐明。已有研究表明运动训练能够诱导大鼠骨骼肌和心肌组织中SIRT1表达。运动改善慢性疾病机理是否与SIRT1有关尚不确定。在总结SIRT1与糖脂代谢关系的基础上,结合运动与SIRT1的研究现状,展望SIRT1在运动医学领域的研究前景。     

蝮蛇短尾亚种冬眠期血乳酸、血糖和糖原的初步研究

蝮蛇短尾亚种(Agistrodon blmhoffiibrericaudus stejneger,后文简称蝮蛇)是日本蝮蛇科的一个亚种,我们对处于冬眠期蝮蛇的一些生化指标进行了测定分析,以便为人工饲养蝮蛇和提取蛇毒提供科学依据,并且为进一步探讨蝮蛇亚种之间的亲缘关系提供一定的理论旁证.1 实验     

补糖与运动后糖原合成

论述了补糖时间对补糖数量及种类对运动员肝、肌糖原合成的影响，并对肌肉损伤与糖原合成、运动后补糖与运动能力的关系进行了讨论     

2型糖尿病伴随高脂血症大鼠模型的建立及二甲双胍的干预

目的研究5%蔗糖饮水和高脂饮食加链脲佐菌素诱导2型糖尿病伴随高脂血症大鼠模型的建立及二甲双胍的治疗作用。方法SD大鼠一次性腹腔注射30 mg/kg链脲佐菌素,给予高脂饮食和5%蔗糖水喂养68 d后进行糖耐量实验,采血检测空腹血糖、血脂、胰岛素、抗氧化水平。结果与对照组比较,模型大鼠空腹血糖、糖耐量试验2 h后血糖、糖化血红蛋白、血清胰岛素和胰岛素抵抗指数显著升高(P<0.05),胰岛素敏感指数显著降低(P<0.05),TG、TC和FFA含量明显升高(P<0.05),SOD活力明显降低(P<0.05),MDA含量显著增加(P<0.05);二甲双胍组胆固醇、游离脂肪酸、空腹血糖、糖耐量异常、糖化血红蛋白、血清胰岛素和胰岛素抵抗指数、MDA显著降低(P<0.05),胰岛素敏感指数和SOD活力显著提高(P<0.05)。结论5%蔗糖饮水能改善大鼠的厌食症状,加上链脲佐菌素的小剂量注射和高脂饮食,可成功复制2型糖尿病大鼠模型,伴随高脂血症和抗氧化损伤。二甲双胍具有降糖、降脂、抗氧化、改善胰岛素抵抗作用,可作为2型糖尿病伴随高脂血症大鼠模型研究的阳性治疗药物。     

Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis

The normal plasma protein serum amyloid P component (SAP) binds to fibrils in all types of amyloid deposits, and contributes to the pathogenesis of amyloidosis. In order to intervene in this process we have developed a drug, R-1-[6-[R-2-carboxy-pyrrolidin-1-yl]-6-oxo-hexanoyl]pyrrolidine-2-carboxylic acid, that is a competitive inhibitor of SAP binding to amyloid fibrils. This palindromic compound also crosslinks and dimerizes SAP molecules, leading to their very rapid clearance by the liver, and thus produces a marked depletion of circulating human SAP. This mechanism of drug action potently removes SAP from human amyloid deposits in the tissues and may provide a new therapeutic approach to both systemic amyloidosis and diseases associated with local amyloid, including Alzheimer's disease and type 2 diabetes.     

Mechanisms linking obesity to insulin resistance and type 2 diabetes

Obesity is associated with an increased risk of developing insulin resistance and type 2 diabetes. In obese individuals, adipose tissue releases increased amounts of non-esterified fatty acids, glycerol, hormones, pro-inflammatory cytokines and other factors that are involved in the development of insulin resistance. When insulin resistance is accompanied by dysfunction of pancreatic islet beta-cells - the cells that release insulin - failure to control blood glucose levels results. Abnormalities in beta-cell function are therefore critical in defining the risk and development of type 2 diabetes. This knowledge is fostering exploration of the molecular and genetic basis of the disease and new approaches to its treatment and prevention.