E-mail: Strippoli GF, Di Paolo S, Cincione R, Di Palma AM, Teutonico A, Grandaliano G, Schena FP, Gesualdo L: Clinical and therapeutic aspects of diabetic nephropathy. The https:// ensures that you are connecting to the There are several possible interpretations of these data. Search for other works by this author on: Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LCI, Hankins GDV, Clark SL: Diabetes. Smulders YM, van Eeden AE, Stehouwer CD, Weijers RN, Slaats EH, Silberbusch J: Can reduction in hypertriglyceridaemia slow progression of microalbuminuria in patients with non-insulin-dependent diabetes mellitus? Hoy AJ, et al. Eichmann TO, et al. Because sn-1,2-DAG was a known bioactive signaling lipid, a simple hypothesis impairment of insulin signaling by DAG activation of protein kinase C (PKC) isoforms was proposed, although the source of the DAGs remained unknown [30]. Gene Wiki entry for DGKA Gene Additional gene information for DGKA Gene HGNC (2849) TG/HDL ratio was calculated by the following formula: TG/HDL ratio = TG (mg/dl)/HDL (mg/dl). Copyright 19952022. Thyroid hormone receptor- gene knockout mice are protected from diet-induced hepatic insulin resistance. Significantly different in percent changes from the baseline to 6 months between the groups: A table elsewhere in this issue shows conventional and Systeme International (SI) units and conversion factors for many substances. Baker VL, Murai JT, Taylor RN: Downregulation of protein kinase C by phorbol ester increases expression of epidermal growth factor receptors in transformed trophoblasts and amplifies human chorionic gonadotropin production. Xia P, Inoguchi T, Kern TS, Engerman RL, Oates PJ, King GL: Characterization of the mechanism for the chronic activation of diacylglycerol-protein kinase C pathway in diabetes and hypergalactosemia. How stable is INSR inhibition by Thr1160 phosphorylation? Liver, muscle, and adipose tissue insulin action is directly related to intrahepatic triglyceride content in obese subjects. In the experiments reported here, we investigated the activities and protein concentrations of PKC , II, , and in embryos and extraembryonic tissues during early organogenesis. We now examine available data concerning the role of ceramides in lipid-induced hepatic insulin resistance. Outstanding Questions). Kurek K, et al. Two subjects in the control group switched their cooking oil to DAG oil, and the remaining five subjects continued to use their usual cooking oil. Various mouse models genetically perturbing ceramide synthesis have been generated to examine the role of ceramides in hepatic insulin resistance. 2008 Jan;108(1):57-66. doi: 10.1016/j.jada.2007.10.014. It is a hetero dimer of an A-chain and a B-chain, which are linked together by disulfide bonds. Studies on the mechanism of insulin resistance in the liver from humans with noninsulin-dependent diabetes. Diacylglycerol oil has an equivalent bioavailability as triacylglycerol oil in relation to providing essential fatty acids. The mechanistic picture for ceramides is somewhat more blurred. This randomised repeated-measures study examined the effects of diet-induced weight loss (DIWL) and aerobic exercise (EX) on insulin sensitivity and intramyocellular triacylglycerol (IMTG), DAG and ceramide. Insulin's structure varies slightly between species of animals. Current Evidence to Propose Different Food Supplements for Weight Loss: A Comprehensive Review. Intrahepatic diacylglycerol content is associated with hepatic insulin resistance in obese subjects. B: Representative immunoblot analysis of two day 9.5 decidua of mice that received saline injections and in two decidua of mice that received glucose injections. PKC is involved in the regulation of human chorionic gonadotropin, estrogen, and progesterone production by trophoblasts. Address correspondence and reprint requests to Mary R. Loeken, Section on Cellular and Molecular Physiology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215. Process for the oral treatment of diabetes FR2663336B1 (fr) 1990-06-18: 1992-09-04: Adir: Nouveaux derives peptidiques, leur procede de preparation et les compositions . the droplets themselves from the neutral lipid precursor diacylglycerol (DAG) [2]. Montgomery MK, et al. Horton WE Jr, Sadler TW: Effects of maternal diabetes on early embryogenesis: alterations in morphogenesis produced by the ketone body, B-hydroxybutyrate. HHS Vulnerability Disclosure, Help Occasionally, conflicting reports arise concerning whether a given model displays hepatic insulin sensitivity or hepatic insulin resistance [51,52]. This research was supported by grants R01-DK52865 to M.R.L. C: DAG concentrations in decidua. In addition to the expected associations with diacylglycerol, triacylglycerol and cholesterol esters, type 2 diabetes and prediabetes were positively associated with ceramide, and its precursor dihydroceramide, along with phosphatidylethanolamine, phosphatidylglycerol and phosphatidylinositol. Parameters of liver and kidney functions and essential fatty acids in serum phospholipids did not differ between groups. We attempt a synthesis of available research examining: 1) levels of DAGs and ceramides in human and rodent models of lipid-induced hepatic insulin resistance, 2) proposed molecular mechanisms for DAG- and ceramide-mediated hepatic insulin resistance, and 3) rodent models interrogating DAG- and ceramide-mediated hepatic insulin resistance. but also in the metabolism of phospholipids [49]. All rights reserved. The Diabetes Control and Complications Trial Study Group: Pregnancy outcomes in the Diabetes Control and Complications Trial. Overall, this criterion poses challenges for both DAG and ceramides. The first and second criteria are strength of association and consistency. Methods Sixteen overweight to obese adults (BMI 30.6 0.8 . Viana M, Herrera E, Bonet B: Teratogenic effects of diabetes mellitus in the rat. As discussed above, intrahepatic DAG has been dissociated from hepatic insulin resistance in a few genetically modified mouse models of altered lipid handling, casting doubt on the DAG-PKC-INSR hypothesis of lipid-induced hepatic insulin resistance [53]. Kim JK, et al. Hormones may act within the same cells (autocrine) or distal cells . Diacylglycerol kinases (DGKs) are a group of ten enzymes that metabolize 1,2,diacylglycerol (DAG) to produce phosphatidic acid (PA). official website and that any information you provide is encrypted NAFLD is a risk factor for nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma. DAG, diacylglycerol; NTD, neural tube defect; PKC, protein kinase C; STZ, streptozotocin. While these data do not formally meet the criterion of temporality for DAG (because both DAG elevations and insulin resistance were present at these early time points), it may not be experimentally feasible to capture a time point in which DAG is elevated but the DAG-PKC-INSR axis has not yet induced hepatic insulin resistance. Kawashima H, Takase H, Yasunaga K, Wakaki Y, Katsuragi Y, Mori K, Yamaguchi T, Hase T, Matsuo N, Yasukawa T, Tokimitsu I, Koyama W. J Am Diet Assoc. Human and rodent clinical studies are broadly consistent with this hypothesis in that IHTG and hepatic insulin resistance are correlated and nearly always move in the same direction upon clinical, dietary, or pharmacologic interventions [8,18,20,21]. In decidua, membrane association of all PKC isoforms examined (PKC , II, , ) were increased in samples from diabetic pregnancies but not in the cytosolic fraction (Fig. Diacylglycerols and ceramides have emerged as the two best-studied putative mediators of lipid-induced hepatic insulin resistance. Becerra JE, Khoury MJ, Cordero JF, Erickson JD: Diabetes mellitus during pregnancy and the risks for the specific birth defects: a population-based case-control study. Increased rate of gluconeogenesis in type II diabetes mellitus. Soon after, livers from Zucker obese rats were found to contain ~1.8-fold higher levels of sn-1,2-DAG content than lean control rats [29]. PKC activity in membrane and cytosolic fractions of day 11.5 embryos and decidua from nondiabetic (control) mice or in normal or abnormal embryos of diabetic mice. The Bradford Hill criteria provide a conceptual framework for assessing putative cause-effect relationships in biology [97]. Though stored hepatic triglyceride is not thought to directly impair insulin action, two lipid classes proposed to mediate lipid-induced hepatic insulin resistance are ceramides and diacylglycerols (DAG). Cellular mechanisms by which FGF21 improves insulin sensitivity in male mice. Iwashita M, Watanabe M, Setoyama T, Mimuro T, Nakayama S, Adachi T, Takeda Y, Sakamoto S: Effects of diacylglycerol and gonadotropin-releasing hormone on human chorionic gonadotropin release by cultured trophoblast cells. In one study, C57BL/6N mice fed HFD for 14 weeks displayed increased 14:0, 16:0, 18:0, 20:0, and 24:1 ceramides [68]. The bioactive lipid metabolites such as diacylglycerols (dags), sphingolipids and acylcarnitines can interfere with insulin sensitivity and are linked to obesity and type 2 diabetes. What is the subcellular localization of the DAG-PKC-INSR interaction? However, in COS-7 cells, PKC translocation was observed in response to treatment with tridecanoate, pentadecanoate, linoleate, arachidonate, and docosahexaenoate, but not other fatty acids including palmitate, stearate, oleate, and others [55]. Xia JY, et al. Kunisaki M, Bursell S-E, Clermont AC, Ishii H, Ballas LM, Jirousek MR, Umeda F, Naata H, King GL: Vitamin E prevents diabetes-induced abnormal retinal blood flow via the diacylglycerol-protein kinase C pathway. Blocking VLDL secretion causes hepatic steatosis but does not affect peripheral lipid stores or insulin sensitivity in mice. Integrative genomic analysis implicates limited peripheral adipose storage capacity in the pathogenesis of human insulin resistance. Diabetes Mellitus, A Fundamental and CLINICAL Text. The target energy and protein intake were 30 kcal/kg and 0.8 g/kg of their ideal body weight (22 H2, where H is the height in meters), respectively. No significant differences in the duration of diabetes, the stages of nephropathy, or other measurements at baseline were found between the groups. Keegan A, Walbank H, Cotter MA, Cameron NE: Chronic vitamin E treatment prevents defective endothelium-dependent relaxation in diabetic rat aorta. Insulin resistance, ectopic lipid, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), insulin receptor kinase, protein kinase C epsilon, ceramide. Studies differ with respect to whether hepatic ceramide content is associated with hepatic insulin resistance in humans. This criterion has been a major sticking point for the DAG-PKC-INSR hypothesis of hepatic insulin resistance. Immunoblot analysis demonstrated that steady-state concentrations of PKC isoforms , II, , and in whole embryo were not significantly affected by maternal diabetes (Fig. 8600 Rockville Pike A causal role for DAG in hepatic insulin resistance is supported by human correlative studies and a direct pathophysiological mechanism in rodents, but challenged by a few rodent models with increased hepatic DAG but preserved hepatic insulin sensitivity. 2. TG/HDL ratio was calculated by the following formula: TG/HDL ratio = TG (mg/dl)/HDL (mg/dl). The antioxidant effect of a 20% hydroalcoholic extract from the flowering aerial part of H. matronalis (HMHE) was evaluated in mice with chronic experimental streptozotocin-induced diabetes (STZ-ID). Inhibition of ceramide de novo synthesis reduces liver lipid accumulation in rats with nonalcoholic fatty liver disease. For example, specific reversal of hepatosteatosis by liver-targeted mitochondrial protonophore treatment in high-fat fed rats, by niclosamide-induced mitochondrial uncoupling in fat-fed mice, by modest weight loss in type 2 diabetic humans, by adipose transplantation in lipodystrophic mice, or by leptin treatment in lipodystrophic humans dramatically reverses hepatic insulin resistance [8,20,2226]. We previously reported that a 3-month intake of DAG oil significantly reduced fasting serum triglycerides in subjects of type 2 diabetes with hypertriglyceridemia (7). Is there a viable, experimentally supported mechanism by which DAG or ceramides may mediate hepatic insulin resistance? Of note, these mechanistic studies relied on cell-permeable short-chain ceramides with cytotoxic properties and often used at unphysiologic concentrations [85]. Minehira K, et al. Diabetes Care 1 February 2006; 29 (2): 417419. The sixth criterion is biological plausibility. Epub 2005 Nov 14. Holland WL, et al. It is the precursor and metabolite of acetylcholine (ACh), plays a role in single-carbon metabolism and is an essential component of different membrane phospholipids (PLs). This study found that muscle diacylglycerol content was temporally associated with protein kinase C activation and impairment of insulin signaling in human skeletal muscle. The adiponectin receptor in particular has been shown to contain ceramidase activity [84]. Birkenfeld AL, et al. Turpin SM, et al. Bethesda, MD 20894, Web Policies In decidua, there was a slight increase in membrane and cytosol PKC activity in both normal and abnormal embryos of diabetic mice, although these increases were not significant. Endocrinology Exam 1 Review Sheet CHAPTER 1 Learning Objectives 1. and transmitted securely. Several studies have demonstrated that antioxidants can prevent diabetic embryopathy in animal models (1417), and we have shown that hyperglycemia-induced oxidative stress inhibits expression of Pax-3 (Chang et al., submitted manuscript). We further speculate that the DAG-PKC-INSR axis is particularly relevant in the early stages of NAFLD (modeled by short-term high fat diets in rodents), and that the progression of whole-body insulin resistance is accompanied by the development of extrahepatic factors that increase HGP, such as inflammation and dysregulated lipolysis, that dilute the quantitative significance of direct lipid-induced hepatocellular insulin resistance. Wilson CG, et al. 5. Insulins direct hepatic effect explains the inhibition of glucose production caused by insulin secretion. Aroor AR, et al. Perry RJ, et al. Camellia oil-based diacylglycerol (CD) oil can reduce the body fat accumulation due to their different metabolic pathways from triacylglycerol (TAG) oil. The role of hepatic lipids in hepatic insulin resistance and type 2 diabetes. How well do hepatic DAG and ceramide levels correlate with hepatic insulin resistance, and is the correlation reproducible across investigators? This latter study is notable for its analysis of specific species of ceramide, rather than reporting the sum of several abundant species. Systematic examination of all PKC isoforms expressed in liver revealed that activation of the isoform was particularly prominent in rats fed a 3-day high fat diet [20]. 1B) resulted from activation of the enzymes, not from new mRNA or protein synthesis. Mills JL, Baker L, Goldman AS: Malformations in infants of diabetic mothers occur before the seventh gestational week: implications for treatment. Conversely, mice haploinsufficient for CerS2 displayed a compensatory increase in hepatic C16:0 ceramides [69]. As type 2 diabetes becomes more prevalent worldwide, the prevalence of diabetic macular oedema is . In Sprague-Dawley rats, high fat feeding (with either saturated fat- or unsaturated fat-based diets) for just 3 days is sufficient to induce hepatic insulin signaling defects but not to increase total hepatic ceramides [75]. In general, the profound alterations in liver and plasma lipids comorbid with hepatic insulin resistance have engendered reluctance to the hypothesis that hepatic lipids drive hepatic insulin resistance [99]. Additionally, proximal insulin signaling is impaired in insulin resistant liver, which is difficult to reconcile with AKT as the main site for insulin resistance [43,92,93]. Kumashiro N, et al. In the human placenta, there are significant increases in PKC II and on the microvillus membrane and in PKC and on the basal membrane between 16 and 40 weeks of gestation (40). Nephroprotective effects of diacylglycerol on diabetic nephropathy in type 2 diabetic rats. sharing sensitive information, make sure youre on a federal Reversal of diet-induced hepatic steatosis and hepatic insulin resistance by antisense oligonucleotide inhibitors of acetyl-CoA carboxylases 1 and 2. Recent human genetic data indicate that impaired adipose tissue storage capacity is an important contributor to whole-body insulin resistance as measured by fasting insulin level, consistent with the ectopic lipid model of hepatic insulin resistance [19]. Diacylglycerol is known to increase the risk of suffering from skin carcinoma. Boggs, K.P. Kim DM, Ahn CW, Park JS, Cha BS, Lim SK, Kim KR, Lee HC, Huh KB: An implication of hypertriglyceridemia in the progression of diabetic nephropathy in metabolically obese, normal weight patients with type 2 diabetes mellitus in Korea. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The study was conducted in a single-center, open-labeled, parallel design. Prediabetes was defined as the presence of IFG and/or IGT. Yang G, et al. E-mail: mary.loeken@joslin.harvard.edu. (MF), only three pathways (transmembrane receptor activity, collagen protein binding, and diacylglycerol binding) were significantly enriched (p-value <0.05) . Hepatic DAG was associated with hepatic insulin resistance in all three studies. These effects were prevented by pre-treatment with the SPT inhibitor myriocin [76]. Peripheral effects of insulin dominate suppression of fasting hepatic glucose production. Holland WL, et al. ZDF, Zucker diabetic fatty. Increases in DAG-PKC signaling have been noted in retina, aorta, heart, and glomeruli of patients with diabetes and diabetic animals and seem to be directly related to elevated glucose concentrations (22,2429). DAG oil intake has been reported to reduce the postprandial elevation in serum lipid levels compared with triacylglycerol intake (3,4). It is not obvious how to reconcile these results with the hypothesis that the membrane-associated compartment contains the active DAG pool; however, it is possible that handling and storage of the human liver biopsy samples following biopsy may have contributed to this distribution. In the present study, a significant weight loss was also observed in the DAG group. In conclusion, the long-term intake of DAG oil prevented the progression of renal function in the subjects of type 2 diabetes with nephropathy, delaying the onset of dialysis. 2B). C: DAG concentrations in decidua; *P < 0.05 vs. control. Samuel VT, et al. They all contain a conserved C'-terminal catalytic domain and two cysteine-rich Zn2+-finger motifs with varied regulatory domains. In two studies of obese nondiabetic humans, hepatic ceramide content was not significantly associated with HOMA-IR [31] or insulin suppression of HGP [35]. By day 10.5, formation of the neural tube is complete and embryos with defective neural tubes can be distinguished from normal embryos. For DAG, models where hepatosteatosis is specifically and acutely reversed and hepatic insulin sensitivity is improved provide inferential evidence that reducing DAG reverses hepatic insulin resistance. Quantitation of bands in the upper panel is shown in the lower panel, with band intensity from embryos of diabetic mice expressed as a percentage of bands from embryos of nondiabetic mice. Diabetes is a heterogeneous group of disorders character-ized by high blood glucose levels, with type 2 diabetes (T2D) being more common than type 1. Therefore, increased PKC activity in defective day 11.5 embryos could be due to abnormal signaling pathways in structures undergoing morphogenesis at that stage of development and that are adversely affected by previously existing structural defects. Further investigations will be needed to clarify the relation between weight loss and the prevention of renal failure by DAG oil intake. A. Nicotinic Acid menghambat hepatosit diacylglycerol acyltransferase Mencegah sintesis trigliserida dalam hepatosit, Membatasi trigliserida yang ada di dalam tubuh. InsrT1150A mice genetically insusceptible to inhibition by PKC were protected from high-fat diet-induced hepatic insulin resistance [45]. Yamamoto K, Asakawa H, Tokunaga K, Watanabe H, Matsuo N, Tokimitsu I, Yagi N: Long-term ingestion of dietary diacylglycerol lowers serum triacylglycerol in type II diabetic patients with hypertriglyceridemia. Please enable it to take advantage of the complete set of features! Analyses were performed using SPSS (version 11.0; SPSS, Chicago, IL). 2005 Mar;105(3):428-40. doi: 10.1016/j.jada.2004.11.029. Controlled-release mitochondrial protonophore reverses diabetes and steatohepatitis in rats. 2007;16 Suppl 1:398-403. Cantley JL, et al. This suggests that, like maternal diabetes, effects of hyperglycemia on PKC activity were due to stimulation of enzymatic activity rather than to de novo mRNA or protein synthesis. Table 1 provides a comprehensive overview of directional changes in hepatic insulin action, IHTG, hepatic DAG, PKC translocation, and hepatic ceramides in studies assessing these parameters in humans and rodents. Fenofibrate insulates diacylglycerol in lipid droplet/ER and preserves insulin signaling transduction in the liver of high fat fed mice. Schmitz-Peiffer C, et al. Hepatic Acetyl CoA Links Adipose Tissue Inflammation to Hepatic Insulin Resistance and Type 2 Diabetes. Colhoun HM, Lee ET, Bennett PH, Lu M, Keen H, Wang SL, Stevens LK, Fuller JH: Risk factors for renal failure: the WHO Mulinational Study of Vascular Disease in Diabetes. Alterations in postprandial hepatic glycogen metabolism in type 2 diabetes. There are three obvious interpretations of the correlation between increased DAG-PKC in embryos of diabetic dams and defective organogenesis: 1) that altered PKC signaling is responsible for abnormal morphogenesis, 2) that DAG-PKC signaling is increased in embryos of diabetic dams as a consequence of an already disturbed developmental program, or 3) that sustained increased DAG-PKC signaling disturbs the formation of structures that form at successively later times in gestation. However, liver-specific overexpression of DGAT2 in mice leads to increased hepatic TAG and, unexpectedly, increased total hepatic DAG content [51,52]. DAG activates protein kinase C (PKC) isoforms, and activation of the isoform (PKC) is most consistently observed in insulin-resistant liver. 2012 Dec 19;2012:750593. doi: 10.5402/2012/750593. Adipose triglyceride lipase-null mice are resistant to high-fat diet-induced insulin resistance despite reduced energy expenditure and ectopic lipid accumulation. Camporez JPG, et al. and transmitted securely. Bikman BT, et al. Insulin receptor Thr1160 phosphorylation mediates lipid-induced hepatic insulin resistance. Tao H, et al. In muscle, DAG is hypothesized to activate a different novel PKC isoform, PKC, with unclear targets in proximal insulin signaling [104]. Petersen MC, et al. Mice with increased hepatocellular lipid uptake due to overexpression of human APOC3 displayed hepatic insulin resistance associated with increased hepatic DAG and TAG but unchanged total hepatic ceramide content [77]. Dosis Nicotinic Acid Dosis diberikan sesuai dengan laporan berdasarkan tanggapan tubuh terhadap obat. M.C.P. In 2014, two groups reported on mice deficient in one of the six ceramide synthase (CerS) enzymes and advanced the hypothesis that C16:0 ceramides are particularly harmful [70]. Mechanism of hepatic insulin resistance in non-alcoholic fatty liver disease. The impaired life official website and that any information you provide is encrypted Adipose triacylglycerol lipase is a major regulator of hepatic lipid metabolism but not insulin sensitivity in mice. Blood samples were collected after fasting for 12 h and measured by standard laboratory procedures. ISRN Vet Sci. Wentzel P, Wentzel CR, Gareskog MB, Eriksson UJ: Induction of embryonic dysmorphogenesis by high glucose concentration, disturbed inositol metabolism, and inhibited protein kinase C activity. Unable to load your collection due to an error, Unable to load your delegates due to an error. Regulation of insulin action by ceramide: dual mechanisms linking ceramide accumulation to the inhibition of Akt/protein kinase B. Galbo T, et al. Does Diacylglycerol Accumulation in Fatty Liver Disease Cause Hepatic Insulin Resistance? Diacylglycerol PKC . Yet, as with all pharmacologic inhibitors, interpretation of in vivo experiments employing myriocin requires caution. Hyperglycemia and diabetic conditions have been reported to increase diacylglycerol (DAG) concentration, which, in turn, activates PKC that increases NADPH oxidase activity, thus promoting ROS . 2015 Aug 26;13(9):5564-78. doi: 10.3390/md13095564. Perry RJ, et al. Quantitation of bands from four replicate decidua of saline-injected pregnancies and four glucose-injected pregnancies is shown in the lower panel. Quantitation of bands from six replicate decidua from nondiabetic pregnancies and six replicate decidua from diabetic pregnancies are shown in the lower panel. Lotta LA, et al. Raichur S, et al. Inhibition of de novo ceramide synthesis reverses diet-induced insulin resistance and enhances whole-body oxygen consumption. DAG accumulates in multiple organs of the obese subjects, which leads to the disruption of metabolic homeostasis and the development of diabetes as well as associated diseases. The increase in PKC activity in embryos of diabetic mice, which was even greater in defective embryos than in embryos that were morphologically normal, supports this interpretation. From:Williams Textbook of Endocrinology (Twelfth Edition), 2011 Related terms: Glycerol Lipid Secretion (Process) Fatty Acid Phospholipid Protein Triacylglycerol Micelle Exosome Triacylglycerol Lipase The fifth criterion is the presence of a biological gradient or dose-response relationship. Although the insulin-sensitizing effects of myriocin have been dissociated from body weight changes in some reports [74,76], it is worth bearing in mind that even minor increases in energy expenditure, too subtle to manifest as weight loss, can have dramatic effects on hepatic and skeletal muscle diacylglycerol content and insulin sensitivity [23,24]. Single phosphorylation sites in Acc1 and Acc2 regulate lipid homeostasis and the insulin-sensitizing effects of metformin. Prediabetes was defined as the presence of IFG and/or IGT. Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus. In the DAG group, body weight, BMI, and serum triglyceride levels were significantly decreased from the baseline to 6 months, and the percent changes were significantly different between the groups. An official website of the United States government. Zhou H, et al. Animal models in which ceramides are altered and hepatic insulin action moves in the predicted direction include: myriocin-treated rats[76], lard oil-infused rats [76,81], Des1+/ mice [76], adiponectin-treated mice [84], CerS2+/ mice [69], liver-specific CerS6/ mice [68], and liver-specific acid-ceramidase overexpressing mice [61]. Evolving concepts in the pathogenesis of NASH: beyond steatosis and inflammation. Suppression of diacylglycerol acyltransferase-2 (DGAT2), but not DGAT1, with antisense oligonucleotides reverses diet-induced hepatic steatosis and insulin resistance. In. Additionally, many key mechanistic studies describing ceramide inhibition of AKT were carried out in myotubes, and have not been replicated in hepatocytes. A value of P < 0.05 was considered statistically significant. Diacylglycerol (DAG) - the structure and sources Diacylglycerol (DAG) is a neutral lipid involved in various metabolic pathways in the cell. Choline participates in several relevant neurochemical processes. Independent Association Between Improvement of Nonalcoholic Fatty Liver Disease and Reduced Incidence of Type 2 Diabetes. Receptor-mediated activation of ceramidase activity initiates the pleiotropic actions of adiponectin. 1Department of Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT 06520, 2Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, 3Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT 06520. Thus, it will be important in the future to determine whether antioxidants normalize DAG and PKC in the embryo and decidua, as it does in retinal and renal tissues (48, 49). CDPdiacylglycerol-Inositol 3-Phosphatidyltransferase. Basu R, et al. Miodovnik M, Mimouni F, Dignan PSJ, Berk MA, Ballard JL, Siddiqi TA, Khoury J, Tsang RC: Major malformations in infants of IDDM women: vasculopathy and early first-trimester poor glycemic control. However, the putative roles for diacylglycerols and ceramides in hepatic insulin resistance have proved more complex than originally imagined, with various genetic and pharmacologic manipulations yielding a vast and occasionally contradictory trove of data to sort through. Differences between the groups in percent changes from the baseline at 6 months were assessed by the Students t test. D: PKC activity in cytosolic and membrane fractions of decidua; *P < 0.001 vs. control. Siman CM, Eriksson UJ: Vitamin E decreases the occurrence of malformations in the offspring of diabetic rats. Boden G, et al. Insulin resistance is a major factor in the development of type 2 diabetes and metabolic syndrome. We conclude with a formal evaluation of DAG- and ceramide-induced hepatic insulin resistance using the Bradford Hill criteria for causality in biological processes. will also be available for a limited time. Because DAG is the synthetic precursor to triglyceride, IHTG correlates well with intrahepatic DAG if lipid handling pathways are genetically intact [3136]. Serum metabolomics profiles in response to n-3 fatty acids in Chinese patients with type 2 diabetes: a double-blind randomised controlled trial. But none of these studies have updated our understanding of the molecular mechanism by which ceramides might themselves directly impair insulin signaling in a hepatocyte-autonomous manner. Knockdown of either lipin-1 or lipin-2 by shRNA in fat-fed mice decreased hepatic DAG and TAG and improved glucose tolerance, and adenoviral overexpression of lipin-2 resulted in the opposite phenotype: increased hepatic DAG and TAG accompanied by glucose intolerance [48,49]. Rando RR, Young N. The stereospecific activation of protein kinase C. Petersen MC, Jurczak MJ. All downstream arms of hepatocellular insulin signaling, including stimulation of net glycogen synthesis, transcriptional upregulation of de novo lipogenic genes, and transcriptional downregulation of gluconeogenic genes, are predicted to be affected by this mechanism. Cockroft DL, Coppola PT: Teratogenic effects of excess glucose on head-fold rat embryos in culture. In these rodent models, hepatic ceramides are dissociated from lipid-induced hepatic insulin resistance. Indeed, myriocin has dramatic effects on energy expenditure and weight gain in mice, confounding attempts to identify the proximate cause of myriocin-induced improvements in hepatic insulin action [74,86]. Serum glucose was also significantly improved in patients with higher glucose levels at baseline (>7.00 mmol/L) in the diacylglycerol oil group. Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the following formula: HOMA-IR = fasting insulin (U/l) fasting glucose (mmol/l)/22.5 [ 22 ]. Regarding GS1-DOWN, changes in BP are mainly . Ceramide inhibits protein kinase B/Akt by promoting dephosphorylation of serine 473. Some research suggests that diacylglycerol might lower blood sugar and blood fats called triglycerides in people who have type 2 diabetes. The definition of the endocrine system Endocrinology is the study of glands, the hormones they produce, and the effects of the hormones. Similar findings of protection from hepatosteatosis and hepatic insulin resistance in association with decreased hepatic ceramides were recently reported in mice with adipose- or liver-specific inducible adiponectin receptor overexpression [96]. The .gov means its official. 1A and B). Quantitation of membrane bands are shown in solid bars and of cytosol bands are shown in shaded bars. Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects. Lipid-Induced Hepatic Insulin Resistance. This protection from steatosis was attributed to increased VLDL secretion in the transgenic mice; fatty acid oxidation was unchanged [61]. After a 1-month lead-in period, the subjects were divided into either a DAG group (n = 8) or a control group (n = 7). DAG exists in three stereoisomers (, A large class of lipids, many of which derive from the condensation of serine and palmitoyl CoA by serine palmitoyltransferase (SPT). Rx, treatment. Inducible overexpression of adiponectin receptors highlight the roles of adiponectin-induced ceramidase signaling in lipid and glucose homeostasis. Diacylglycerol oil consumption improved biomarkers and anthropometric parameters of type 2 DM compared with triacylglycerol oil. Schubert KM, et al. There is also some evidence that diacylglycerol might also slow progression of kidney failure in people with type 2 diabetes, possibly by reducing triglycerides. In the third human study to measure intrahepatic DAG and HOMA-IR, four of five DAG species measured were positively correlated with HOMA-IR [37]. Cultured hepatocytes treated with PMA displayed impairments in insulin receptor tyrosine kinase (IRK) activity and insulin-stimulated glycogen synthase activity [27,28]. For rodent studies, hepatic insulin action was assessed as suppression of HGP during hyperinsulinemic-euglycemic clamp studies unless otherwise noted. Liver pathology in morbidly obese patients with and without diabetes. One possibility is that DAG is an excellent biomarker of hepatic insulin resistance but not a causal factor. It is known that weight loss caused by an insufficient energy intake may lead to a further impairment in renal function (16,17). Yet the mechanisms now proposed for DAG- and ceramide-induced hepatic insulin resistance are somewhat different than those identified in skeletal muscle. Kang N, Alexander G, Park JK, Maasch C, Buchwalow I, Luft FC, Haller H: Differential expression of protein kinase C isoforms in streptozotocin-induced diabetic rats. Interestingly, both lipid infusions impaired insulin suppression of HGP, and myriocin prevented this impairment in both lard oil and soy oil-infused rats, even though hepatic ceramides were totally unaffected by myriocin treatment in the soy oil-infused group [76]. American Diabetes Association. All subjects consumed triacylglycerol oil in the lead-in period (14 days), then they were randomly divided into two groups and consumed diacylglycerol or triacylglycerol oil with a similar fatty acid composition (25 g/day) for 120 days. Stratford S, et al. Petersen KF, et al. Hepatic steatosis, or nonalcoholic fatty liver disease (NAFLD), is present in about 70% of type 2 diabetics [9,10] and nearly all obese type 2 diabetics [11] and is a particularly strong predictor of insulin resistance [1215]. The final Bradford Hill criterion is analog the principle that if causality has been established for one cause-effect pair, the burden of proof for related cause-effect pairs in the future should not be as strong. Galbo T, et al. Although the technique commonly employed is relatively crude (the membrane fraction includes all membranous organelles and the plasma membrane), it may be further refined in the future. acknowledges grant support from the National Institutes of Health: R01 DK-40936, P30 DK-045735. A paired t test was used to assess changes from the baseline. Takayama S, et al. There is also significant underappreciation in the field of the potentially confounding contribution of extrahepatic insulin action to readouts of hepatic insulin action such as the suppression of HGP [4,101,102]. Learn more Similarly, a general PKC inhibitor, isoquinolinesulfonamide (H7) attenuates DNA synthesis in proliferating and differentiating trophoblast cells and accelerates the acquisition of progesterone biosynthetic capabilities (38). We apologize to the many colleagues whose valuable contributions could not be discussed owing to space limitations. is supported by NIH Medical Scientist Training Program grant T32 GM-007205 and the NIH National Research Service Award (NRSA) grant F30 DK-104596. The hepatic DAG-PKC-INSR axis, despite emerging more recently, is now better understood than the analogous DAG-PKC axis in skeletal muscle. HFF, high-fat diet fed. Insulin resistance: a metabolic pathway to chronic liver disease.
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