Cruciani-Guglielmacci C, Hervalet A, Douared L, Sanders N M, Levin B E, Ktorza A, Magnan C
Laboratory of the Physiopathology of Nutrition, Université Paris 7, CNRS UMR 7059, 2, place Jussieu, case 7126, 75251 Paris cedex 05, France.
Diabetologia. 2004 Nov;47(11):2032-8. doi: 10.1007/s00125-004-1569-2. Epub 2004 Nov 30.
AIMS/HYPOTHESIS: NEFA play a key role in the setting of insulin resistance and hyperinsulinaemia, which are both features of the prediabetic state. In addition to the direct effects on pancreas and peripheral tissues, NEFA have been reported to act via changes in autonomic nervous system activity. The present study was aimed at studying the effects of a local increase in NEFA in the brain on glucose-induced insulin secretion (GIIS) and on insulin action. We hypothesised that cerebral NEFA beta oxidation is a prerequisite for these central effects.
Male Wistar rats were infused with Intralipid/heparin for 24 h through the carotid artery towards the brain (IL rats), after which we performed the GIIS test, a euglycaemic-hyperinsulinaemic clamp and c-fos immunochemistry. In another series of experiments, Intralipid/heparin infusion was coupled with lateral ventricular infusion of etomoxir, a CPT1 inhibitor, which was initiated 5 days previously.
During the infusion period, there were no changes in plasma NEFA, insulin or glucose concentrations. IL rats displayed an increased GIIS compared with control rats (C rats) infused with saline/heparin, and their liver insulin sensitivity was decreased. Furthermore, lipid infusion induced a significant decrease in c-fos-like immunoreactive neurons in medial hypothalamic nuclei, and an increase in lateral hypothalamus. Neuronal activation profile was almost normalised in IL rats infused with etomoxir, and GIIS was strongly decreased, possibly because of the concomitant normalisation of hepatic glucose output.
CONCLUSIONS/INTERPRETATION: These results strongly suggest that beta oxidation is required for the central effects of NEFA on GIIS.
目的/假设:游离脂肪酸(NEFA)在胰岛素抵抗和高胰岛素血症的发生过程中起关键作用,而这两者都是糖尿病前期状态的特征。除了对胰腺和外周组织的直接作用外,据报道NEFA还通过自主神经系统活动的改变发挥作用。本研究旨在探讨脑内局部NEFA增加对葡萄糖诱导的胰岛素分泌(GIIS)和胰岛素作用的影响。我们假设脑内NEFA的β氧化是这些中枢效应的先决条件。
通过颈动脉向脑内输注脂质乳剂/肝素24小时(IL大鼠),之后进行GIIS试验、正常血糖-高胰岛素钳夹试验和c-fos免疫组化。在另一系列实验中,脂质乳剂/肝素输注与侧脑室输注依他莫昔(一种肉碱棕榈酰转移酶1(CPT1)抑制剂)相结合,依他莫昔在5天前开始输注。
在输注期间,血浆NEFA、胰岛素或葡萄糖浓度无变化。与输注生理盐水/肝素的对照大鼠(C大鼠)相比,IL大鼠的GIIS增加,且肝脏胰岛素敏感性降低。此外,脂质输注导致内侧下丘脑核中c-fos样免疫反应性神经元显著减少,而外侧下丘脑则增加。在输注依他莫昔的IL大鼠中,神经元激活模式几乎恢复正常,且GIIS显著降低,这可能是由于肝葡萄糖输出同时恢复正常所致。
结论/解读:这些结果强烈表明,β氧化是NEFA对GIIS产生中枢效应所必需的。