Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv, Israel.
J Hepatol. 2011 Jun;54(6):1214-23. doi: 10.1016/j.jhep.2010.09.032. Epub 2010 Oct 26.
BACKGROUND & AIMS: Glucagon-like peptide-1 (GLP-1), a gut-derived peptide degraded by dipeptidyl peptidase-4 (DPP4), stimulates insulin secretion in response to nutrients, yet its direct effect on the liver is controversial. We investigated the effects of GLP-1 on hepatic fat and glucose metabolism and elucidated its mechanism of action.
Hepatic fat metabolism, including lipogenic enzymes and signal transduction regulators, was assessed in livers of DPP4-deficient rats (DPP4-) with chronically elevated GLP-1 and in GLP-1-treated primary hepatocytes. The effect of chronic elevated GLP-1 on insulin sensitivity was measured using the hyperinsulinemic-euglycemic clamp.
Normal and high fat diet fed DPP4-rats displayed reduced hepatic triglycerides, accompanied by down-regulation of lipogenesis enzymes and parallel up-regulation of carnitine palmitoyltransferase-1, a key enzyme in fatty acid β-oxidation. In vitro studies demonstrated that these effects were directly induced by GLP-1. Mechanistically, GLP-1 increased cAMP in hepatocytes, resulting in the phosphorylation of cAMP-activated protein kinase (AMPK), a suppressor of lipogenesis. Indeed, hepatocytes expressing a dominant negative Ad-DN-AMPK displayed attenuated GLP-1 effects on AMPK phosphorylation and its downstream lipogenic targets. Importantly, normoglycemic DPP4-rats did not display improved hepatic insulin sensitivity in vivo, suggesting a direct effect of GLP-1 on fat metabolism. Finally, DPP4-rats expressed lower levels of hepatic proinflammatory and profibrotic cytokines in response to nutrient stimuli.
GLP-1 suppresses hepatic lipogenesis via activation of the AMPK pathway. GLP-1 inhibitory effects on hepatic fat accumulation and nutrient-induced hepatic proinflammatory response suggest GLP-1 analogs as novel therapies for non-alcoholic fatty liver diseases.
胰高血糖素样肽-1(GLP-1)是一种由二肽基肽酶-4(DPP4)降解的肠道来源的肽,它能响应营养物质刺激胰岛素分泌,但它对肝脏的直接作用仍存在争议。我们研究了 GLP-1 对肝脏脂肪和葡萄糖代谢的影响,并阐明了其作用机制。
通过检测慢性高 GLP-1 大鼠(DPP4-)和 GLP-1 处理的原代肝细胞中的肝脂肪代谢,包括生脂酶和信号转导调节剂,来评估 GLP-1 的作用。采用高胰岛素-正葡萄糖钳夹试验测定慢性升高的 GLP-1 对胰岛素敏感性的影响。
正常饮食和高脂饮食喂养的 DPP4-大鼠肝甘油三酯减少,伴随着生脂酶的下调和肉碱棕榈酰转移酶-1(脂肪酸β氧化的关键酶)的平行上调。体外研究表明,这些作用是由 GLP-1 直接诱导的。机制上,GLP-1 增加了肝细胞中的 cAMP,导致 cAMP 激活蛋白激酶(AMPK)的磷酸化,AMPK 是生脂作用的抑制剂。事实上,表达显性负性 Ad-DN-AMPK 的肝细胞表现出 GLP-1 对 AMPK 磷酸化及其下游生脂靶标的作用减弱。重要的是,正常血糖的 DPP4-大鼠在体内并未显示出肝胰岛素敏感性的改善,这表明 GLP-1 对脂肪代谢有直接作用。最后,营养刺激时,DPP4-大鼠肝脏中表达的促炎和促纤维化细胞因子水平较低。
GLP-1 通过激活 AMPK 通路抑制肝生脂作用。GLP-1 抑制肝脂肪堆积和营养诱导的肝炎症反应表明 GLP-1 类似物可作为非酒精性脂肪性肝病的新型治疗方法。