Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.
PLoS One. 2012;7(6):e38952. doi: 10.1371/journal.pone.0038952. Epub 2012 Jun 20.
Fatty liver disease (FLD) is commonly associated with insulin resistance and obesity, but interestingly it is also observed at low insulin states, such as prolonged fasting. Thus, we asked whether insulin is an independent modulator of hepatic lipid accumulation.
METHODS/PRINCIPAL FINDINGS: In mice we induced, hypo- and hyperinsulinemia associated FLD by diet induced obesity and streptozotocin treatment, respectively. The mechanism of free fatty acid induced steatosis was studied in cell culture with mouse liver cells under different insulin concentrations, pharmacological phosphoinositol-3-kinase (PI3K) inhibition and siRNA targeted gene knock-down. We found with in vivo and in vitro models that lipid storage is increased, as expected, in both hypo- and hyperinsulinemic states, and that it is mediated by signaling through either insulin receptor substrate (IRS) 1 or 2. As previously reported, IRS-1 was up-regulated at high insulin concentrations, while IRS-2 was increased at low levels of insulin concentration. Relative increase in either of these insulin substrates, was associated with an increase in liver-specific fatty acid transport proteins (FATP) 2&5, and increased lipid storage. Furthermore, utilizing pharmacological PI3K inhibition we found that the IRS-PI3K pathway was necessary for lipogenesis, while FATP responses were mediated via IRS signaling. Data from additional siRNA experiments showed that knock-down of IRSs impacted FATP levels.
CONCLUSIONS/SIGNIFICANCE: States of perturbed insulin signaling (low-insulin or high-insulin) both lead to increased hepatic lipid storage via FATP and IRS signaling. These novel findings offer a common mechanism of FLD pathogenesis in states of both inadequate (prolonged fasting) and ineffective (obesity) insulin signaling.
脂肪肝疾病(FLD)通常与胰岛素抵抗和肥胖有关,但有趣的是,它也在胰岛素水平较低的情况下出现,如长时间禁食。因此,我们想知道胰岛素是否是肝脏脂质积累的独立调节剂。
方法/主要发现:我们通过饮食诱导肥胖和链脲佐菌素处理分别在小鼠中诱导了低胰岛素血症和高胰岛素血症相关的 FLD。我们在不同胰岛素浓度下的细胞培养中,用小鼠肝细胞研究了游离脂肪酸诱导脂肪变性的机制,使用了药理学磷酸肌醇-3-激酶(PI3K)抑制和靶向基因敲低的 siRNA。我们发现,在体内和体外模型中,脂肪储存都如预期的那样在低胰岛素血症和高胰岛素血症状态下增加,并且是通过胰岛素受体底物(IRS)1 或 2 的信号转导介导的。如前所述,IRS-1 在高胰岛素浓度下上调,而 IRS-2 在低胰岛素浓度下增加。这些胰岛素底物中的任何一种的相对增加,都与肝特异性脂肪酸转运蛋白(FATP)2&5 的增加和脂质储存增加有关。此外,利用药理学 PI3K 抑制,我们发现 IRS-PI3K 途径是脂肪生成所必需的,而 FATP 反应是通过 IRS 信号介导的。来自其他 siRNA 实验的数据表明,IRS 的敲低会影响 FATP 水平。
结论/意义:受干扰的胰岛素信号(低胰岛素或高胰岛素)状态都会通过 FATP 和 IRS 信号导致肝脂质储存增加。这些新发现为胰岛素信号不足(长时间禁食)和无效(肥胖)状态下 FLD 发病机制提供了一个共同的机制。