去卵巢手术后的雌激素治疗可预防脂肪肝,并可能改善特定通路的胰岛素抵抗。

Estrogen treatment after ovariectomy protects against fatty liver and may improve pathway-selective insulin resistance.

机构信息

Tennessee Valley Healthcare System, Nashville, Tennessee, USA.

出版信息

Diabetes. 2013 Feb;62(2):424-34. doi: 10.2337/db11-1718. Epub 2012 Sep 10.

Abstract

Pathway-selective insulin resistance where insulin fails to suppress hepatic glucose production but promotes liver fat storage may underlie glucose and lipid abnormalities after menopause. We tested the mechanisms by which estrogen treatment may alter the impact of a high-fat diet (HFD) when given at the time of ovariectomy (OVX) in mice. Female C57BL/6J mice underwent sham operation, OVX, or OVX with estradiol (E2) treatment and were fed an HFD. Hyperinsulinemic-euglycemic clamps were used to assess insulin sensitivity, tracer incorporation into hepatic lipids, and liver triglyceride export. OVX mice had increased adiposity that was prevented with E2 at the time of OVX. E2 treatment increased insulin sensitivity with OVX and HFD. In sham and OVX mice, HFD feeding induced fatty liver, and insulin reduced hepatic apoB100 and liver triglyceride export. E2 treatment reduced liver lipid deposition and prevented the decrease in liver triglyceride export during hyperinsulinemia. In mice lacking the liver estrogen receptor α, E2 after OVX limited adiposity but failed to improve insulin sensitivity, to limit liver lipid deposition, and to prevent insulin suppression of liver triglyceride export. In conclusion, estrogen treatment may reverse aspects of pathway-selective insulin resistance by promoting insulin action on glucose metabolism but limiting hepatic lipid deposition.

摘要

胰岛素抵抗导致肝葡萄糖生成不受抑制而促进肝脂肪储存,可能是绝经后糖脂代谢异常的原因之一。本研究旨在探讨雌激素治疗对去卵巢(OVX)小鼠高脂饮食(HFD)影响的作用机制。将雌性 C57BL/6J 小鼠行假手术(sham)、OVX 或 OVX 加雌二醇(E2)处理,并给予 HFD 喂养。通过高胰岛素-正葡萄糖钳夹试验评估胰岛素敏感性、肝脂质的示踪剂掺入和肝甘油三酯输出。OVX 小鼠表现出肥胖增加,而 E2 治疗可预防 OVX 时的肥胖。OVX 和 HFD 可增加胰岛素敏感性,E2 治疗可改善这种敏感性。在 sham 和 OVX 小鼠中,HFD 喂养诱导脂肪肝,胰岛素降低肝载脂蛋白 B100 和肝甘油三酯输出。E2 治疗可减少肝脂质沉积,并防止高胰岛素血症时肝甘油三酯输出减少。在缺乏肝脏雌激素受体α的小鼠中,OVX 后的 E2 可限制肥胖,但不能改善胰岛素敏感性,限制肝脂质沉积,也不能防止胰岛素抑制肝甘油三酯输出。综上所述,雌激素治疗可能通过促进胰岛素对葡萄糖代谢的作用来逆转选择性胰岛素抵抗途径,同时限制肝脂质沉积。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60ef/3554377/5a8c45eb22b9/424fig1.jpg

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