Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada.
Nat Med. 2013 Jun;19(6):766-72. doi: 10.1038/nm.3115. Epub 2013 May 19.
Glucagon activates hepatic protein kinase A (PKA) to increase glucose production, but the gluco-stimulatory effect is transient even in the presence of continuous intravenous glucagon infusion. Continuous intravenous infusion of insulin, however, inhibits glucose production through its sustained actions in both the liver and the mediobasal hypothalamus (MBH). In a pancreatic clamp setting, MBH infusion with glucagon activated MBH PKA and inhibited hepatic glucose production (HGP) in rats, as did central glucagon infusion in mice. Inhibition of glucagon receptor-PKA signaling in the MBH and hepatic vagotomy each negated the effect of MBH glucagon in rats, whereas the central effect of glucagon was diminished in glucagon receptor knockout mice. A sustained rise in plasma glucagon concentrations transiently increased HGP, and this transiency was abolished in rats with negated MBH glucagon action. In a nonclamp setting, MBH glucagon infusion improved glucose tolerance, and inhibition of glucagon receptor-PKA signaling in the MBH enhanced the ability of intravenous glucagon injection to increase plasma glucose concentrations. We also detected a similar enhancement of glucose concentrations that was associated with a disruption in MBH glucagon signaling in rats fed a high-fat diet. We show that hypothalamic glucagon signaling inhibits HGP and suggest that hypothalamic glucagon resistance contributes to hyperglycemia in diabetes and obesity.
胰高血糖素激活肝蛋白激酶 A(PKA)以增加葡萄糖生成,但即使持续静脉输注胰高血糖素,其促糖作用也是短暂的。然而,胰岛素的持续静脉输注通过其在肝脏和中脑基底部(MBH)中的持续作用来抑制葡萄糖生成。在胰腺夹闭设置中,MBH 中胰高血糖素的输注激活了 MBH PKA,并抑制了大鼠的肝葡萄糖生成(HGP),如同在小鼠中中枢输注胰高血糖素一样。MBH 中的胰高血糖素受体-PKA 信号的抑制和肝迷走神经切断术都消除了 MBH 胰高血糖素在大鼠中的作用,而在胰高血糖素受体敲除小鼠中,胰高血糖素的中枢作用减弱。血浆胰高血糖素浓度的持续升高短暂地增加了 HGP,而在消除了 MBH 胰高血糖素作用的大鼠中,这种短暂性被消除。在非夹闭设置中,MBH 胰高血糖素输注改善了葡萄糖耐量,并且 MBH 中胰高血糖素受体-PKA 信号的抑制增强了静脉内胰高血糖素注射增加血糖浓度的能力。我们还在高脂肪饮食喂养的大鼠中检测到与 MBH 胰高血糖素信号中断相关的类似葡萄糖浓度增强,这表明下丘脑胰高血糖素信号抑制 HGP,并且提示下丘脑胰高血糖素抵抗导致糖尿病和肥胖中的高血糖。