Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Department of Biology and Center for Obesity Reversal, Georgia State University, Atlanta, GA 30302-4010, USA.
Mol Metab. 2017 Jun 6;6(8):854-862. doi: 10.1016/j.molmet.2017.05.017. eCollection 2017 Aug.
We have previously shown that the consumption of a low-carbohydrate ketogenic diet (KD) by mice leads to a distinct physiologic state associated with weight loss, increased metabolic rate, and improved insulin sensitivity [1]. Furthermore, we identified fibroblast growth factor 21 (FGF21) as a necessary mediator of the changes, as mice lacking FGF21 fed KD gain rather than lose weight [2]. FGF21 activates the sympathetic nervous system (SNS) [3], which is a key regulator of metabolic rate. Thus, we considered that the SNS may play a role in mediating the metabolic adaption to ketosis.
To test this hypothesis, we measured the response of mice lacking all three β-adrenergic receptors (β-less mice) to KD feeding.
In contrast to wild-type (WT) controls, β-less mice gained weight, increased adipose tissue depots mass, and did not increase energy expenditure when consuming KD. Remarkably, despite weight-gain, β-less mice were insulin sensitive. KD-induced changes in hepatic gene expression of β-less mice were similar to those seen in WT controls eating KD. Expression of FGF21 mRNA rose over 60-fold in both WT and β-less mice fed KD, and corresponding circulating FGF21 levels were 12.5 ng/ml in KD-fed wild type controls and 35.5 ng/ml in KD-fed β-less mice.
The response of β-less mice distinguishes at least two distinct categories of physiologic effects in mice consuming KD. In the liver, KD regulates peroxisome proliferator-activated receptor alpha (PPARα)-dependent pathways through an action of FGF21 independent of the SNS and beta-adrenergic receptors. In sharp contrast, induction of interscapular brown adipose tissue (BAT) and increased energy expenditure absolutely require SNS signals involving action on one or more β-adrenergic receptors. In this way, the key metabolic actions of FGF21 in response to KD have diverse effector mechanisms.
我们之前的研究表明,食用低碳水化合物生酮饮食(KD)可使小鼠产生明显的生理状态,与体重减轻、代谢率增加和胰岛素敏感性提高有关[1]。此外,我们发现成纤维细胞生长因子 21(FGF21)是这种变化的必要介质,因为缺乏 FGF21 的小鼠即使喂食 KD 也不会减轻体重,反而会增加体重[2]。FGF21 可激活交感神经系统(SNS)[3],这是代谢率的关键调节因素。因此,我们认为 SNS 可能在介导代谢适应酮症中起作用。
为了验证这一假设,我们检测了缺乏三种β肾上腺素能受体(β-less 小鼠)的小鼠对 KD 喂养的反应。
与野生型(WT)对照组相比,β-less 小鼠在食用 KD 时体重增加、脂肪组织储存增加,且能量消耗没有增加。值得注意的是,尽管体重增加,β-less 小鼠仍对胰岛素敏感。KD 诱导的β-less 小鼠肝基因表达变化与 WT 对照组食用 KD 时相似。FGF21 mRNA 在 WT 和 KD 喂养的β-less 小鼠中均增加了 60 多倍,相应的循环 FGF21 水平在 KD 喂养的野生型对照组中为 12.5ng/ml,在 KD 喂养的β-less 小鼠中为 35.5ng/ml。
β-less 小鼠的反应将至少区分出两种不同的生理效应类别,即食用 KD 的小鼠。在肝脏中,KD 通过 FGF21 的作用调节过氧化物酶体增殖物激活受体α(PPARα)依赖性途径,而该作用独立于 SNS 和β肾上腺素能受体。与此形成鲜明对比的是,肩胛间棕色脂肪组织(BAT)的诱导和能量消耗的增加绝对需要涉及一个或多个β肾上腺素能受体的 SNS 信号。通过这种方式,FGF21 对 KD 的关键代谢作用具有多种效应机制。