University of Washington Medicine Diabetes Institute, Department of Medicine, University of Washington, Seattle, WA.
Gastroenterology and Hepatology, Department of Pediatrics, University of Washington, Seattle, WA.
Diabetes. 2019 Mar;68(3):654-664. doi: 10.2337/db18-0498. Epub 2018 Dec 6.
We recently reported that in rodent models of type 2 diabetes (T2D), a single intracerebroventricular (icv) injection of fibroblast growth factor 1 (FGF1) induces remission of hyperglycemia that is sustained for weeks. To clarify the peripheral mechanisms underlying this effect, we used the Zucker diabetic fatty / rat model of T2D, which, like human T2D, is characterized by progressive deterioration of pancreatic β-cell function after hyperglycemia onset. We report that although icv FGF1 injection delays the onset of β-cell dysfunction in these animals, it has no effect on either glucose-induced insulin secretion or insulin sensitivity. These observations suggest that FGF1 acts in the brain to stimulate insulin-independent glucose clearance. On the basis of our finding that icv FGF1 treatment increases hepatic glucokinase gene expression, we considered the possibility that increased hepatic glucose uptake (HGU) contributes to the insulin-independent glucose-lowering effect of icv FGF1. Consistent with this possibility, we report that icv FGF1 injection increases liver glucokinase activity by approximately twofold. We conclude that sustained remission of hyperglycemia induced by the central action of FGF1 involves both preservation of β-cell function and stimulation of HGU through increased hepatic glucokinase activity.
我们最近报道,在 2 型糖尿病(T2D)的啮齿动物模型中,单次脑室内(icv)注射成纤维细胞生长因子 1(FGF1)可诱导持续数周的高血糖缓解。为了阐明这种效应的外周机制,我们使用了 T2D 的 Zucker 糖尿病肥胖/大鼠模型,该模型与人类 T2D 一样,其特征是在高血糖发作后胰岛 β 细胞功能逐渐恶化。我们报告称,尽管 icv FGF1 注射可延迟这些动物中 β 细胞功能障碍的发生,但对葡萄糖诱导的胰岛素分泌或胰岛素敏感性没有影响。这些观察结果表明,FGF1 在大脑中起作用,刺激胰岛素非依赖性的葡萄糖清除。基于我们发现 icv FGF1 治疗可增加肝葡萄糖激酶基因表达,我们考虑了增加肝葡萄糖摄取(HGU)可能有助于 icv FGF1 的胰岛素非依赖性降血糖作用的可能性。与这种可能性一致,我们报告称,icv FGF1 注射可使肝葡萄糖激酶活性增加约两倍。我们得出结论,FGF1 的中枢作用诱导的高血糖持续缓解既涉及β细胞功能的保存,也涉及通过增加肝葡萄糖激酶活性刺激 HGU。