Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL, USA.
IMDEA-Food, Madrid, Spain.
Endocrinology. 2021 Nov 1;162(11). doi: 10.1210/endocr/bqab175.
Thiazolidinediones (TZD) are peroxisome proliferator-activated receptor γ (PPARγ) agonists that may reduce hepatic steatosis through their effects in adipose tissue and therefore have been assessed as potential therapies to treat nonalcoholic fatty liver disease (NAFLD) in humans. However, some studies suggest that expression and activation of hepatocyte PPARγ promotes steatosis and that would limit the benefits of TZD as a NAFLD therapy. To further explore this possibility, we examined the impact of short-term rosiglitazone maleate treatment after the development of moderate or severe diet-induced obesity, in both control and adult-onset hepatocyte-specific PPARγ knockout (PpargΔHep) mice. Independent of the level of obesity and hepatic PPARγ expression, the TZD treatment enhanced insulin sensitivity, associated with an increase in white adipose tissue (WAT) fat accumulation, consistent with clinical observations. However, TZD treatment increased hepatic triglyceride content only in control mice with severe obesity. Under these conditions, PpargΔHep reduced diet-induced steatosis and prevented the steatogenic effects of short-term TZD treatment. In these mice, subcutaneous WAT was enlarged and associated with increased levels of adiponectin, while hepatic levels of phosphorylated adenosine 5'-monophosphate-activated protein kinase were also increased. In addition, in mice with severe obesity, the expression of hepatic Cd36, Cidea, Cidec, Fabp4, Fasn, and Scd-1 was increased by TZD in a PPARγ-dependent manner. Taken together, these results demonstrate that hepatocyte PPARγ expression offsets the antisteatogenic actions of TZD in mice with severe obesity. Therefore, in obese and insulin resistant humans, TZD-mediated activation of hepatocyte PPARγ may limit the therapeutic potential of TZD to treat NAFLD.
噻唑烷二酮类(TZD)是过氧化物酶体增殖物激活受体γ(PPARγ)激动剂,可通过其在脂肪组织中的作用减少肝脂肪变性,因此被评估为治疗非酒精性脂肪性肝病(NAFLD)的潜在疗法。然而,一些研究表明,肝细胞 PPARγ 的表达和激活会促进脂肪变性,从而限制 TZD 作为 NAFLD 治疗的益处。为了进一步探索这种可能性,我们研究了在中度或重度饮食诱导肥胖后短期马来酸罗格列酮治疗对对照和成年期肝细胞特异性 PPARγ 敲除(PpargΔHep)小鼠的影响。独立于肥胖程度和肝 PPARγ 表达,TZD 治疗增强了胰岛素敏感性,伴随着白色脂肪组织(WAT)脂肪积累的增加,与临床观察一致。然而,TZD 治疗仅在严重肥胖的对照小鼠中增加了肝甘油三酯含量。在这些条件下,PpargΔHep 减少了饮食诱导的脂肪变性,并阻止了短期 TZD 治疗的致脂肪变性作用。在这些小鼠中,皮下 WAT 增大,并伴随着脂联素水平的增加,而肝磷酸化腺苷 5'-单磷酸激活蛋白激酶的水平也增加。此外,在严重肥胖的小鼠中,TZD 以 PPARγ 依赖性方式增加了肝 Cd36、Cidea、Cidec、Fabp4、Fasn 和 Scd-1 的表达。综上所述,这些结果表明,肝细胞 PPARγ 的表达抵消了 TZD 在严重肥胖小鼠中的抗脂肪变性作用。因此,在肥胖和胰岛素抵抗的人群中,TZD 介导的肝细胞 PPARγ 激活可能限制了 TZD 治疗 NAFLD 的治疗潜力。