Cardiac Department, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Department of Internal Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Utah, Salt Lake City, UT.
Diabetes. 2023 Aug 1;72(8):1154-1160. doi: 10.2337/db22-0902.
Lactate is an important metabolic substrate for sustaining brain energy requirements when glucose supplies are limited. Recurring exposure to hypoglycemia (RH) raises lactate levels in the ventromedial hypothalamus (VMH), which contributes to counterregulatory failure. However, the source of this lactate remains unclear. The current study investigates whether astrocytic glycogen serves as the major source of lactate in the VMH of RH rats. By decreasing the expression of a key lactate transporter in VMH astrocytes of RH rats, we reduced extracellular lactate concentrations, suggesting excess lactate was locally produced from astrocytes. To determine whether astrocytic glycogen serves as the major source of lactate, we chronically delivered either artificial extracellular fluid or 1,4-dideoxy-1,4-imino-d-arabinitol to inhibit glycogen turnover in the VMH of RH animals. Inhibiting glycogen turnover in RH animals prevented the rise in VMH lactate and the development of counterregulatory failure. Lastly, we noted that RH led to an increase in glycogen shunt activity in response to hypoglycemia and elevated glycogen phosphorylase activity in the hours following a bout of hypoglycemia. Our data suggest that dysregulation of astrocytic glycogen metabolism following RH may be responsible, at least in part, for the rise in VMH lactate levels.
Astrocytic glycogen serves as the major source of elevated lactate levels in the ventromedial hypothalamus (VMH) of animals exposed to recurring episodes of hypoglycemia. Antecedent hypoglycemia alters VMH glycogen turnover. Antecedent exposure to hypoglycemia enhances glycogen shunt activity in the VMH during subsequent bouts of hypoglycemia. In the immediate hours following a bout of hypoglycemia, sustained elevations in glycogen phosphorylase activity in the VMH of recurrently hypoglycemic animals contribute to sustained elevations in local lactate levels.
当葡萄糖供应有限时,乳酸是维持大脑能量需求的重要代谢底物。反复发生的低血糖(RH)会提高腹内侧下丘脑(VMH)中的乳酸水平,这有助于对抗调节失败。然而,这种乳酸的来源仍不清楚。本研究调查了在 RH 大鼠的 VMH 中,星形胶质细胞糖原是否是乳酸的主要来源。通过降低 RH 大鼠 VMH 星形胶质细胞中关键的乳酸转运蛋白的表达,我们降低了细胞外乳酸浓度,表明过多的乳酸是由星形胶质细胞局部产生的。为了确定星形胶质细胞糖原是否是乳酸的主要来源,我们在 RH 动物的 VMH 中慢性给予人工细胞外液或 1,4-二脱氧-1,4-亚氨基-D-阿拉伯糖醇,以抑制糖原周转。抑制 RH 动物的糖原周转可防止 VMH 乳酸升高和对抗调节失败的发展。最后,我们注意到 RH 导致低血糖反应时糖原穿梭活性增加,并在低血糖发作后的几个小时内升高糖原磷酸化酶活性。我们的数据表明,RH 后星形胶质细胞糖原代谢的失调至少部分导致了 VMH 乳酸水平的升高。
在反复发生低血糖的动物的腹内侧下丘脑(VMH)中,星形胶质细胞糖原是升高的乳酸水平的主要来源。先前的低血糖会改变 VMH 中的糖原周转。先前暴露于低血糖会增强低血糖发作期间 VMH 中的糖原穿梭活性。在低血糖发作后的几个小时内,反复低血糖动物 VMH 中糖原磷酸化酶活性的持续升高导致局部乳酸水平的持续升高。