Department of the Core Facility, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China; Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
Maternity and Child Dept, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
Clin Nutr. 2024 Feb;43(2):366-378. doi: 10.1016/j.clnu.2023.12.008. Epub 2023 Dec 12.
BACKGROUND & AIMS: Hyperglycemia is associated with lipid disorders in patients with diabetes. Ceramides are metabolites involved in sphingolipid metabolism that accumulate during lipid disorders and exert deleterious effects on glucose and lipid metabolism. However, the effects of ceramide on glucagon-mediated hepatic gluconeogenesis remain largely unknown. This study was designed to investigate the impact of ceramides on gluconeogenesis in the context of the hepatic glucagon response, with the aim of finding new pharmacological interventions for hyperglycemia in diabetes.
Liquid chromatography-mass spectrometry was used to quantify ceramide content in the serum of patients with diabetes. Primary hepatocytes were isolated from male C57BL/6J mice to study the effects of ceramide on hepatic glucose production. Immunofluorescence staining was performed to view cAMP-responsive element-binding protein (CREB)- regulated transcription co-activator 2 (CRTC2) nuclear translocation in hepatocytes. Serine palmitoyl-transferase, long chain base subunit 2 (Sptlc2) knockdown mice were generated using an adeno-associated virus containing shRNA, and hepatic glucose production was assessed glucagon tolerance and pyruvate tolerance tests in mice fed a normal chow diet and high-fat diet.
Increased ceramide levels were observed in the serum of patients newly diagnosed with type 2 diabetes. De novo ceramide synthesis was activated in mice with metabolic disorders. Ceramide enhanced hepatic glucose production in primary hepatocytes. In contrast, genetic silencing of Sptlc2 prevented this process. Mechanistically, ceramides de-phosphorylate CRTC2 (Ser 171) and facilitate its translocation into the nucleus for CREB activation, thereby augmenting the hepatic glucagon response. Hepatic Sptlc2 silencing blocked ceramide generation in the liver and thus restrained the hepatic glucagon response in mice fed a normal chow diet and high-fat diet.
These data indicate that ceramide serves as an intracellular messenger that augments hepatic glucose production by regulating CRTC2/CREB activity in the context of the hepatic glucagon response, suggesting that CRTC2 phosphorylation might be a potential node for pharmacological interventions to restrain the hyperglycemic response during fasting in diabetes.
高血糖与糖尿病患者的脂质紊乱有关。神经酰胺是参与鞘脂代谢的代谢物,在脂质紊乱时积累,并对葡萄糖和脂质代谢产生有害影响。然而,神经酰胺对胰高血糖素介导的肝糖异生的影响在很大程度上尚不清楚。本研究旨在研究神经酰胺在肝胰高血糖素反应背景下对糖异生的影响,以期为糖尿病的高血糖找到新的药物干预靶点。
采用液相色谱-质谱法检测糖尿病患者血清中神经酰胺的含量。从小鼠原代肝细胞中分离出肝细胞,研究神经酰胺对肝葡萄糖生成的影响。免疫荧光染色观察肝细胞中环磷酸腺苷反应元件结合蛋白(CREB)调节转录共激活因子 2(CRTC2)的核转位。利用腺相关病毒携带 shRNA 生成丝氨酸棕榈酰转移酶,长链碱基亚基 2(Sptlc2)敲低小鼠,在正常饮食和高脂肪饮食喂养的小鼠中进行胰高血糖素耐量和丙酮酸耐量试验,评估肝葡萄糖生成。
新诊断为 2 型糖尿病患者的血清中神经酰胺水平升高。代谢紊乱小鼠中神经酰胺的从头合成被激活。神经酰胺增强原代肝细胞的肝葡萄糖生成。相反,Sptlc2 的基因沉默阻止了这一过程。机制上,神经酰胺使 CRTC2(Ser171)去磷酸化,促进其向核内易位,从而增强肝胰高血糖素反应。肝 Sptlc2 沉默阻断了肝脏中神经酰胺的生成,从而抑制了正常饮食和高脂肪饮食喂养的小鼠的肝胰高血糖素反应。
这些数据表明,神经酰胺作为一种细胞内信使,通过调节肝胰高血糖素反应中的 CRTC2/CREB 活性增强肝葡萄糖生成,提示 CRTC2 磷酸化可能是药物干预以抑制糖尿病空腹高血糖反应的潜在节点。