Abstract

Clinical studies have shown hyperuricemia strongly associated with insulin resistance as well as cardiovascular disease. Direct evidence of how high uric acid (HUA) affects insulin resistance in cardiomyocytes, but the pathological mechanism of HUA associated with cardiovascular disease remains to be clarified. We aimed to examine the effect of HUA on insulin sensitivity in cardiomyocytes and on insulin resistance in hyperuricemic mouse model. We exposed primary cardiomyocytes and a rat cardiomyocyte cell line, H9c2 cardiomyocytes, to HUA, then quantified glucose uptake with a fluorescent glucose analog, 2-NBDG, after insulin challenge and detected reactive oxygen species (ROS) production. Western blot analysis was used to examine the levels of insulin receptor (IR), phosphorylated insulin receptor substrate 1 (IRS1, Ser307) and phospho-Akt (Ser473). We monitored the impact of HUA on insulin resistance, insulin signaling and IR, phospho-IRS1 (Ser307) and phospho-Akt levels in myocardial tissue of an acute hyperuricemia mouse model established by potassium oxonate treatment. HUA inhibited insulin-induced glucose uptake in H9c2 and primary cardiomyocytes. It increased ROS production; pretreatment with N-acetyl-L-cysteine (NAC), a ROS scavenger, reversed HUA-inhibited glucose uptake induced by insulin. HUA exposure directly increased the phospho-IRS1 (Ser307) response to insulin and inhibited that of phospho-Akt in H9C2 cardiomyocytes, which was blocked by NAC. Furthermore, the acute hyperuricemic mice model showed impaired glucose tolerance and insulin tolerance accompanied by increased phospho-IRS1 (Ser307) and inhibited phospho-Akt response to insulin in myocardial tissues. HUA inhibited insulin signaling and induced insulin resistance in cardiomyocytes in vitro and in vivo, which is a novel potential mechanism of hyperuricemic-related cardiovascular disease.

Highlights

  • Uric acid (UA) is the final product of purine metabolism

  • We investigated the effect of high uric acid (HUA) on oxidative stress, insulin signaling and insulin resistance, as manifested by changes in reactive oxygen species (ROS) production, glucose uptake and phospho-IRS1 (Ser307) and -Akt activity in H9C2, primary cardiomyocytes and cardiac tissue from an acute hyperuricemia mice model

  • Pretreatment with the antioxidant NAC partially reversed HUA-generated ROS (Fig 2D–2F), which suggests that HUA directly caused oxidative stress in H9c2 cardiomyocytes

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Summary

Introduction

Elevated serum UA levels have been identified as a potential risk factor for gout, abnormal glucose metabolism, dyslipidemia and hypertension in the clinic and strongly associated with cardiovascular diseases, including ischemic heart disease and heart failure [1,2,3,4,5]. Recent clinical studies have revealed that increased serum UA level is an independent risk factor for insulin resistance, and basic studies have showed that high uric acid (HUA) induced insulin resistance in liver, muscle and adipocytes. A pivotal role of HUA in insulin resistance in cardiac dysfunction is not yet established, increasing evidence has suggested that oxidative stress plays a causal role in the cardiac complications of insulin resistance, and overgenerated ROS and insulin resistance may both be implicated in cardiac dysfunction [12]

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