Abstract

Metformin has been used to treat patients with type 2 diabetes for over 60 years, however, its mechanism of action is still not completely understood. Our previous reports showed that high-fat-diet (HFD)-fed mice with liver-specific knockout of both AMPK catalytic α1 and α2 subunits exhibited significantly higher fasting blood glucose levels and produced more glucose than floxed AMPK catalytic α1 and α2 mice after long-term metformin treatment, and that metformin promotes the formation of the functional AMPK αβγ heterotrimeric complex. We tested the importance of each regulatory γ subunit isoform to metformin action in this current study. We found that depletion of γ1, but not γ2 or γ3, drastically reduced metformin activation of AMPK. HFD-fed mice with depletion of the γ1 subunit are resistant to metformin suppression of liver glucose production. Furthermore, we determined the role of each regulatory cystathionine-β-synthase (CBS) domain in the γ1 subunit in metformin action and found that deletion of either CBS1 or CBS4 negated metformin’s effect on AMPKα phosphorylation at T172 and suppression of glucose production in hepatocytes. Our data indicate that the γ1 subunit is required for metformin’s control of glucose metabolism in hepatocytes. Furthermore, in humans and animal models, metformin treatment leads to the loss of body weight, we found that the decrease in body weight gain in mice treated with metformin is not directly attributable to increased energy expenditure.

Highlights

  • Diabetes affects at least 425 million people worldwide, with type 2 diabetes (T2D) accounting for more than 90% of diabetes cases

  • Since the regulatory γ subunit plays a critical role in the activation of the catalytic α subunit and AMPK heterotrimeric complexes containing different γ subunit isoforms are regulated differently[26], we determined the importance of each γ subunit isoform and individual CBS domain in the γ subunit to metformin action in this current study

  • It has been proposed that the principal mechanism of metformin action is through an AMPK-independent pathway[34,35]

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Summary

Introduction

Diabetes affects at least 425 million people worldwide, with type 2 diabetes (T2D) accounting for more than 90% of diabetes cases. HFD-fed mice with liver-specific knockout of both AMPK catalytic α1 and α2 subunits produced significantly more glucose compared to floxed AMPKα1 and α2 mice after long-term treatment with a clinically relevant metformin dose (50 mg/kg/day)[16]. These data demonstrate that liver AMPKα1 and α2 subunits have important roles in metformin’s control of glucose metabolism and improvement of hyperglycemia in HFD-fed mice. Since the regulatory γ subunit plays a critical role in the activation of the catalytic α subunit and AMPK heterotrimeric complexes containing different γ subunit isoforms are regulated differently[26], we determined the importance of each γ subunit isoform and individual CBS domain in the γ subunit to metformin action in this current study. These data provide important new insights into the mechanisms of metformin action

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