Abstract
Metabolic syndrome (MetSyn) is a combination of metabolic abnormalities that lead to the development of cardiovascular disease (CVD) and Type 2 Diabetes (T2D). Although various criteria for defining MetSyn exist, common abnormalities include abdominal obesity, elevated serum triglyceride, insulin resistance, and blood glucose, decreased high-density lipoprotein cholesterol (HDL-C), and hypertension. MetSyn prevalence has been increasing with the rise of obesity worldwide, with significantly higher prevalence in women compared with men and in Hispanics compared with Whites. Affected individuals are at a higher risk of developing T2D (5-fold) and CVD (2-fold). Heritability estimates for individual components of MetSyn vary between 40 and 70%, suggesting a strong contribution of an individual's genetic makeup to disease pathology. The advent of next-generation sequencing technologies has enabled large-scale genome-wide association studies (GWAS) into the genetics underlying MetSyn pathogenesis. Several such studies have implicated the transcription factor KLF14, a member of the Krüpple-like factor family (KLF), in the development of metabolic diseases, including obesity, insulin resistance, and T2D. How KLF14 regulates these metabolic traits and increases the risk of developing T2D, atherosclerosis, and liver dysfunction is still unknown. There have been some debate and controversial results with regards to its expression profile and functionality in various tissues, and a systematic review of current knowledge on KLF14 is lacking. Here, we summarize the research progress made in understanding the function of KLF14 and describe common attributes of its biochemical, physiological, and pathophysiological roles. We also discuss the current challenges in understanding the role of KLF14 in metabolism and provide suggestions for future directions.
Highlights
genome-wide association studies (GWAS) identified several genetic variants near the KLF14 gene on chromosome 7 to be associated with a multitude of metabolic pathologies, including insulin resistance, Type 2 Diabetes (T2D) [1,2,3], and coronary artery disease (CAD) [4]
Klf14 knockdown reduced PGC-1α, thereby constraining glucose production [93]. These results suggested that KLF14 modulates hepatic glucose metabolism by regulating the activity of PGC-1α
The association of genetic variants with KLF14 expression is only observed in adipose tissue suggesting that, instead of the liver, the metabolic effects of the risk variants are in the adipose tissue, which was not addressed in the aforementioned studies
Summary
GWAS identified several genetic variants near the KLF14 gene on chromosome 7 to be associated with a multitude of metabolic pathologies, including insulin resistance, T2D [1,2,3], and coronary artery disease (CAD) [4]. Three distinct lines of evidence predict that the transcription factor KLF14 is the causal gene in this GWAS locus and it functions in the adipose tissue: 1. Overexpression of Klf14 leads to increased transcription activation of PGC-1α, the histone deacetylase Sirtuin 1 and hepatocyte nuclear transcription factor 4α, all of which are insulin signaling-associated factors and play a role in glucose production in the liver [50, 51, 93, 101].
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