The degree of hepatic lipid accumulation in obesity directly correlates with the severity of hyperinsulinemia and systemic insulin resistance. Here, we propose a mechanism that explains this associative link, whereby, hepatic steatosis dysregulates glucose and insulin homeostasis. Obesity-induced lipid accumulation results in hepatocyte depolarization. We have established that hepatocyte depolarization depresses hepatic vagal afferent nerve (HVAN) firing (22.9 ± 7.6%; P < 0.05). The HVAN plays a key role in regulating whole-body glucose homeostasis. Accordingly, we propose that dysregulated hepatocyte-vagal communication underlies the metabolic dysfunction in obesity. Using an ex vivo explant liver slice model, we showed that diet induced obesity nearly triples hepatic GABA release/mg DNA in mice (P < 0.05). We hypothesize that hepatic GABA release decreases HVAN activity to stimulate insulin release and decrease peripheral insulin sensitivity. To establish that hepatocyte depolarization encourages GABA export in obesity, we virally induced expression of Kir2.1, a hyperpolarizing channel, in hepatocytes. Kir2.1 expression decreased hepatic slice GABA release to half of that observed in control obese mice, while protecting against hyperinsulinemia and insulin resistance on a high fat diet. Hepatic GABA is synthesized by GABA-Transaminase (GABA-T). To determine the role of hepatic GABA production in diet induced metabolic dysfunction, we treated obese mice with the irreversible GABA-T inhibitors, ethanolamine-O-sulphate (EOS) or vigabatrin (8mg/day; IP). Within 5 days, GABA-T inhibition ameliorated the hyperinsulinemia and insulin resistance of obesity (P < 0.05). These improvements in glucose homeostasis are dependent on an intact HVAN, as EOS did not affect serum insulin or insulin sensitivity in obese hepatic vagotomized mice. This work establishes that limiting hepatocyte GABA production or release can mute the glucoregulatory dysfunction common to obesity. Disclosure C. Geisler: None. S. Ghimire: None. B.J. Renquist: None. Funding Arizona Biomedical Research Commission (ADHS14-082986, ADHS18-201472 to B.J.R.); American Heart Association (15BGIA25090300 to B.J.R.)
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