Insulin Receptor Gene Research Articles

The effect of gelatinized brown rice extract on type 2 diabetes mellitus via inhibition of insulin resistance mediators in HepG2 cells

The purpose of this study evaluated effects of gelatinized brown rice extract (GBE) on type 2 diabetes mellitus by analyzing antioxidant activity, polysaccharide-degrading enzymes activity, and regulation of insulin secretion and glucose transport-related factors in human liver cells (HepG2). Quantified polyphenols and flavonoids in extract showed 6.7 mg gallic acid equivalent/g dry matter (DM) and 5.3 mg quercetin equivalent/g DM, respectively, with DPPH and ABTS radical scavenging activities confirmed to 67.1 ~ 77.7%. Additionally, extract inhibited alpha-glucosidase activity by 81.9%, thereby demonstrating potential for improving blood glucose regulation. To demonstrate alleviation of type 2 diabetes through mitigation of insulin resistance and promotion of glucose transport, expression of genes related to insulin receptor genes (Insulin Receptor Substrate-1, Protein Kinase B) increased by 18.5 ~ 28.3%, while expression of counterregulatory hormone genes (Insulin-like Growth Factor-1) decreased by 33.3%. Additionally, expression of glucose transporter proteins (Glucose Transporter Type-4, 2) increased by 30.9 ~ 42.0%, and expression of proteins that reduce insulin sensitivity (Insulin Receptor Substrate-2) decreased by 34.6%. These results indicated that insulin resistance in hepatocytes alleviated, and glucose transport promoted, leading to decreased blood glucose levels.

Structural insights into conformational stability of both wild-type and mutant Insulin Receptor Gene

Type 2 diabetes (T2D) poses a health challenge. It can lead to complications such as heart disease, hypertension, heart failure, and stroke. Factors like obesity and lack of activity can contribute to insulin resistance. The insulin receptor gene (INSR) is responsible for producing insulin receptors. When this gene malfunctions, it can contribute to the development of T2D.In this study, we investigated the stability of the structure of variants of INSR using an extended molecular dynamics simulation and the perturbation effect of compound CheBI_88339 on the protein structure. During the analysis, we observed that all three systems—the wild-type INSR, the R1191Q variant, and the R1191Q variant bound to compound CheBI_88339 (R1191Q-D) reached equilibrium in 30ns without any instability. Throughout the simulation process, it was generally observed that the wild-type INSR exhibited higher stability than the R1191Q variant and R1191Q-D. The Root Mean Square Deviation (RMSD) and root-mean-square fluctuation (RMSF) of INSR, R1191Q and the variant bound to compound CheBI_88339 (R1191Q-D) are 9.28Å, 10.35Å, 8.65Å, 2.59Å, 2.98Å, and 2.89Å respectively.These values indicate that the mutated INSR introduced levels of deviations and flexibility in the protein structure. However, considering the variant bound to compound CheBI_88339 suggests that this drug may contribute to stabilizing the dynamics of the mutant protein. Overall, our findings shed light on the effect of genetic variants and their impact on protein stability. This research provides further insight into the dynamics of INSR and the potential of CheBI_88339 in targeting INSR. However, this study is computational, and further experimental studies are required.

Role of Vitamin D Receptor (BsmI-VDR) and Insulin Receptor (NsiI-A/G) Gene Polymorphisms in Colorectal Adenoma Susceptibility.

Vitamin D deficiency and type 2 diabetes mellitus are risk factors for colorectal cancer, suggesting a role for vitamin D receptor (VDR) and insulin receptor (INSR) gene polymorphisms. We investigated the prevalence of the VDR-BsmI (rs1544410) and NsiI A/G-INSR (rs2059806) polymorphisms and their associations with colorectal adenoma (CRA) in a Romanian population. A case-control study was conducted with 110 participants (67 with CRA and 43 controls) who underwent colonoscopy. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to determine the genotype and allele frequencies of the two polymorphisms. Regarding rs1544410 and CRA patients, genotype distribution was 35% B/B, 47% B/b, and 19% b/b. In the controls, the distribution was 21% B/B, 45% B/b, and 34% b/b. For rs2059806, 12% of CRA patients had A/A, 30% A/G, and 58% G/G, while 8% of the controls had A/A, 40% A/G, and 52% G/G. The recessive model showed an odds ratio of 2.84 (95% CI: 1.04-7.72, p = 0.033) for the b/b genotype. CRA patients with b/b or G/G genotypes were diagnosed at a younger age. The b allele of the rs1544410 was a risk factor for CRA. Patients with the b/b and G/G genotypes were diagnosed earlier.

Exposure to 6-PPD quinone disrupts glucose metabolism associated with lifespan reduction by affecting insulin and AMPK signals in Caenorhabditis elegans

Glucose metabolism plays an important role for formation of normal physiological state of organisms. However, association between altered glucose metabolism and toxicity of 6-PPD quinone (6-PPDQ) remains largely unknown. In 1–100 μg/L 6-PPDQ exposed Caenorhabditis elegans, we observed increased glucose content. After 6-PPDQ exposure (1–100 μg/L), expressions of F47B8.10 and fbp-1 governing gluconeogenesis were increased, and expressions of hxk-1, hxk-3, pfk-1.1, pyk-1, and pyk-2 governing glycolysis were decreased. Under 6-PPDQ exposure condition, glucose content could be changed by RNAi of F47B8.10, hxk-1, and hxk-3, key genes for gluconeogenesis and glycolysis. In 6-PPDQ exposed nematodes, RNAi of daf-16 and aak-2 elevated glucose content, increased expressions of F47B8.10 and/or fbp-1, and decreased expressions of hxk-1, hxk-3, and/or pfk-1.1. Additionally, lifespan and locomotion during aging were increased by RNAi of F47B8.10 and decreased by RNAi of hxk-1 and hxk-3 in 6-PPDQ exposed nematodes. Moreover, after 6-PPDQ exposure, RNAi of F47B8.10 decreased expressions of insulin peptide genes (ins-7 and daf-28) and insulin receptor gene daf-2 and increased expressions of daf-16 and aak-2. In 6-PPDQ exposed nematodes, RNAi of hxk-1 and hxk-3 further increased expressions of ins-7, daf-28, and daf-2 and decreased expressions of daf-16 and aak-2. Our results demonstrated important association between altered glucose metabolism and toxicity of 6-PPDQ in inducing lifespan reduction in organisms.

Hereditary Severe Insulin-resistance Syndrome and Acanthosis Nigricans Caused by Novel Mutations in the INSR Gene.

Most cases associated with Hereditary Severe Insulin Resistance Syndrome (H-SIRS) are linked to mutations in the insulin receptor (INSR) gene. Patients with H-SIRS typically manifest symptoms of hyperinsulinemia, insulin resistance, and diabetes mellitus. Other symptoms include impaired glucose regulation, hyperandrogenism, and the presence of acanthosis nigricans (AN). In this report, we present two cases of H-SIRS in female children exhibiting various symptoms, such as hyperinsulinemia, fasting hypoglycemia, postprandial hyperglycemia, overweight, fatty liver, hyperandrogenism, and varying degrees of AN. One patient also presented with mental retardation. Gene sequencing identified specific mutations in the INSR gene for both patients: c.2663A > G (p.Tyr888Cys) and c.38_61del (p.Pro13_Ala20del). These mutations have the potential to disrupt the interaction between INSR and insulin, leading to abnormal insulin signaling, insulin resistance, and various clinical manifestations.

Beyond the Obvious: Acanthosis Nigricans as a Clue to the Rare Case of Rabson–Mendenhall Syndrome

Rabson–Mendenhall syndrome (RMS) is a genetic disorder with autosomal recessive inheritance caused by mutations in the insulin receptor (INSR) gene. It is characterized by severe insulin resistance, acanthosis nigricans, skin tags, and growth retardation. Management of this condition is challenging and requires multidisciplinary approach. We present a case report on RMS in a 7-year-old girl who presented with coarse facies, acanthosis nigricans, skin tags, short stature, abdominal distension, and hyperglycemia with hyperinsulinemia. Her genetic analysis revealed a mutation in exon 3 of the INSR gene. The patient is being treated with tablet metformin and is being followed up.

Rabson-Mendenhall Syndrome: Analysis of the Clinical Characteristics and Gene Mutations in 42 Patients.

Rabson-Mendenhall syndrome (RMS) is a rare autosomal, recessive disorder characterized by severe insulin resistance due to mutations in the insulin receptor (INSR) gene. This study aims to analyze the clinical features and gene mutations in RMS, which have not been extensively studied. PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang were searched for "Rabson-Mendenhall syndrome" or "Black acanthosis hirsutism insulin resistance syndrome." A total of 42 cases from 33 articles were included. The body mass index ranged from 18.50 to 20.00 kg/m2 with an average of 16.00 kg/m2. There were no overweight (25.00∼29.90 kg/m2) or obese (≥30.00 kg/m2) patients. Acanthosis was present in 29 cases (29/42, 69.05%); growth retardation in 25 cases (25/42, 59.52%); dental anomalies including absence of teeth, crowding, and malocclusion in 23 cases (23/42, 54.76%); and hirsutism in 17 cases (17/42, 40.48%). The average glycosylated hemoglobin was 9.35%, and the average fasting blood-glucose was 8.44 mmol/L; the mean fasting insulin was 349.96 μIU/mL, and the average fasting C-peptide was 6.00 ng/mL. Diabetes was reported in 25 cases (25/33, 75.76%) all of which were diagnosed before 23 years old. All 42 patients had recorded gene mutations, with 22 patients (22/42, 52.38%) having ≥ 2 mutations and 20 cases (20/42, 47.62%) having only 1 mutation. No statistical differences were found in clinical features and laboratory parameters between patients with different mutations. The study indicates that RMS should be considered in young patients with hyperinsulinemia, hyperglycemia with low weight, acanthosis nigricans, growth retardation, dental anomalies, and hirsutism.

Imprinted Grb10, encoding growth factor receptor bound protein 10, regulates fetal growth independently of the insulin-like growth factor type 1 receptor (Igf1r) and insulin receptor (Insr) genes

BackgroundOptimal size at birth dictates perinatal survival and long-term risk of developing common disorders such as obesity, type 2 diabetes and cardiovascular disease. The imprinted Grb10 gene encodes a signalling adaptor protein capable of inhibiting receptor tyrosine kinases, including the insulin receptor (Insr) and insulin-like growth factor type 1 receptor (Igf1r). Grb10 restricts fetal growth such that Grb10 knockout (KO) mice are at birth some 25-35% larger than wild type. Using a mouse genetic approach, we test the widely held assumption that Grb10 influences growth through interaction with Igf1r, which has a highly conserved growth promoting role.ResultsShould Grb10 interact with Igf1r to regulate growth Grb10:Igf1r double mutant mice should be indistinguishable from Igf1r KO single mutants, which are around half normal size at birth. Instead, Grb10:Igf1r double mutants were intermediate in size between Grb10 KO and Igf1r KO single mutants, indicating additive effects of the two signalling proteins having opposite actions in separate pathways. Some organs examined followed a similar pattern, though Grb10 KO neonates exhibited sparing of the brain and kidneys, whereas the influence of Igf1r extended to all organs. An interaction between Grb10 and Insr was similarly investigated. While there was no general evidence for a major interaction for fetal growth regulation, the liver was an exception. The liver in Grb10 KO mutants was disproportionately overgrown with evidence of excess lipid storage in hepatocytes, whereas Grb10:Insr double mutants were indistinguishable from Insr single mutants or wild types.ConclusionsGrb10 acts largely independently of Igf1r or Insr to control fetal growth and has a more variable influence on individual organs. Only the disproportionate overgrowth and excess lipid storage seen in the Grb10 KO neonatal liver can be explained through an interaction between Grb10 and the Insr. Our findings are important for understanding how positive and negative influences on fetal growth dictate size and tissue proportions at birth.

Lactobacillus casei-fermented Amomum xanthioides ameliorates metabolic dysfunction in high-fat diet-induced obese mice.

Amomum xanthioides (AX) has been used as an edible herbal medicine to treat digestive system disorders in Asia. Additionally, Lactobacillus casei is a well-known probiotic commonly used in fermentation processes as a starter. The current study aimed to investigate the potential of Lactobacillus casei-fermented Amomum xanthioides (LAX) in alleviating metabolic disorders induced by high-fat diet (HFD) in a mouse model. LAX significantly reduced the body and fat weight, outperforming AX, yet without suppressing appetite. LAX also markedly ameliorated excessive lipid accumulation and reduced inflammatory cytokine (IL-6) levels in serum superior to AX in association with UCP1 activation and adiponectin elevation. Furthermore, LAX noticeably improved the levels of fasting blood glucose, serum insulin, and HOMA-IR through positive regulation of glucose transporters (GLUT2, GLUT4), and insulin receptor gene expression. In conclusion, the fermentation of AX demonstrates a pronounced mitigation of overnutrition-induced metabolic dysfunction, including hyperlipidemia, hyperglycemia, hyperinsulinemia, and obesity, compared to non-fermented AX. Consequently, we proposed that the fermentation of AX holds promise as a potential candidate for effectively ameliorating metabolic disorders.

The brain insulin receptor gene network and associations with frailty index.

To investigate longitudinal associations between variations in the co-expression-based brain insulin receptor polygenic risk score and frailty, as well as change in frailty across follow-up. This longitudinal study included 1605 participants from the Helsinki Birth Cohort Study. Biologically informed expression-based polygenic risk scores for the insulin receptor gene network, which measure genetic variation in the function of the insulin receptor, were calculated for the hippocampal (hePRS-IR) and the mesocorticolimbic (mePRS-IR) regions. Frailty was assessed in at baseline in 2001-2004, 2011-2013 and 2017-2018 by applying a deficit accumulation-based frailty index. Analyses were carried out by applying linear mixed models and logistical regression models adjusted for adult socioeconomic status, birthweight, smoking and their interactions with age. The FI levels of women were 1.19%-points (95% CI 0.12-2.26, P =0.029) higher than in men. Both categorical and continuous hePRS-IR in women were associated with higher FI levels than in men at baseline (P < 0.05). In women with high hePRS-IR, the rate of change was steeper with increasing age compared to those with low or moderate hePRS-IR (P < 0.05). No associations were detected between mePRS-IR and frailty at baseline, nor between mePRS-IR and the increase in mean FI levels per year in either sex (P > 0.43). Higher variation in the function of the insulin receptor gene network in the hippocampus is associated with increasing frailty in women. This could potentially offer novel targets for future drug development aimed at frailty and ageing.

Biologically Informed Polygenic Scores for Brain Insulin Receptor Network Are Associated with Cardiometabolic Risk Markers and Diabetes in Women.

To investigate associations between variations in the co-expression-based brain insulin receptor polygenic score and cardiometabolic risk factors and diabetes mellitus. This cross-sectional study included 1,573 participants from the Helsinki Birth Cohort Study. Biologically informed expression-based polygenic risk scores for the insulin receptor gene network were calculated for the hippocampal (hePRS-IR) and the mesocorticolimbic (mePRS-IR) regions. Cardiometabolic markers included body composition, waist circumference, circulating lipids, insulin-like growth factor 1 (IGF-1), and insulin-like growth factor-binding protein 1 and 3 (IGFBP-1 and -3). Glucose and insulin levels were measured during a standardized 2-hour 75 g oral glucose tolerance test and impaired glucose regulation status was defined by the World Health Organization 2019 criteria. Analyzes were adjusted for population stratification, age, smoking, alcohol consumption, socioeconomic status, chronic diseases, birth weight, and leisure-time physical activity. Multinomial logistic regression indicated that one standard deviation increase in hePRS-IR was associated with increased risk of diabetes mellitus in all participants (adjusted relative risk ratio, 1.17; 95% confidence interval, 1.01 to 1.35). In women, higher hePRS-IR was associated with greater waist circumference and higher body fat percentage, levels of glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein B, insulin, and IGFBP-1 (all P≤0.02). The mePRS-IR was associated with decreased IGF-1 level in women (P=0.02). No associations were detected in men and studied outcomes. hePRS-IR is associated with sex-specific differences in cardiometabolic risk factor profiles including impaired glucose regulation, abnormal metabolic markers, and unfavorable body composition in women.

Abstract 7047: Comparative analysis of transcriptomic and immunological profiles in treatment-naïve black and non-Hispanic White women with high-grade serous ovarian cancer

Abstract Background: Ovarian cancer is a highly lethal gynecological malignancy and high-grade serous histology (HGSOC) accounts for the majority of cases. Platinum-based chemotherapy is the primary treatment. Notably, Black women face the highest mortality-to-incidence ratio across all ethnic groups. This study investigated transcriptomic and immunological differences in tumors from Black compared to NHW women that might explain the poor clinical outcomes observed within this patient cohort. Methods: We collected primary tumor specimens from 36 Black and 31 treatment-naïve NHW patients. After RNA isolation, RNA sequencing (RNA-seq) identified differentially expressed transcripts and Enrichr performed pathway enrichment studies. To confirm the observed gene expression differences, we employed quantitative reverse transcription PCR (qRT-PCR), western blotting, and multiplex immunohistochemistry (mIHC). Additionally, we conducted cell proliferation, colony formation, and cell viability assays to functionally validate potential target genes of interest. Results: Our findings revealed 277 genes with significant differential expression between Black and NHW patients (FDR-adjusted p-value &amp;lt; 0.05). Among these, 103 coding genes were up-regulated, while 81 coding genes were down-regulated in tumors from Black compared to NHW patients. Gene Ontology analyses of these significantly differentially expressed genes highlighted enriched pathways related to DNA damage response, including the insulin receptor (INSR) gene, p53/apoptosis signaling components such as Forkhead box proteins A1 (FOXA1) and FOXB1, as well as genes involved in the cholesterol/lipid modulation pathway, including Low-density lipoprotein (LDL) receptor and Stearoyl-CoA Desaturase (SCD). Notably, silencing INSR and FOXA1 enhanced sensitivity to platinum-based drugs and inhibited cell growth and colony formation. Furthermore, we identified differences in the proportions of key immune cell types between the two patient groups, with tumors from Black patients exhibiting a significantly lower proportion of CD4+ Naïve T-cells and CD4+ regulatory T-cells (Tregs). Conclusions: Overall, our study reveals significant differential gene expression patterns between HGSOC tumors from Black and NHW patients, as well as differences in the proportions of immune cell types. These discoveries provide valuable insights into the biological mechanisms underlying the disparities in outcomes observed between black and NHW patients afflicted with HGSOC. It is critical to further investigate how these biological differences affect clinical outcomes and treatment response in Black women. Citation Format: Hao Huang, Russel Keathley, Ujin Kim Kim, Horacio Cardenas, Ping Xie, Jianjun Wei, Guangyuan Zhao, Emma L. Barber, Ernst Lengyel, Kenneth P. Nephew, Victoria Bae-Jump, Bin Zhang, Daniela Matei. Comparative analysis of transcriptomic and immunological profiles in treatment-naïve black and non-Hispanic White women with high-grade serous ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7047.

Creation of Knock-In Alleles of Insulin Receptor Tagged by Fluorescent Proteins mCherry or EYFP in Fruit Fly Drosophila melanogaster.

The insulin/insulin-like growth factor-like signaling (IIS) pathway is highly conserved across metazoans and regulates numerous physiological functions, including development, metabolism, fecundity, and lifespan. The insulin receptor (InR), a crucial membrane receptor in the IIS pathway, is known to be ubiquitously expressed in various tissues, albeit at generally low levels, and its subcellular localization remains incompletely characterized. In this study, we employed CRISPR-mediated mutagenesis in the fruit fly Drosophila to create knock-in alleles of InR tagged with fluorescent proteins (InR::mCherry or InR::EYFP). By inserting the coding sequence of the fluorescent proteins mCherry or EYFP near the end of the coding sequence of the endogenous InR gene, we could trace the natural InR protein through their fluorescence. As an example, we investigated epithelial cells of the male accessory gland (AG), an internal reproductive organ, and identified two distinct patterns of InR::mCherry localization. In young AG, InR::mCherry accumulated on the basal plasma membrane between cells, whereas in mature AG, it exhibited intracellular localization as multiple puncta, indicating endocytic recycling of InR during cell growth. In the AG senescence accelerated by the mutation of Diuretic hormone 31 (Dh31), the presence of InR::mCherry puncta was more pronounced compared to the wild type. These findings raise expectations for the utility of the newly created InR::mCherry/EYFP alleles for studying the precise expression levels and subcellular localization of InR. Furthermore, this fluorescently tagged allele approach can be extended to investigate other membrane receptors with low abundance, facilitating the direct examination of their true expression and localization.

IDF23-0393 Effect of Zingiber officinale ethanolic extract on insulin receptor gene in nSTZ-induced diabetic model rats

IDF23-0393 Effect of Zingiber officinale ethanolic extract on insulin receptor gene in nSTZ-induced diabetic model rats

Impact of a glyphosate-based herbicide on the longevity, fertility, and transgenerational effects on Chrysopa pallens (Rambur) (Neuroptera: Chrysopidae).

Glyphosate-based herbicides (GBHs) are common herbicide formulations used in the field and are increasingly used worldwide with the widespread cultivation of herbicide-tolerant genetically modified crops. As a result, the risk of arthropod exposure to GBH is increasing rapidly. Chrysopa pallens (Rambur) (Neuroptera: Chrysopidae) is a common predatory natural enemy in agroecosystems, which is exposed to GBH (Roundup®) while preying on pests. To identify and characterize the potential effects of GBH on C. pallens, the life tables of C. pallens larvae and adults fed with GBH were constructed. Moreover, the effects of GBH treatment on the expression of genes involved in insulin signalling in adults were analyzed using qRT-PCR. The results showed that GBH treatment altered the pupal period and preadult stage of C. pallens larvae. However, it did no effect on longevity, fecundity, and population parameters and two insulin receptor genes (InR1, InR2), a serine/threonine kinase (Akt), an extracellular-signal-regulated kinase (erk), and vitellogenin (Vg1) expression of C. pallens. Adults feeding on GBH significantly altered development, longevity, and differences in the mean generation time of the F0 generation. However, GBH feeding only minimally influenced the growth and population parameters of the F1 generation. In addition, InR1, InR2, erk, and Vg1 expression in the F0 generation were downregulated on the fifth day of feeding on GBH. Furthermore, the expression levels of InR1, InR2, Akt, erk, and Vg1 in C. pallens decreased with the increase of GBH concentration, although the expression levels returned to control levels on the tenth day. Overall, the consumption of the GBH by larvae and adults of C. pallens had minimal effect on the growth and population parameters of C. pallens. The findings of this study can provide a reference for elucidating the environmental risks of GBH, guiding the optimal use of glyphosate in agricultural practices in the future.

Decoding alternative splicing control in the insulin receptor gene: Insights from experiments and simulations

Decoding alternative splicing control in the insulin receptor gene: Insights from experiments and simulations

Regulation of Neuropeptide Y Receptor Gene Expression and Hormone Level in Obese Male Rats Receiving 6-Gingerol and L-Arginine Supplementation.

Obesity and its associated disorders, such as hyperlipidemia, have become a ‎global issue following the consumption of unhealthy, high-fat, and high-‎carbohydrate foods, which burdens the economies and the ‎health systems of human societies worldwide. This study aimed to evaluate ‎the effect of oral consumption of 6-gingerol and L-arginine supplements on obesity factors. Thirty rats in five groups were fed a diet specific to each ‎group for 12 weeks and then treated with the oral administration of L-arginine (200 mg/day) and 6-gingerol (100 mg/day) for 12 weeks. The food and water ‎intake and weight change, were then measured. In addition, plasma glucose, ‎triglyceride, cholesterol, high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL)‎, low-density ‎lipoprotein (LDL), and serum hormone levels, including corticosterone, testosterone, and insulin, were measured, and NPY, Y1, and Y5 receptor gene expression were recorded using real-time PCR. Administration of 6-gingerol and L-arginine decreased food intake, ‎weight gain, glucose levels, insulin levels, and homeostasis model assessment-insulin resistance (HOMA-IR) index compared to ‎the HCD control group. In addition, corticosterone and testosterone levels in the ‎study groups showed a significant decrease (P<0.05) and increase (P<0.01) compared to the control groups, respectively. Triglyceride, total cholesterol, HDL, and VLDL levels in the groups treated with L-arginine and gingerol alone or combined significantly decreased compared to ‎the control group (P<0.01). This study confirms that 6-gingerol and L-arginine supplements prevent ‎HCD-induced hyperlipidemia by controlling hormones and neurotransmitters ‎involved in the general metabolism.‎.

O-08 Mutation in insulin receptor gene with hypoglycemia symptoms

Abstract Introduction Monoallelic/heterozygous mutations in the insulin receptor INSR gene are typically associated with type A insulin resistance syndrome, but less is known about INSR-related hyperinsulinemic hypoglycaemia (HH) characterized by fasting hyperinsulinemia and postprandial hypoglycemia. Clinical Case A 38-year-old woman with a history of migraines not needing preventive medication was admitted to an endocrinology outpatient clinic because of general malaise, weakness, and reduced exercise tolerance. For several years, she has had to eat small snacks during the workday to avoid sudden hypoglycemic symptoms. As a result, she gained nearly 30 kilograms in a few years. The symptoms started after she lost 23 kg and weighed 55 kg after following a ketogenic diet in 2016. The symptoms worsened despite weight regain and dietary changes to attempt to avoid hypoglycemia. Diagnostic evaluation: Initial BMI was 31.5 kg/m2. Continuous glucose monitoring (CGM) showed low blood glucose levels during extended fasting, such as during the night or prolonged meal intervals during the workdays (Figure 1). Hypoglycemia also occurred during and after exercise. She underwent a 2-hour glucose tolerance test, a mixed-meal test and a 72-hour fasting test (Tables 1 and 2), abdominal CT, and endoscopic ultrasonography, none of which led to a specific diagnosis. The glucose profile of this patient had hypoglycemias &amp;lt;3.0 mmol/L only a few times, and normal findings on imaging suggest that insulinoma is unlikely. Blood samples were taken during a postprandial hypoglycemic episode at work, but the plasma glucose (3.2 mmol/L) did not meet the criteria for Whipple's triad (&amp;lt;2.7 mmol/L), despite pronounced symptoms that were relieved by consuming carbohydrates. Finally, gene panel for monogenic causes of hypoglycemia identified a likely pathogenic INSR mutation c.2106T&amp;gt;G, p. (Tyr702*), which turned out to have been found in a symptomatic third-degree relative several years ago. Isolated case reports have found a beneficial effect of metformin in decreasing hypoglycemic symptoms, although the exact mechanisms by which it may decrease symptoms are unclear. We conducted a treatment trial with increasing doses of metformin to manage the patient's symptoms and to decrease the insulin resistance that had developed as a result of the INSR mutation and pronounced weight gain. Before the treatment trial, BMI was 34.4 kg / m2. Patient responded positively to metformin and weight started to decrease. Her quality of health increased subjectively and hypoglycemic episodes decreased during work and exercise. Conclusion The differential diagnostics of hypoglycemia may be challenging. Monogenic causes for adulthood-onset hypoglycemia are very rare but should be considered in cases of prolonged hypoglycemia susceptibility impairing daily activities. Genetic testing is also warranted in cases of family history of hypoglycemia symptoms.Figure 1.Continuous glucose monitor (CGM)Patient had low blood glucose levels (2.9-3.6 mmol/L) during extended fasting, such as during the night or prolonged meal intervals during the workdays. Hypoglycemiasymptoms also occurred during and after exercise. Table 1.Laboratory Values Table 2.72-hour fasting test and 5-hour Mixed-Meal test

Cortisol controls endoplasmic reticulum stress and hypoxia dependent regulation of insulin receptor and related genes expression in HEK293 cells.

Objective. Glucocorticoids are important stress-responsive regulators of insulin-dependent metabolic processes realized through specific changes in genome function. The aim of this study was to investigate the impact of cortisol on insulin receptor and related genes expression in HEK293 cells upon induction the endoplasmic reticulum (ER) stress by tunicamycin and hypoxia. Methods. The human embryonic kidney cell line HEK293 was used. Cells were exposed to cortisol (10 µM) as well as inducers of hypoxia (dimethyloxalylglycine, DMOG; 0.5 mM) and ER stress (tunicamycin; 0.2 µg/ml) for 4 h. The RNA from these cells was extracted and reverse transcribed. The expression level of INSR, IRS2, and INSIG2 and some ER stress responsive genes encoding XBP1n, non-spliced variant, XBP1s, alternatively spliced variant of XBP1, and DNAJB9 proteins, was measured by quantitative polymerase chain reaction and normalized to ACTB. Results. We showed that exposure of HEK293 cells to cortisol elicited up-regulation in the expression of INSR and DNAJB9 genes and down-regulation of XBP1s, XBP1n, IRS2, and INSIG2 mRNA levels. At the same time, induction of hypoxia by DMOG led to an up-regulation of the expression level of most studied mRNAs: XBP1s and XBP1n, IRS2 and INSIG2, but did not change significantly INSR and DNAJB9 gene expression. We also showed that combined impact of cortisol and hypoxia introduced the up-regulation of INSR and suppressed XBP1n mRNA expression levels. Furthermore, the exposure of HEK293 cells to tunicamycin affected the expression of IRS2 gene and increased the level of XBP1n mRNA. At the same time, the combined treatment of these cells with cortisol and inductor of ER stress had much stronger impact on the expression of all the tested genes: strongly increased the mRNA level of ER stress dependent factors XBP1s and DNAJB9 as well as INSR and INSIG2, but down-regulated IRS2 and XBP1n. Conclusion. Taken together, the present study indicates that cortisol may interact with ER stress and hypoxia in the regulation of ER stress dependent XBP1 and DNAJB9 mRNA expression as well as INSR and its signaling and that this corticosteroid hormone modified the impact of hypoxia and especially tunicamycin on the expression of most studied genes in HEK293 cells. These data demonstrate molecular mechanisms of glucocorticoids interaction with ER stress and insulin signaling at the cellular level.

A case of type A insulin resistance syndrome in a 14-year-old adolescent girl without common clinical features.

Type A insulin resistance syndrome is a rare congenital disorder caused by insulin receptor dysfunction arising from heterozygous mutations in the insulin receptor (INSR) gene. It is usually diagnosed in non-obese female adolescents with insulin resistance, acanthosis nigricans, or ovarian hyperandrogenism. We present the case of a 14-year-old adolescent girl with non-obesity diabetes and insulin resistance; however, she had no acanthosis nigricans, or menstrual abnormalities. The laboratory results were as follows: fasting plasma glucose 179 mg/dL; C-peptide 1.8 ng/mL; insulin 34.8 lU/mL; HbA1c 10.6%. Islet cell autoantibodies, insulin autoantibodies, and glutamic acid decarboxylase antibodies were negative. We performed a next-generation sequencing-based targeted gene panel for the known maturity-onset diabetes of the young and found a heterozygous mutation in the INSR gene c.3602G>A (p.Arg1201Gln). Her mother carried the same mutation as her and also did not present with acanthosis nigricans or menstruation abnormalities. Type A insulin resistance syndrome has diverse clinical phenotypes even with the same type of mutation at the same site in the INSR gene. Clinicians should consider genetic testing for early detection and adequate treatment approaches.