Insulin-stimulated Glucose Oxidation Research Articles

The ketogenic diet does not improve cardiac function and blunts glucose oxidation in ischemic heart failure.

Cardiac energy metabolism is perturbed in ischemic heart failure and is characterized by a shift from mitochondrial oxidative metabolism to glycolysis. Notably, the failing heart relies more on ketones for energy than a healthy heart, an adaptive mechanism that improves the energy-starved status of the failing heart. However, whether this can be implemented therapeutically remains unknown. Therefore, our aim was to determine if increasing ketone delivery to the heart via a ketogenic diet can improve the outcomes of heart failure. C57BL/6J male mice underwent either a sham surgery or permanent left anterior descending (LAD) coronary artery ligation surgery to induce heart failure. After 2 weeks, mice were then treated with either a control diet or a ketogenic diet for 3 weeks. Transthoracic echocardiography was then carried out to assess in vivo cardiac function and structure. Finally, isolated working hearts from these mice were perfused with appropriately 3H or 14C labelled glucose (5 mM), palmitate (0.8 mM), and ß-hydroxybutyrate (0.6 mM) to assess mitochondrial oxidative metabolism and glycolysis. Mice with heart failure exhibited a 56% drop in ejection fraction which was not improved with a ketogenic diet feeding. Interestingly, mice fed a ketogenic diet had marked decreases in cardiac glucose oxidation rates. Despite increasing blood ketone levels, cardiac ketone oxidation rates did not increase, probably due to a decreased expression of key ketone oxidation enzymes. Furthermore, in mice on the ketogenic diet no increase in overall cardiac energy production was observed, and instead there was a shift to an increased reliance on fatty acid oxidation as a source of cardiac energy production. This resulted in a decrease in cardiac efficiency in heart failure mice fed a ketogenic diet. We conclude that the ketogenic diet does not improve heart function in failing hearts, due to ketogenic diet-induced excessive fatty acid oxidation in the ischemic heart and a decrease in insulin-stimulated glucose oxidation.

Effect of resveratrol on insulin action in primary myotubes from lean individuals and individuals with severe obesity.

Resveratrol, a natural polyphenol compound contained in numerous plants, has been proposed as a treatment for obesity-related disease processes such as insulin resistance. However, in humans there are conflicting results concerning the efficacy of resveratrol in improving insulin action; the purpose of the present study was to determine whether obesity status (lean, severely obese) affects the response to resveratrol in human skeletal muscle. Primary skeletal muscle cells were derived from biopsies obtained from age-matched lean and insulin-resistant women with severe obesity and incubated with resveratrol (1 µM) for 24 h. Insulin-stimulated glucose oxidation and incorporation into glycogen, insulin signal transduction, and energy-sensitive protein targets [AMP-activated protein kinase (AMPK), Sirt1, and PGC1α] were analyzed. Insulin-stimulated glycogen synthesis, glucose oxidation, and AMPK phosphorylation increased with resveratrol incubation compared with the nonresveratrol conditions (main treatment effect for resveratrol). Resveratrol further increased IRS1, Akt, and TBC1D4 insulin-stimulated phosphorylation and SIRT1 content in myotubes from lean women, but not in women with severe obesity. Resveratrol improves insulin action in primary human skeletal myotubes derived from lean women and women with severe obesity. In women with obesity, these improvements may be associated with enhanced AMPK phosphorylation with resveratrol treatment.NEW & NOTEWORTHY A physiologically relevant dose of resveratrol increases insulin-stimulated glucose oxidation and glycogen synthesis in myotubes from individuals with severe obesity. Furthermore, resveratrol improved insulin signal transduction in myotubes from lean individuals but not from individuals with obesity. Activation of AMPK plays a role in resveratrol-induced improvements in glucose metabolism in individuals with severe obesity.

Mitochondrial fatty acid oxidation is the major source of cardiac adenosine triphosphate production in heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a prevalent disease worldwide. While it is well established that alterations of cardiac energy metabolism contribute to cardiovascular pathology, the precise source of fuel used by the heart in HFpEF remains unclear. The objective of this study was to define the energy metabolic profile of the heart in HFpEF. Eight-week-old C57BL/6 male mice were subjected to a '2-Hit' HFpEF protocol [60% high-fat diet (HFD) + 0.5 g/L of Nω-nitro-L-arginine methyl ester]. Echocardiography and pressure-volume loop analysis were used for assessing cardiac function and cardiac haemodynamics, respectively. Isolated working hearts were perfused with radiolabelled energy substrates to directly measure rates of fatty acid oxidation, glucose oxidation, ketone oxidation, and glycolysis. HFpEF mice exhibited increased body weight, glucose intolerance, elevated blood pressure, diastolic dysfunction, and cardiac hypertrophy. In HFpEF hearts, insulin stimulation of glucose oxidation was significantly suppressed. This was paralleled by an increase in fatty acid oxidation rates, while cardiac ketone oxidation and glycolysis rates were comparable with healthy control hearts. The balance between glucose and fatty acid oxidation contributing to overall adenosine triphosphate (ATP) production was disrupted, where HFpEF hearts were more reliant on fatty acid as the major source of fuel for ATP production, compensating for the decrease of ATP originating from glucose oxidation. Additionally, phosphorylated pyruvate dehydrogenase levels decreased in both HFpEF mice and human patient's heart samples. In HFpEF, fatty acid oxidation dominates as the major source of cardiac ATP production at the expense of insulin-stimulated glucose oxidation.

Stimulating cardiac glucose oxidation lessens the severity of heart failure in aged female mice.

Heart failure is a prevalent disease worldwide. While it is well accepted that heart failure involves changes in myocardial energetics, what alterations that occur in fatty acid oxidation and glucose oxidation in the failing heart remains controversial. The goal of the study are to define the energy metabolic profile in heart failure induced by obesity and hypertension in aged female mice, and to attempt to lessen the severity of heart failure by stimulating myocardial glucose oxidation. 13-Month-old C57BL/6 female mice were subjected to 10weeks of a 60% high-fat diet (HFD) with 0.5g/L of Nω-nitro-L-arginine methyl ester (L-NAME) administered via drinking water to induce obesity and hypertension. Isolated working hearts were perfused with radiolabeled energy substrates to directly measure rates of myocardial glucose oxidation and fatty acid oxidation. Additionally, a series of mice subjected to the obesity and hypertension protocol were treated with a pyruvate dehydrogenase kinase inhibitor (PDKi) to stimulate cardiac glucose oxidation. Aged female mice subjected to the obesity and hypertension protocol had increased body weight, glucose intolerance, elevated blood pressure, cardiac hypertrophy, systolic dysfunction, and decreased survival. While fatty acid oxidation rates were not altered in the failing hearts, insulin-stimulated glucose oxidation rates were markedly impaired. PDKi treatment increased cardiac glucose oxidation in heart failure mice, which was accompanied with improved systolic function and decreased cardiac hypertrophy. The primary energy metabolic change in heart failure induced by obesity and hypertension in aged female mice is a dramatic decrease in glucose oxidation. Stimulating glucose oxidation can lessen the severity of heart failure and exert overall functional benefits.

442 Awardee Talk: Adaptive Programming of Poor Skeletal Muscle Growth and Metabolism Associated with Heat Stress-Induced Intrauterine Growth Restriction

Abstract Intrauterine growth restriction (IUGR) is associated with reduced β2 adrenergic sensitivity, which contributes to poor postnatal muscle growth and metabolic inefficiency. Thus, our objective was to determine if stimulating β2 adrenergic activity would rescue deficits in muscle growth, body composition, and indicators of metabolic homeostasis in IUGR offspring. Maternal heat stress (40°C, 35% humidity, THI = 85) from d 40 to 95 of gestation was used to produce IUGR lambs. From birth, IUGR lambs received daily IM injections of saline (IUGR; n = 12) or 0.8 μg/kg clenbuterol HCl (IUGR+CLEN; n = 11). Placebo-injected controls (n = 13) were born to pair-fed thermoneutral ewes. Body composition was estimated by ultrasound and bioelectrical impedance analyses (BIA) at d 58. Lambs were catheterized at d 55 and necropsied at d 60. Square-wave hyperglycemic clamps and indirect calorimetry were performed at d 57. Hyperinsulinemic-euglycemic clamps were performed at d 58. Bodyweights were lighter (P ≤ 0.05) for IUGR and IUGR+CLEN lambs than for controls at birth, d 30, and d 60. Average daily gain was less (P ≤ 0.05) for IUGR compared with controls and was intermediate for IUGR+CLEN lambs. BIA-estimated fat-free mass, ultrasound-estimated loin eye area (LEA), actual LEA, and flexor digitorum superficialis (FDS) muscle weight were less (P ≤ 0.05) for IUGR but not IUGR+CLEN lambs than for controls. Semitendinosus from IUGR lambs had less (P ≤ 0.05) β2 adrenoreceptor content, fewer (P ≤ 0.05) proliferating myoblasts, tended to have fewer (P = 0.08) differentiated myoblasts, and had smaller (P ≤ 0.05) muscle fibers than controls. Proliferating myoblasts and fiber size but not β2 adrenoreceptor content or differentiated myoblasts were rescued (P ≤ 0.05) in IUGR+CLEN lambs compared with IUGR lambs. Basal plasma insulin did not differ, but glucose-stimulated insulin secretion was 44% less (P ≤ 0.05) for IUGR lambs than for controls and was intermediate for IUGR+CLEN lambs. Basal and insulin-stimulated hindlimb glucose uptake and basal glucose oxidation did not differ among groups. Insulin-stimulated glucose oxidation was 54% less (P ≤ 0.05) for IUGR lambs but not IUGR+CLEN lambs compared with controls. Ex vivo glucose uptake was 25% less (P ≤ 0.05) for FDS from IUGR and IUGR+CLEN lambs than from controls. Ex vivo glucose oxidation was less (P ≤ 0.05) for FDS and soleus from IUGR lambs compared with controls and was intermediate (P ≤ 0.05) for FDS but not soleus from IUGR+CLEN lambs. Whole-body O2 consumption was 22% less (P ≤ 0.05) for IUGR and IUGR+CLEN lambs than for controls. Whole-body CO2 production was 17% less (P ≤ 0.05) for IUGR but not IUGR+CLEN lambs than for controls. These findings show that IUGR muscle remained responsive to β2 adrenergic stimulation despite reduced β2 adrenoreceptor content, and thus β2 adrenergic pathways may be a strategic target for improving muscle growth, body composition, and metabolic efficiency in IUGR-born offspring.

245 Fish Oil and Dexamethasone Administration Each Partially Improve Indicators of Glucose Metabolism and Fat Homeostasis By Reducing Systemic Inflammation in Heat-Stressed Feedlot Wethers

Abstract Heat stress is costly for livestock production due to its impact on metabolism, which negatively affects health and growth. Previous pair-fed studies demonstrated that heat stress-induced inflammation is associated with disruptions in metabolism and growth. Therefore, the objective of this study was to determine whether targeting systemic inflammation in heat-stressed wethers improves metabolic and stress indicators. Feedlot wethers were randomly assigned to 30-d heat stress (40°C; THI = 85) or were pair-fed under thermoneutral conditions (controls; 25°C; n = 11). Heat-stressed wethers were administered oral fish oil capsules twice daily (HeatStress+FO; 2,400 mg/d; n = 11), injected with dexamethasone every 3 d (HeatStress+DEX; 0.15 mg/kg, i.m.; n = 11), or received no intervention (HeatStress; n = 11). Plasma hormones and lipids were assessed over the 30-d period, and soleus muscle and adipose tissue were collected at necropsy for ex vivo glucose metabolism studies and non-esterified fatty acid (NEFA) mobilization analyses, respectively. Plasma TNFα was up to 3-fold greater (P < 0.05) in HeatStress wethers than controls throughout the study. By the end of the study, plasma TNFα in HeatStress+DEX and HeatStress+FO was reduced (P < 0.05) by 38% and 47%, respectively, compared with HeatStress and did not differ from controls. Plasma insulin did not differ among groups early in the study but by d 30 were increased (P < 0.05) in HeatStress and HeatStress+DEX compared with controls and HeatStress+FO. Blood glucose-to-insulin ratios were less (P < 0.05) for HeatStress wethers than controls throughout the study and were intermediate for HeatStress+DEX and HeatStress+FO. Plasma cortisol did not differ among groups and was less (P < 0.05) at d 30 than d -3 for all weathers. Plasma eicosapentaenoic acid and triglycerides were 15% to 22% less (P < 0.05) for HeatStress and HeatStress+DEX but not HeatStress+FO than for controls throughout the study. High density lipoprotein-bound cholesterol was 8% and 22% less (P < 0.05), respectively, for HeatStress and HeatStress+DEX wethers but not HeatStress+FO wethers compared with controls. Ex vivo basal and insulin-stimulated glucose oxidation rates were reduced (P < 0.05) by 32% in muscle from HeatStress wethers but not HeatStress+DEX, or HeatStress+FO wethers compared with muscle from controls. Glucose uptake rates did not differ among groups. Mobilization of NEFA was reduced (P < 0.05) by 19% and 37%, respectively, in fat from HeatStress wethers and HeatStress+DEX wethers compared with controls and was intermediate in fat from HeatStress+FO wethers. These data indicate that supplementation of DEX and FO partially improve muscle-specific glucose metabolism as well as lipid homeostasis and stress indicators, which provides a fundamental basis for heat stress interventions that utilize anti-inflammatory supplements.

A Fructose-Rich Diet Decreases Insulin-Stimulated Glucose Incorporation into Lipids but Not Glucose Transport in Adipocytes of Normal and Diabetic Rats

To study the cellular mechanisms underlying fructose-induced insulin resistance in rats, the effects of fructose feeding on insulin-stimulated glucose transport, oxidation and incorporation into lipids in epididymal adipocytes were evaluated in 27 normal and 27 noninsulin-dependent diabetic male Sprague-Dawley rats. Diabetes was induced by streptozotocin injection 2 d after birth. At 5 wk of age, both normal and diabetic rats were fed a diet containing 62% carbohydrate as fructose, dextrose or cornstarch. Fructose feeding for 6 wk induced glucose intolerance in normal rats (P < 0.05) and aggravated that of diabetic rats (P < 0.05). Plasma triacylglycerol concentration was higher in fructose-fed than in starch-fed or dextrose-fed rats (P < 0.05). Adipocytes of fructose-fed rats had significantly lower maximum insulin-stimulated glucose incorporation into total lipids than those of rats fed starch, and tended (P = 0.22) to have lower production of CO2 from glucose than adipocytes of the other dietary groups. Glucose transport in adipocytes of dextrose-, starch- and fructose-fed rats did not differ. We conclude that in both normal and diabetic rats, a chronic fructose-rich diet induced hypertriacylglycerolemia, glucose intolerance and insulin resistance of adipocytes.

Dietary (n-3) Polyunsaturated Fatty Acids Improve Adipocyte Insulin Action and Glucose Metabolism in Insulin-Resistant Rats: Relation to Membrane Fatty Acids

To study the effects of dietary fish oil on insulin-stimulated glucose metabolism in adipocytes of insulin-resistant rats (rats fed 50% sucrose and 30% fat), eighteen 5-wk-old Sprague-Dawley rats were fed, for 6 wk, a diet containing 30% fat as either fish oil (FO) or a mixture of vegetable and animal oils [control oils (CO)]. A third reference group was fed a standard diet (62% corn starch and 13% fat). At the end of the 6-wk period, the two experimental groups had comparable plasma glucose concentrations that were higher than that found in the reference group. FO feeding corrected the hyperinsulinemia of the experimental rats (P < 0.05) to reach values in the reference group. Plasma triacylglycerol (P < 0.01) and cholesterol (P < 0.001) concentrations were also lower in rats fed FO than in those fed CO. The body weights of FO-fed rats were similar to that of CO-fed rats, but epididymal adipose tissue weight was lower (P < 0.01). Adipocytes of FO-fed rats, compared with those of CO-fed rats, had high insulin-stimulated glucose transport (P < 0.05), oxidation (P < 0.001) and incorporation into total lipids (P < 0.05). The incorporation of (n-3) polyunsaturated fatty acids in adipocyte membrane phospholipids was higher in FO-fed rats than in those fed CO (P < 0.0001). Insulin action was positively correlated with the fatty acid unsaturation index in membrane phospholipids. Thus dietary fish oil has beneficial effects on insulinemia, plasma lipids and insulin-stimulated glucose metabolism in insulin-resistant slightly diabetic rats.

The ketogenic diet blunts insulin-stimulated glucose oxidation in the failing heart

Cardiac metabolism is perturbed in heart failure and is characterized by a shift from mitochondrial oxidative metabolism to glycolysis. Notably, the failing heart relies more on ketones for energy than a healthy heart, an adaptive mechanism that improves the energy-starved status of the failing heart. However, whether this can be implemented therapeutically remains unknown. Therefore, our aim was to determine if increasing ketone delivery to the heart via a ketogenic diet can improve the outcomes of heart failure.

Intermittent maternofetal oxygenation during late gestation improved birthweight, neonatal growth, body symmetry, and muscle metabolism in intrauterine growth-restricted lambs.

In humans and animals, intrauterine growth restriction (IUGR) results from fetal programming responses to poor intrauterine conditions. Chronic fetal hypoxemia elevates circulating catecholamines, which reduces skeletal muscle β2 adrenoceptor content and contributes to growth and metabolic pathologies in IUGR-born offspring. Our objective was to determine whether intermittent maternofetal oxygenation during late gestation would improve neonatal growth and glucose metabolism in IUGR-born lambs. Pregnant ewes were housed at 40 °C from the 40th to 95th day of gestational age (dGA) to produce IUGR-born lambs (n = 9). A second group of IUGR-born lambs received prenatal O2 supplementation via maternal O2 insufflation (100% humidified O2, 10 L/min) for 8 h/d from dGA 130 to parturition (IUGR+O2, n = 10). Control lambs (n = 15) were from pair-fed thermoneutral ewes. All lambs were weaned at birth, hand-reared, and fitted with hindlimb catheters at day 25. Glucose-stimulated insulin secretion (GSIS) and hindlimb hyperinsulinemic-euglycemic clamp (HEC) studies were performed at days 28 and 29, respectively. At day 30, lambs were euthanized and ex vivo HEC studies were performed on isolated muscle. Without maternofetal oxygenation, IUGR lambs were 40% lighter (P < 0.05) at birth and maintained slower (P < 0.05) growth rates throughout the neonatal period compared with controls. At 30 d of age, IUGR lambs had lighter (P < 0.05) hindlimbs and flexor digitorum superficialis (FDS) muscles. IUGR+O2 lambs exhibited improved (P < 0.05) birthweight, neonatal growth, hindlimb mass, and FDS mass compared with IUGR lambs. Hindlimb insulin-stimulated glucose utilization and oxidation rates were reduced (P < 0.05) in IUGR but not IUGR+O2 lambs. Ex vivo glucose oxidation rates were less (P < 0.05) in muscle from IUGR but not IUGR+O2 lambs. Surprisingly, β2 adrenoceptor content and insulin responsiveness were reduced (P < 0.05) in muscle from IUGR and IUGR+O2 lambs compared with controls. In addition, GSIS was reduced (P < 0.05) in IUGR lambs and only modestly improved (P < 0.05) in IUGR+O2. Insufflation of O2 also increased (P < 0.05) acidosis and hypercapnia in dams, perhaps due to the use of 100% O2 rather than a gas mixture with a lesser O2 percentage. Nevertheless, these findings show that intermittent maternofetal oxygenation during late gestation improved postnatal growth and metabolic outcomes in IUGR lambs without improving muscle β2 adrenoceptor content.

Distinct mechanisms involving diacylglycerol, ceramides, and inflammation underlie insulin resistance in oxidative and glycolytic muscles from high fat-fed rats

This study investigated whether oxidative and glycolytic rat skeletal muscles respond differently to a high-fat (HF) sucrose-enriched diet with respect to diacylglycerol (DAG) and ceramides accumulation, protein kinase C (PKC) activation, glucose metabolism, and the expression of inflammatory genes. HF diet (8 weeks) suppressed insulin-stimulated glycogen synthesis and glucose oxidation in soleus (Sol), extensor digitorum longus (EDL) and epitrochlearis (Epit) muscles. However, DAG and ceramides levels increased in Sol and EDL, but not in Epit muscles of HF-fed rats. Additionally, membrane-bound PKC-delta and PKC-theta increased in Sol and EDL, whereas in Epit muscles both PKC isoforms were reduced by HF diet. In Epit muscles, HF diet also increased the expression of tumor necrosis factor-α (TNF-α) receptors (CD40 and FAS), toll-like receptor 4 (TLR4), and nuclear factor kappa light polypeptide gene enhancer in B cells (NF-kB), whereas in Sol and EDL muscles the expression of these inflammatory genes remained unchanged upon HF feeding. In conclusion, HF diet caused DAG and ceramides accumulation, PKC activation, and the induction of inflammatory pathways in a fiber type-specific manner. These findings help explain why oxidative and glycolytic muscles similarly develop insulin resistance, despite major differences in their metabolic characteristics and responsiveness to dietary lipid abundance.

Deletion of BCATm increases insulin-stimulated glucose oxidation in the heart

BackgroundsBranched chain amino acid (BCAA) oxidation is impaired in cardiac insulin resistance, leading to the accumulation of BCAAs and the first products of BCAA oxidation, the branched chain ketoacids. However, it is not clear whether it is the BCAAs, BCKAs or both that are mediating cardiac insulin resistance. To determine this, we produced mice with a cardiac-specific deletion of BCAA aminotransferase (BCATm−/−), the first enzyme in the BCAA oxidation pathway that is responsible for converting BCAAs to BCKAs. MethodsEight-week-old BCATm cardiac specific knockout (BCATm−/−) male mice and their α-MHC (myosin heavy chain) - Cre expressing wild type littermates (WT-Cre+/+) received tamoxifen (50 mg/kg i.p. 6 times over 8 days). At 16-weeks of age, cardiac energy metabolism was assessed in isolated working hearts. ResultsBCATm−/− mice have decreased cardiac BCAA oxidation rates, increased cardiac BCAAs and a reduction in cardiac BCKAs. Hearts from BCATm−/− mice showed an increase in insulin stimulation of glucose oxidation and an increase in p-AKT. To determine the impact of reversing these events, we perfused isolated working mice hearts with high levels of BCKAs, which completely abolished insulin-stimulated glucose oxidation rates, an effect associated with decreased p-AKT and inactivation of pyruvate dehydrogenase (PDH), the rate-limiting enzyme in glucose oxidation. ConclusionThis implicates the BCKAs, and not BCAAs, as the actual mediators of cardiac insulin resistance and suggests that lowering cardiac BCKAs can be used as a therapeutic strategy to improve insulin sensitivity in the heart.

Insulin directly stimulates mitochondrial glucose oxidation in the heart

BackgroundGlucose oxidation is a major contributor to myocardial energy production and its contribution is orchestrated by insulin. While insulin can increase glucose oxidation indirectly by enhancing glucose uptake and glycolysis, it also directly stimulates mitochondrial glucose oxidation, independent of increasing glucose uptake or glycolysis, through activating mitochondrial pyruvate dehydrogenase (PDH), the rate-limiting enzyme of glucose oxidation. However, how insulin directly stimulates PDH is not known. To determine this, we characterized the impacts of modifying mitochondrial insulin signaling kinases, namely protein kinase B (Akt), protein kinase C-delta (PKC-δ) and glycogen synthase kinase-3 beta (GSK-3β), on the direct insulin stimulation of glucose oxidation.MethodsWe employed an isolated working mouse heart model to measure the effect of insulin on cardiac glycolysis, glucose oxidation and fatty acid oxidation and how that could be affected when mitochondrial Akt, PKC-δ or GSK-3β is disturbed using pharmacological modulators. We also used differential centrifugation to isolate mitochondrial and cytosol fraction to examine the activity of Akt, PKC-δ and GSK-3β between these fractions. Data were analyzed using unpaired t-test and two-way ANOVA.ResultsHere we show that insulin-stimulated phosphorylation of mitochondrial Akt is a prerequisite for transducing insulin’s direct stimulation of glucose oxidation. Inhibition of mitochondrial Akt completely abolishes insulin-stimulated glucose oxidation, independent of glucose uptake or glycolysis. We also show a novel role of mitochondrial PKC-δ in modulating mitochondrial glucose oxidation. Inhibition of mitochondrial PKC-δ mimics insulin stimulation of glucose oxidation and mitochondrial Akt. We also demonstrate that inhibition of mitochondrial GSK3β phosphorylation does not influence insulin-stimulated glucose oxidation.ConclusionWe identify, for the first time, insulin-stimulated mitochondrial Akt as a prerequisite transmitter of the insulin signal that directly stimulates cardiac glucose oxidation. These novel findings suggest that targeting mitochondrial Akt is a potential therapeutic approach to enhance cardiac insulin sensitivity in condition such as heart failure, diabetes and obesity.

Abstract MP125: Branched-chain Keto Acids, Not Branched-chain Amino Acids, Impairs Cardiac Insulin Sensitivity by Disrupting Insulin Signaling in the Mitochondria

Alterations in branched-chain amino acids (BCAA) oxidation have been linked to the development of cardiac insulin resistance and its negative impact on cardiac function. However, it is not clear if these detrimental effects are due to the accumulation of BCAAs or branched-chain keto acids (BCKAs). It is also unknown how impaired BCAAs oxidation mediates cardiac insulin resistance. To examine this, we specifically deleted mitochondrial branched-chain aminotransferase (BCATm) in the heart to selectively increase in BCAAs and decrease in BCKAs in the heart. BCATm -/- mice had normal cardiac function compared to their wildtype littermates (WT Cre+/+ ). However, there was a significant increase in insulin-stimulated cardiac glucose oxidation rates in BCATm -/- mice, independent of any changes in glucose uptake or glycolytic rates. This enhancement in cardiac insulin sensitivity was associated with an increase in the phosphorylation of Akt and activation of pyruvate dehydrogenase (PDH), the rate-limiting enzyme of glucose oxidation. To determine the impact of reversing these events, we examined the effects of increasing cardiac BCKAs on cardiac insulin sensitivity. We perfused isolated working mice hearts with high levels of BCKAs (α;-keto-isocaproate 80 μM, α;-keto-β;-methylvalorate 100μM, α;-keto-isovalorate 70 μM), levels that can be seen during diabetes and obesity. The BCKAs completely blunted insulin-stimulated glucose oxidation rates. We also found that BCKAs abolished insulin-stimulated mitochondrial translocation of Akt, an effect which was associated with PDH deactivation. We conclude that the accumulation of BCKAs, and not BCAAs, is a major contributor to cardiac insulin resistance via abrogating mitochondrial translocation of Akt.

Heat stress-induced deficits in growth, metabolic efficiency, and cardiovascular function coincided with chronic systemic inflammation and hypercatecholaminemia in ractopamine-supplemented feedlot lambs.

Heat stress hinders growth and well-being in livestock, an effect that is perhaps exacerbated by the β1 agonist ractopamine. Heat stress deficits are mediated in part by reduced feed intake, but other mechanisms involved are less understood. Our objective was to determine the direct impact of heat stress on growth and well-being in ractopamine-supplemented feedlot lambs. Commercial wethers were fed under heat stress (40 °C) for 30 d, and controls (18 °C) were pair-fed. In a 2 × 2 factorial, lambs were also given a daily gavage of 0 or 60 mg ractopamine. Growth, metabolic, cardiovascular, and stress indicators were assessed throughout the study. At necropsy, 9th to 12th rib sections (four-rib), internal organs, and feet were assessed, and sartorius muscles were collected for ex vivo glucose metabolic studies. Heat stress increased (P < 0.05) rectal temperatures and respiration rates throughout the study and reduced (P < 0.05) weight gain and feed efficiency over the first week, ultrasonic loin-eye area and loin depth near the end of the study, and four-rib weight at necropsy. Fat content of the four-rib and loin were also reduced (P < 0.05) by heat stress. Ractopamine increased (P < 0.05) loin weight and fat content and partially moderated the impact of heat stress on rectal temperature and four-rib weight. Heat stress reduced (P < 0.05) spleen weight, increased (P < 0.05) adrenal and lung weights, and was associated with hoof wall overgrowth but not organ lesions. Ractopamine did not affect any measured indicators of well-being. Heat stress reduced (P < 0.05) blood urea nitrogen and increased (P < 0.05) circulating monocytes, granulocytes, and total white blood cells as well as epinephrine, TNFα, cholesterol, and triglycerides. Cortisol and insulin were not affected. Heat stress reduced (P < 0.05) blood pressure and heart rates in all lambs and increased (P < 0.05) left ventricular wall thickness in unsupplemented but not ractopamine-supplemented lambs. No cardiac arrhythmias were observed. Muscle glucose uptake did not differ among groups, but insulin-stimulated glucose oxidation was reduced (P < 0.05) in muscle from heat-stressed lambs. These findings demonstrate that heat stress impairs growth, metabolism, and well-being even when the impact of feed intake is eliminated by pair-feeding and that systemic inflammation and hypercatecholaminemia likely contribute to these deficits. Moreover, ractopamine improved muscle growth indicators without worsening the effects of heat stress.

Roux-en-Y gastric bypass surgery restores insulin-mediated glucose partitioning and mitochondrial dynamics in primary myotubes from severely obese humans.

Background/Objectives:Impaired insulin-mediated glucose partitioning is an intrinsic metabolic defect in skeletal muscle from severely obese humans (BMI ≥ 40 kg/m2). Roux-en-Y gastric bypass (RYGB) surgery has been shown to improve glucose metabolism in severely obese humans. The purpose of the study was to determine the effects of RYGB surgery on glucose partitioning, mitochondrial network morphology, and markers of mitochondrial dynamics skeletal muscle from severely obese humans.Subject/Methods:Human skeletal muscle cells were isolated from muscle biopsies obtained from RYGB patients (BMI = 48.0 ± 2.1, n=7) prior to, 1-month and 7-months following surgery and lean control subjects (BMI = 22.4 ± 1.1, n=7). Complete glucose oxidation, non-oxidized glycolysis rates, mitochondrial respiratory capacity, mitochondrial network morphology and regulatory proteins of mitochondrial dynamics were determined in differentiated human myotubes.Results:Myotubes derived from severely obese humans exhibited enhanced glucose oxidation (13.5%; 95%CI [7.6, 19.4], P = 0.043) and reduced non-oxidized glycolysis (−1.3%; 95%CI [−11.1, 8.6]) in response to insulin stimulation at 7-months after RYGB when compared to the pre-surgery state (−0.6%; 95%CI [−5.2, 4.0] and 19.5%; 95%CI [4.0, 35.0], P =0.006), and were not different from the lean controls (16.7%; 95%CI [11.8, 21.5] and 1.9%; 95%CI [−1.6, 5.4], respectively). Further, number of fragmented mitochondria and Drp1(Ser616) phosphorylation and were trended to reduced/reduced (0.0104, 95%CI [0.0085, 0.0126], P = 0.091 and 0.0085, 95%CI [0.0068, 0.0102], P = 0.05) in myotubes derived from severely obese humans at 7-months after RYGB surgery in comparison to the pre-surgery state. Finally, Drp1(Ser616) phosphorylation was negatively correlated with insulin-stimulated glucose oxidation (r = −0.49, P = 0.037).Conclusion/Interpretation:These data indicate that an intrinsic metabolic defect of glucose partitioning in skeletal muscle from severely obese humans is restored by RYGB surgery. The restoration of glucose partitioning may be regulated through reduced mitochondrial fission protein Drp1 phosphorylation.

Abstract 856: Mitochondrial Protein Kinase B (akt) Translocation Mediates Insulin-stimulated Cardiac Glucose Oxidation

Introduction: Insulin stimulates glucose oxidation, an effect which is associated with simulating pyruvate dehydrogenase (PDH). However, how the insulin signal is transduced from the cell membrane to the mitochondria to stimulate PDH is not known. Protein kinase B (Akt), protein kinase C-delta (PKCδ) and glycogen synthase kinase-3beta (GSK-3β) are main components of the cytosolic insulin signalling pathway and it has been suggested that they can be translocated to the mitochondria following insulin receptor activation in noncardiac tissue. Therefore, we investigated whether any of these kinases has a role mediated cardiac insulin-stimulated glucose oxidation in the heart. Methods and Results: Male and female C57BL/6 mice were anesthetized and hearts were collected and perfused in the isolated working heart mode. Hearts were perfused with [5- 3 H] glucose and [U- 14 C] glucose to simultaneously measure glycolysis and glucose oxidation rates, respectively, in the presence and absence of insulin. Insulin enhanced the phosphorylation and translocation of Akt Ser473 , PKCδ Tyr311 and GSK-3β Ser9 to the cardiac mitochondria along with enhancing PDH activity by decreasing its phosphorylation. Pharmacological inhibition of Akt using AktiVIII completely abolish the stimulatory effect of insulin on cardiac glucose oxidation rates (354 ± 145 vs 2307 ± 185 nmol. g dry wt -1 . min -1 in vehicle-treated hearts, p&lt;0.05). However, pharmacological inhibition of either PKCδ or GSK-3β using Bisindolylmaleimide I or 3F8, respectively, did not have a significant effect on insulin-stimulated glucose oxidation rates. None of the pharmacological inhibitors had any significant effect on cardiac glycolysis. Conclusion: Insulin mediates its stimulatory effect on cardiac glucose oxidation via a mechanism which involve the activation and translocation of Akt to the mitochondria.

Abstract 868: A Cardiac Specific Branched Chain Aminotransferase Deletion Increases Insulin Stimulated Glucose Oxidation in the Mouse Heart

Impaired branched chain amino acid (BCAA) oxidation at the level of downstream BCAA catabolic enzymes cause cardiac insulin resistance and dysfunction. However, it is not known whether it is the accumulation of BCAAs or branched chain keto acids (BCKAs) due to impaired cardiac BCAA oxidation that result in these cardiac metabolic detrimental effects. Our objective was to inhibit cardiac branched chain aminotransferase (BCATm), the first enzyme in the BCAA oxidative pathway, which functions to produce BCKAs. We anticipate deletion of upstream BCAA catabolic enzyme will result in reduced cardiac BCAA oxidation and increase BCAAs but decrease BCKAs. Ten-week-old BCATm cardiac specific knockout (BCATm -/- ) male mice and their α-MHC-Cre expressing wildtype littermates (WT-Cre +/+ ) received 6 intraperitoneal injections of tamoxifen (50 mg/kg). All mice were allowed a 6-week washout post-tamoxifen, following which 16-week-old mice were used to assess cardiac energy metabolism. Isolated working hearts were perfused with oxygenated Krebs–Henseleit solution, consisting of either 5mM [5- 3 H/U- 14 C] glucose, 0.8mM palmitate, 3%BSA, 0.5mM BCAA for glycolysis and glucose oxidation measurements, or 0.5mM glucose, 0.8mM [9,10- 3 H] palmitate, 3%BSA and 0.5mM [U- 14 C] BCAA from combination of 0.15mM leucine/isoleucine and 0.2mM valine for fatty acid oxidation and BCAA oxidation measurements respectively. There was no body weight, glucose tolerance or cardiac function differences observed in BCATm -/- mice compared to WT-Cre +/+ mice (control). As expected, cardiac BCAA oxidation was significantly reduced in BCATm -/- mice compared to control, however, adding insulin after 30 min of perfusion did not change BCAA oxidation rates. Interestingly, glucose oxidation was significantly higher in BCATm -/- mice. Adding insulin further increased glucose oxidation in BCATm -/- mice. Additionally, the contribution of glucose oxidation to ATP production was significantly higher in the BCATm -/- mice compared to control. We conclude that impaired BCAA oxidation due to the upstream catabolic enzyme deletion increases cardiac insulin sensitivity. This also indicates that accumulation of BCKAs, not BCAAs, may be primarily contributing to cardiac insulin resistance.

Abstract 797: Obesity-associated, but not obesity-independent, tumors respond to insulin by increasing mitochondrial glucose oxidation

Abstract Obesity is associated with increased incidence and worse prognosis of more than one dozen tumor types; however, the molecular mechanisms for this association are unknown. We hypothesized that insulin, which is elevated in obesity-driven insulin resistance, would increase tumor glucose oxidation in obesity-associated tumors. To test this hypothesis, we developed a stable isotope method in which tumor cells are incubated in physiological concentrations (5 mM) of [13C6] glucose and the ratio of pyruvate dehydrogenase flux to citrate synthase flux (VPDH/VCS, i.e. the percent of total mitochondrial oxidation fueled by glucose oxidation) is given as [4,5-13C2]glutamate/[13C3]alanine, measured by gas chromatography/mass spectrometry and liquid chromatography-tandem mass spectrometry respectively. Using this method, we found that both breast cancer (4T1) and colon cancer (MC38) cells, tumors that are associated with obesity, exhibit greater relative rates of glucose oxidation to total mitochondrial oxidation (VPDH/VCS 61±3% and 60±2%, respectively) than melanoma (YUMM) and Renca (renal cell carcinoma) cells (41±4% and 37±2%, respectively; P&amp;lt;0.05 for all comparisons between obesity-associated and non-obesity-associated tumors). In addition, both 4T1 and MC38 cells increased VPDH/VCS upon incubation in 100 nM insulin (75±3% and 81±2%, respectively, P&amp;lt;0.01 vs. the same tumor type without insulin), whereas there was no change in glucose oxidation with insulin in YUMM or Renca cells (35±3% and 36±2%, respectively). These data reveal that a shift in substrate preference may comprise a metabolic signature of obesity-associated tumors that differs from that of those not associated with obesity. In addition, contrary to the conventionally held view that glucose oxidation in tumor cells is constitutively high, these data reveal that obesity-driven tumors respond acutely to insulin by increasing mitochondrial glucose oxidation, whereas obesity-independent tumor cells do not. CONCLUSION: These data demonstrate that obesity associated tumors (breast and colon), in contrast to tumors that are not associated with obesity (melanoma, renal cell), are insulin-responsive and have higher rates of basal and insulin-stimulated mitochondrial glucose oxidation. Therefore assessment of in vitro tumor mitochondrial substrate preference may predict whether interventions to reverse hyperinsulinemia or reduce insulin-responsive glucose oxidation in tumors may be attractive therapeutic modalities in cancer types associated with obesity. Citation Format: Aviva Rabin-Court, Gerald I. Shulman, Rachel J. Perry. Obesity-associated, but not obesity-independent, tumors respond to insulin by increasing mitochondrial glucose oxidation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 797.

Weight loss enhances cardiac energy metabolism and function in heart failure associated with obesity

Obesity is associated with high rates of cardiac fatty acid oxidation, low rates of glucose oxidation, cardiac hypertrophy and heart failure. Whether weight loss can lessen the severity of heart failure associated with obesity is not known. We therefore determined the effect of weight loss on cardiac energy metabolism and the severity of heart failure in obese mice with heart failure. Obesity and heart failure were induced by feeding mice a high-fat (HF) diet and subjecting them to transverse aortic constriction (TAC). Obese mice with heart failure were then switched for 8 weeks to either a low-fat (LF) diet (HF TAC LF) or caloric restriction (CR) (40% caloric intake reduction, HF TAC CR) to induce weight loss. Weight loss improved cardiac function (%EF was 38 ± 6% and 36 ± 6% in HF TAC LF and HF TAC CR mice vs 25 ± 3% in HF TAC mice, P < 0.05) and it decreased cardiac hypertrophy post TAC (left ventricle mass was 168 ± 7 and 171 ± 10 mg in HF TAC LF and HF TAC CR mice, respectively, vs 210 ± 8 mg in HF TAC mice, P < 0.05). Weight loss enhanced cardiac insulin signalling, insulin-stimulated glucose oxidation rates (1.5 ± 0.1 and 1.5 ± 0.1 μmol/g dry wt/min in HF TAC LF and HF TAC CR mice, respectively, vs 0.2 ± 0.1 μmol/g dry wt/min in HF TAC mice, P < 0.05) and it decreased pyruvate dehydrogenase phosphorylation. Cardiac fatty acid oxidation rates, AMPKTyr172 /ACCSer79 signalling and the acetylation of ß-oxidation enzymes, were attenuated following weight loss. Weight loss is an effective intervention to improve cardiac function and energy metabolism in heart failure associated with obesity.