Stimulation Of Hepatic Glucose Output Research Articles

D-chiro-Inositol Attenuates Epinephrine-stimulated Hepatic Glucose Output in the Isolated Perfused Liver Independently of Insulin

D-chiro-Inositol (DCI) is a cyclic sugar alcohol that evokes both antidiabetic and insulin sensitizing effects. Pharmacological administration of DCI has been shown to lower blood glucose in rat models of diabetes mellitus and enhance insulin sensitivity in humans with polycystic ovary syndrome (PCOS). We hypothesised that the antidiabetic effects of DCI could be due to inhibition of hepatic glucose output (HGO). To test this hypothesis, we perfused isolated rat livers either with buffer, myo-inositol, DCI, or insulin, and investigated their respective effects on the stimulation of HGO by epinephrine. We found that perfusion with 200 μM DCI attenuated epinephrine-stimulated HGO by 35% over 30 min as compared to the buffer control perfusion (p=0.05). By comparison, perfusion with 1 nM insulin attenuated epinephrine-stimulated HGO by 57% (p<0.0001). The glucose-lowering effects by DCI occurred independently of insulin and were specific to the DCI stereoisomer as 200 μM myo-inositol had no effect. These findings suggest that DCI could evoke its antidiabetic effects in vivo by inhibition of HGO. Further identification of the protein targets involved could open up new avenues to regulate hyperglycaemia with wider implications for the treatment of hepatic insulin resistance in PCOS.

The glucose-fatty acid cycle: a physiological perspective.

Glucose and fatty acids are the major fuels for mammalian metabolism and it is clearly essential that mechanisms exist for mutual co-ordination of their utilization. The glucose-fatty acid cycle, as it was proposed in 1963, describes one set of mechanisms by which carbohydrate and fat metabolism interact. Since that time, the importance of the glucose-fatty acid cycle has been confirmed repeatedly, in particular by elevation of plasma non-esterified fatty acid concentrations and demonstration of an impairment of glucose utilization. Since 1963 further means have been elucidated by which glucose and fatty acids interact. These include stimulation of hepatic glucose output by fatty acids, potentiation of glucose-stimulated insulin secretion by fatty acids, and the cellular mechanism whereby high glucose and insulin concentrations inhibit fatty acid oxidation via malonyl-CoA regulation of carnitine palmitoyltransferase-1. The last of these mechanisms, discovered by Denis McGarry and Daniel Foster in 1977, provides an almost exact complement to the mechanism described in the glucose-fatty acid cycle whereby high concentrations of fatty acids inhibit glucose utilization. These additional discoveries have not detracted from the important of the glucose-fatty acid cycle: rather, they have reinforced the importance of mechanisms whereby glucose and fat can interact.

Glucagon stimulates expression of the inducible cAMP early repressor and suppresses insulin gene expression in pancreatic beta-cells.

The hormone glucagon is secreted by the alpha-cells of the endocrine pancreas (islets of Langerhans) during fasting and is essential for the maintenance of blood glucose levels by stimulation of hepatic glucose output. Excessive production and secretion of glucagon by the alpha-cells of the islets is a common accompaniment to diabetes. The resulting hyperglucagonemia stimulates hepatic glucose production, thereby contributing to hyperglycemia of diabetes. The reduced insulin secretion in diabetes and resultant failure to suppress glucagon secretion by intra-islet paracrine mechanisms is believed to cause the hypersecretion of glucagon. Here, we report the discovery of a new mechanism by which glucagon suppresses insulin secretion. We show that glucagon, but not glucagon-like peptide 1 (GLP-1), or pituitary adenylyl cyclase-activating peptide (PACAP) specifically induces the expression of the transcriptional repressor inducible cAMP early repressor (ICER) in pancreatic beta-cells, resulting in a repression of the transcriptional expression of the insulin gene. Remarkably, glucagon, GLP-1, and PACAP all stimulate the formation of cAMP to a comparable extent in rat pancreatic islets, but only glucagon activates the expression of ICER and represses insulin gene transcription in beta-cells. These findings lead us to propose that hyperglucagonemia may additionally aggravate the diabetic phenotype via a suppression of insulin gene expression mediated by the transcriptional repressor ICER.

Effects of leukotrienes and the thromboxane A2 analogue U-46619 in isolated perfused rat liver. Metabolic, hemodynamic and ion-flux responses.

1) Addition of leukotriene C4 to isolated perfused rat liver led to a stimulation of hepatic glucose output, a slight decrease of 14CO2 production from [1-14C] glutamate, an increase of portal pressure and an inhibition of hepatic oxygen uptake. Withdrawal of leukotriene C4 caused a transient further stimulation of hepatic glucose output. 2) These effects were accompanied by a slow net Ca2+ release from the liver, which was not completed within 8 min. Following leukotriene withdrawal there was a further Ca2+ release for about 1 min superimposing a slow reuptake of Ca2+ of about 10 min duration. 3) Leukotriene C4 induced a characteristic biphasic K+ release from the liver. Withdrawal of the leukotriene resulted in a further net K+ release for about 4 min, being followed by a K+ reuptake over more than 10 min. 4) Effects comparable to those induced with leukotriene C4 (20nM) were obtained with leukotriene D4 (20nM), were as leukotriene B4 and E4 (20nM each) were much less effective. 5) The thromboxane A2 analogue U-46619 produced ionic, metabolic and hemodynamic responses similar to leukotriene C4; however, when given at concentration yielding a comparable glucose release, the thromboxane analogue was much more vasoactive than leukotriene C4. The thromboxane A2 receptor antagonist BM-13.177 (20 microM) blocked the metabolic, hemodynamic and ion flux responses to U-46619 almost completely, but had no effect on the response to leukotriene C4. 6) Each, leukotrienes, U-46619 and UTP led to an inhibition of hepatic oxygen uptake. The extent of inhibition of oxygen uptake induced by these compounds was not exclusively explained by their effects on hepatic circulation: a 30% inhibition of oxygen uptake by leukotriene C4, U-46619 or UTP was accompanied by increases of the portal pressure of 4.9 +/- 0.4 (481 +/- 39 Pa) (n = 7), 16.0 +/- 1.9 (1570 +/- 186 Pa) (n = 7) or 11.4 +/- 0.4 (1118 +/- 39 Pa) (n = 13) cm H2O, respectively. 7) The data show that leukotrienes and possibly also thromboxanes are potent regulators of hepatic metabolism and hemodynamics, probably acting by a Ca2+ mobilizing mechanism and involving different receptor systems. The response of perfused liver to these compounds is qualitatively similar to that obtained with extracellular UTP, but different to that with prostaglandins, extracellular ATP or phenylephrine. The data further support the view that eicosanoids are important modulators of hepatic metabolism and point to a complex regulatory interaction between hepatic parenchymal and non-parenchymal cells.

Stimulation of glycogenolysis and platelet-activating factor production by heat-aggregated immunoglobulin G in the perfused rat liver.

Infusion of heat-aggregated immunoglobulin G (IgG) into perfused livers from fed rats resulted in a dose-dependent but transient stimulation of hepatic glucose output. Oxygen consumption and lactate production by the liver also were stimulated, while the lactate/pyruvate ratio of the effluent perfusate was increased. Upon return of hepatic glucose output to the basal rate following immune aggregate stimulation, a second infusion of immune aggregate caused little or no increase in glucose output, indicating desensitization of the response. Infusion of immune aggregate into rat livers also resulted in the appearance of platelet-activating factor activity in the effluent perfusate. Synthetic platelet-activating factor or acetylglyceryl ether phosphorylcholine (AGEPC) has been demonstrated to be a potent glycogenolytic agonist in the perfused liver (Buxton, D.B., Shukla, S. D., Hanahan, D. J., and Olson, M.S. (1984) J. Biol. Chem. 259, 1468-1471). The glycogenolytic response of the liver to immune aggregate infusion was not desensitized by prior infusion of AGEPC. Co-infusion of the cyclooxygenase inhibitor indomethacin prevented the immune aggregate-induced glycogenolytic response but had no effect on AGEPC-stimulated hepatic glucose output. It is suggested that the mechanism by which aggregated IgG activates hepatic glycogenolysis requires the synthesis of AGEPC by the liver by a pathway which involves the metabolism of arachadonic acid.

Role of cyclic AMP in glucagon-induced stimulation of hepatic glucose output in man

Role of cyclic AMP in glucagon-induced stimulation of hepatic glucose output in man

Role of cyclic AMP in glucagon-induced stimulation of hepatic glucose output in man

The interrelationship between glucagon action on splanchnic glucose output and cyclic AMP production was studied in healthy volunteers after hepatic venous catheterization. Glucagon was infused according to four different protocols to achieve arterial levels ranging from 300 to 9000 ng/l. Infusion of glucagon which resulted in arterial levels of the hormone of 4000-9000 ng/l was associated with a marked increase in net splanchnic cyclic AMP production and in the arterial levels of the cyclic nucleotide. The rise in cyclic AMP efflux from the splanchnic area was transient but an augmented splanchnic production was still evident after 30 min of glucagon infusion. Splanchnic glucose output rose 3-5 fold. Infusion of glucagon at lower rates, resulting in arterial levels of 300-900 ng/l, did not measureably stimulate the efflux of cyclic AMP from the splanchnic area. In spite of this, splanchnic glucose output rose 2-3 fold and the blood glucose level increased 20-50% during glucagon infusion at these lower rates. It is concluded that (1) factors other than cyclic AMP are rate limiting in the stimulation of hepatic glucose production, and (2) although cyclic AMP is an established 'second messenger' of glucagon action, other factors may also be of importance in mediating the physiological response of this hormone.

Stimulation by vasopressin of glycogen breakdown and gluconeogenesis in the perfused rat liver.

1. Vasopressin (anti-diuretic hormone, [8-arginine]vasopressin) stimulated the breakdown of glycogen in perfused livers of fed rats, at concentrations (50-600muunits/ml) that have been reported in the blood of intact rats, especially during acute haemorrhagic shock. 2. In perfused livers from starved rats, vasopressin (30-150muunits/ml) stimulated gluconeogenesis from a mixture of lactate, pyruvate and glycerol. 3. Vasopressin prevented accumulation of liver glycogen in the perfused liver of starved rats, or in starved intact rats. 4. The action of vasopressin on hepatic carbohydrate metabolism thus resembles that of glucagon; the minimum effective circulating concentrations of these hormones are of the same order (100pg/ml). 5. The stimulation of hepatic glucose output by vasopressin is discussed in connexion with the release of glucose and water from the liver.