Optimizing the beneficial health effects of exercise for diabetes: focus on the liver!
One of the earliest hallmarks of type 2 diabetes is resistance of the peripheral tissues liver and muscle to the action of insulin, which is generally referred to as insulin resistance. Physical exercise training is perhaps the single most effective intervention to both prevent and treat insulin resistance and type 2 diabetes mellitus. Moreover, exercise training often has beneficial health effects – such as improvements in cardiovascular risk markers – that extend beyond the improvements of insulin sensitivity. Accumulating evidence now suggests that the liver plays an important role in determining the overall health benefits of exercise training in healthy human subjects and type 2 diabetic patients, but the underlying mechanisms are unclear.
Using a multidisciplinary but strongly integrated approach, we will address whether the beneficial effects of exercise training on metabolic risk markers are determined by effects on liver metabolism, and we will investigate the underlying molecular pathways. We will investigate the effect of acute exercise and exercise training on liver fat content and liver mitochondrial metabolism in diabetic patients (subproject 1) and extend these findings to relevant mouse models (subproject 2). In addition, we will identify proteins released from skeletal muscle into the circulation during acute exercise and following exercise training (myokines; subproject 3), and their expression will be correlated with liver fat and other metabolic parameters in diabetic patients. The physiological and molecular effects of these myokines on hepatic metabolism, fat storage, and function will be addressed in mouse models (subproject 2) and tissue culture systems (subproject 4). Finally, we will identify novel components of the skeletal muscle extracellular “metabolome” and test their effects on hepatic lipid metabolism (subprojects 2, 3 and 4). Together, these 4 subprojects are expected to provide better insight into how exercise programs can be optimized to treat the complications of type 2 diabetes mellitus. In addition, understanding the underlying molecular pathways may reveal novel targets for the treatment of the metabolic abnormalities associated with type 2 diabetes.
This project is financed by a grant from the Dutch Diabetes Research Foundation (DFN)
PhD-student: Bram Brouwers
Collaborators: Prof. Dr. Sander Kersten, Wageningen University
Prof. Dr. Eric Kalkhoven, Utrecht University
Hepatic steatosis: Imaging the fate of fat
Hepatic triglyceride accumulation (steatosis) is a major health threat, giving rise to insulin resistance and hyperlipidemia. At present >30% of adults suffer from fatty liver due to the increased obesity prevalence. New evidence suggests that low hepatic ATP concentrations -indicative of compromised mitochondrial function- may underlie triglyceride accumulation. Using novel non-invasive Magnetic Resonance Spectroscopy (MRS) tools we propose to test the hypothesis that diminished hepatic mitochondrial function (investigated by 31P-MRS) leads to excessive retention of dietary fat in the liver, ultimately resulting in hepatic steatosis. Dietary fatty acid (FA) retention will be determined by 13C-MRSbased fatty FA-tracking and steatosis will be determined by 1H-MRS. We will combine human and rodent experiments to study physiological relevance and molecular mechanisms. Given the massive (and growing) number of patients with fatty liver and insulin resistance, the importance of efficient treatment and prevention is evident. Identifying hepatic mitochondrial function as a central player in the development of steatosis and insulin resistance can lead to new targets to prevent diabetes and other obesity-linked morbidity.
This project is financed by a VENI grant from the Netherlands Organisation for Scientific Research (NWO), granted to Dr. Vera Schrauwen-Hinderling