Introduction: Diabetes mellitus is comprised of several metabolic disorders with different aetiopathogenesis. They are characterized by hyperglycaemia, which results from impaired insulin secretion and/or insulin resistance in insulin-responsive tissues, such as liver, fat and skeletal muscle. Excess endogenous or exogenous glucocorticoids, such as cortisol and dexamethasone, can lead to insulin resistance, impaired glucose tolerance and diabetes mellitus (so-called steroid diabetes). Skeletal muscle is an important site of insulin-stimulated glucose uptake and one of the most important organs affected by insulin resistance. Pharmacological activation of AMP-activated protein kinase (AMPK), a cellular energy sensor, in skeletal muscle increases insulin sensitivity and thus helps to improve glucose homeostasis of the whole body.
Aim: The exact mechanism of glucocorticoid induced insulin resistance in skeletal muscle is unknown. The aim of our study was to test whether inhibition of AMPK action could contribute to glucocorticoid-induced insulin resistance.
Hypotheses: 1) Cortisol and dexamethasone suppress insulin signalling in L6 skeletal muscle cells. 2) Cortisol and dexamethasone suppress insulin-stimulated glucose uptake in L6 skeletal muscle cells despite an increase in the expression of GLUT1 and GLUT4 transporters. 3) Cortisol and dexamethasone decrease A769662-induced AMPK and acetyl-CoA carboxylase (ACC) phosphorylation in L6 skeletal muscle cells. 4) Cortisol and dexamethasone decrease A769662-stimulated glucose uptake in L6 skeletal muscle cells despite an increase in the expression of GLUT1 and GLUT4 transporters.
Methods: The experiments were performed on rat L6 skeletal muscle cells. Insulin signalling pathway and AMPK activity were evaluated by western blotting, which assessed phosphorylation of AKT (Thr308 and Ser473), AS160 (Thr642), ERK1/2 (Thr202 and Tyr204), S6 ribosomal protein (Ser235/236, S6RP), AMPK (Thr172) and ACC (Ser79). The glucose uptake in cultured cells was estimated by 3H-2-deoxyglucose uptake assay. The expression of GLUT1 and GLUT4 transporters was evaluated with real time quantitative polymerase chain reaction. A769662 was used for pharmacological activation of AMPK.
Results: In the presence of insulin (12 and 120 nM), cortisol and dexamethasone (0.1 µM and 1 µM) increased the AKT (Thr308 and Ser473) phosphorylation. In insulin stimulated samples, cortisol and dexamethasone did not affect (24-hour treatment) or reduced (72-hour treatment) phosphorylation of AS160 (Thr642), while they increased GLUT1 and GLUT4 mRNA expression and enhanced the insulin-stimulated (12 and 120 nM) glucose uptake. In the presence of insulin, phosphorylation of ERK1/2 (Thr202 and Tyr204) and S6RP (Ser235/236) was reduced by the treatment with glucocorticoids. While cortisol and dexamethasone did not alter the phosphorylation of AMPK (Thr172), they suppressed the A769662-induced phosphorylation of ACC (Ser79) and enhanced the A769662-stimulated glucose uptake.
Conclusions: 1) Cortisol and dexamethasone did not decrease the activity of insulin signaling in L6 skeletal muscle cells. 2) Cortisol and dexamethasone increased both the expression of GLUT1 and GLUT4 transporters and insulin-stimulated glucose uptake. 3) Cortisol and dexamethasone diminished A769662-stimulated phosphorylation of ACC but not AMPK. 4) Cortisol and dexamethasone elevated A769662-stimulated glucose uptake.
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