Insulin resistance and improvements in signal transduction

Nicolas Musi, Laurie J. Goodyear

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Type 2 diabetes and obesity are common metabolic disorders characterized by resistance to the actions of insulin to stimulate skeletal muscle glucose disposal. Insulin-resistant muscle has defects at several steps of the insulin-signaling pathway, including decreases in insulin-stimulated insulin receptor and insulin receptor substrate-1 tyrosine phosphorylation, and phosphatidylinositol 3-kinase (PI 3-kinase) activation. One approach to increase muscle glucose disposal is to reverse/improve these insulin-signaling defects. Weight loss and thiazolidinediones (TZDs) improve glucose disposal, in part, by increasing insulin-stimulated insulin receptor and IRS-1 tyrosine phosphorylation and PI 3-kinase activity. In contrast, physical training and metformin improve whole-body glucose disposal but have minimal effects on proximal insulin-signaling steps. A novel approach to reverse insulin resistance involves inhibition of the stress-activated protein kinase Jun N-terminal kinase (JNK) and the protein tyrosine phosphatases (PTPs). A different strategy to increase muscle glucose disposal is by stimulating insulin-independent glucose transport. AMP-activated protein kinase (AMPK) is an enzyme that works as a fuel gauge and becomes activated in situations of energy consumption, such as muscle contraction. Several studies have shown that pharmacologic activation of AMPK increases glucose transport in muscle, independent of the actions of insulin. AMPK activation is also involved in the mechanism of action of metformin and adiponectin. Moreover, in the hypothalamus, AMPK regulates appetite and body weight. The effect of AMPK to stimulate muscle glucose disposal and to control appetite makes it an important pharmacologic target for the treatment of type 2 diabetes and obesity.

Original languageEnglish (US)
Pages (from-to)73-80
Number of pages8
JournalEndocrine
Volume29
Issue number1
DOIs
StatePublished - 2006

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Insulin Resistance
Signal Transduction
Insulin
AMP-Activated Protein Kinases
Glucose
Muscles
Phosphatidylinositol 3-Kinase
Metformin
Insulin Receptor
Appetite
Type 2 Diabetes Mellitus
Tyrosine
Obesity
Phosphorylation
Insulin Receptor Substrate Proteins
Thiazolidinediones
Protein Tyrosine Phosphatases
Adiponectin
Muscle Contraction
Heat-Shock Proteins

Keywords

  • AMPK
  • Exercise
  • Glucose transport
  • JNK
  • Obesity
  • PTP1B
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology

Cite this

Insulin resistance and improvements in signal transduction. / Musi, Nicolas; Goodyear, Laurie J.

In: Endocrine, Vol. 29, No. 1, 2006, p. 73-80.

Research output: Contribution to journalArticle

Musi, Nicolas ; Goodyear, Laurie J. / Insulin resistance and improvements in signal transduction. In: Endocrine. 2006 ; Vol. 29, No. 1. pp. 73-80.
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