Variants in genes controlling oxidative metabolism contribute to lower hepatic ATP independent of liver fat content in type 1 diabetes

S Gancheva, A Bierwagen, K Kaul, C Herder… - Diabetes, 2016 - Am Diabetes Assoc
S Gancheva, A Bierwagen, K Kaul, C Herder, P Nowotny, S Kahl, G Giani, B Klueppelholz…
Diabetes, 2016Am Diabetes Assoc
Type 1 diabetes has been recently linked to nonalcoholic fatty liver disease (NAFLD), which
is known to associate with insulin resistance, obesity, and type 2 diabetes. However, the role
of insulin resistance and hyperglycemia for hepatic energy metabolism is yet unclear. To
analyze early abnormalities in hepatic energy metabolism, we examined 55 patients with
recently diagnosed type 1 diabetes. They underwent hyperinsulinemic-normoglycemic
clamps with [6, 6-2H2] glucose to assess whole-body and hepatic insulin sensitivity. Hepatic …
Type 1 diabetes has been recently linked to nonalcoholic fatty liver disease (NAFLD), which is known to associate with insulin resistance, obesity, and type 2 diabetes. However, the role of insulin resistance and hyperglycemia for hepatic energy metabolism is yet unclear. To analyze early abnormalities in hepatic energy metabolism, we examined 55 patients with recently diagnosed type 1 diabetes. They underwent hyperinsulinemic-normoglycemic clamps with [6,6-2H2]glucose to assess whole-body and hepatic insulin sensitivity. Hepatic γATP, inorganic phosphate (Pi), and triglyceride concentrations (hepatocellular lipid content [HCL]) were measured with multinuclei magnetic resonance spectroscopy (31P/1H-MRS). Glucose-tolerant humans served as control (CON) (n = 57). Whole-body insulin sensitivity was 44% lower in patients than in age- and BMI-matched CON. Hepatic γATP was 15% reduced (2.3 ± 0.6 vs. 2.7 ± 0.6 mmol/L, P < 0.001), whereas hepatic Pi and HCL were similar in patients when compared with CON. Across all participants, hepatic γATP correlated negatively with glycemia and oxidized LDL. Carriers of the PPARG G allele (rs1801282) and noncarriers of PPARGC1A A allele (rs8192678) had 21 and 13% lower hepatic ATP concentrations. Variations in genes controlling oxidative metabolism contribute to a reduction in hepatic ATP in the absence of NAFLD, suggesting that alterations in hepatic mitochondrial function may precede diabetes-related liver diseases.
Am Diabetes Assoc