Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Insulin treatment increases myocardial ceramide accumulation and disrupts cardiometabolic function

Authors: Aimee E. Hodson, Trevor S. Tippetts, Benjamin T. Bikman

Published in: Cardiovascular Diabetology | Issue 1/2015

Login to get access

Abstract

Background

States of hyperinsulinemia, particularly insulin resistance and type 2 diabetes mellitus, are becoming remarkably common, with roughly half a billion people likely to suffer from the disorder within the next 15 years. Along with this rise has been an associated increased burden of cardiovascular disease. Considering type 2 diabetics treated with insulin are more likely to suffer from heart complications, we sought to determine the specific effect of insulin on ceramide-dependent cardiometabolic risk factors, including insulin resistance and altered heart mitochondrial physiology.

Methods

H9c2 cardiomyocytes and adult mice were treated with insulin with or without myriocin to inhibit ceramide biosynthesis. Insulin and glucose changes were tracked throughout the study and mitochondrial bioenergetics was determined in permeabilized cardiomyocytes and myocardium.

Results

Herein, we demonstrate that insulin is sufficient to disrupt heart mitochondrial respiration in both isolated cardiomyocytes and whole myocardium, possibly by increasing mitochondrial fission. Further, insulin increases ceramide accrual in a time-dependent manner, which is necessary for insulin-induced alterations in heart mitochondrial respiration and insulin resistance.

Conclusions

Collectively, these observations have two implications. First, they indicate a pathological role of insulin in heart complications stemming from mitochondrial disruption. Second, they identify ceramide as a possible mediator of insulin-related heart disorders.
Literature
1.
go back to reference Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA J Am Med Assoc. 1979;241(19):2035–8.CrossRef Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA J Am Med Assoc. 1979;241(19):2035–8.CrossRef
2.
5.
go back to reference Centers for Disease C, Prevention. prevalence of diabetes and impaired fasting glucose in adults—United States, 1999–2000. MMWR Morbidity and mortality weekly report. 2003;52(35):833–7. Centers for Disease C, Prevention. prevalence of diabetes and impaired fasting glucose in adults—United States, 1999–2000. MMWR Morbidity and mortality weekly report. 2003;52(35):833–7.
8.
9.
go back to reference Group AC, Patel A, MacMahon S, Chalmers J, Neal B, Billot L et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–72. doi:10.1056/NEJMoa0802987. Group AC, Patel A, MacMahon S, Chalmers J, Neal B, Billot L et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–72. doi:10.1056/NEJMoa0802987.
11.
go back to reference Tilton RG, Chang K, Nyengaard JR, Van den Enden M, Ido Y, Williamson JR. Inhibition of sorbitol dehydrogenase. Effects on vascular and neural dysfunction in streptozocin-induced diabetic rats. Diabetes. 1995;44(2):234–42.PubMedCrossRef Tilton RG, Chang K, Nyengaard JR, Van den Enden M, Ido Y, Williamson JR. Inhibition of sorbitol dehydrogenase. Effects on vascular and neural dysfunction in streptozocin-induced diabetic rats. Diabetes. 1995;44(2):234–42.PubMedCrossRef
12.
go back to reference Schmidt AM, Yan SD, Wautier JL, Stern D. Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis. Circ Res. 1999;84(5):489–97.PubMedCrossRef Schmidt AM, Yan SD, Wautier JL, Stern D. Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis. Circ Res. 1999;84(5):489–97.PubMedCrossRef
13.
go back to reference Yan SF, Ramasamy R, Schmidt AM. Mechanisms of disease: advanced glycation end-products and their receptor in inflammation and diabetes complications. Nat Clin Pract Endocrinol Metab. 2008;4(5):285–93. doi:10.1038/ncpendmet0786.PubMedCrossRef Yan SF, Ramasamy R, Schmidt AM. Mechanisms of disease: advanced glycation end-products and their receptor in inflammation and diabetes complications. Nat Clin Pract Endocrinol Metab. 2008;4(5):285–93. doi:10.​1038/​ncpendmet0786.PubMedCrossRef
14.
go back to reference Nelson MB, Swensen AC, Winden DR, Bodine JS, Bikman BT, Reynolds PR. Cardiomyocyte mitochondrial respiration is reduced by receptor for advanced glycation end-product signaling in a ceramide-dependent manner. Am J Physiol Heart Circ Physiol. 2015;309(1):H63–9. doi:10.1152/ajpheart.00043.2015.PubMedCrossRef Nelson MB, Swensen AC, Winden DR, Bodine JS, Bikman BT, Reynolds PR. Cardiomyocyte mitochondrial respiration is reduced by receptor for advanced glycation end-product signaling in a ceramide-dependent manner. Am J Physiol Heart Circ Physiol. 2015;309(1):H63–9. doi:10.​1152/​ajpheart.​00043.​2015.PubMedCrossRef
15.
go back to reference Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106(16):2067–72.PubMedCrossRef Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106(16):2067–72.PubMedCrossRef
18.
go back to reference McAuley KA, Williams SM, Mann JI, Walker RJ, Lewis-Barned NJ, Temple LA, et al. Diagnosing insulin resistance in the general population. Diabetes Care. 2001;24(3):460–4.PubMedCrossRef McAuley KA, Williams SM, Mann JI, Walker RJ, Lewis-Barned NJ, Temple LA, et al. Diagnosing insulin resistance in the general population. Diabetes Care. 2001;24(3):460–4.PubMedCrossRef
19.
20.
go back to reference Action to Control Cardiovascular Risk in Diabetes Study G, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59. doi:10.1056/NEJMoa0802743.CrossRef Action to Control Cardiovascular Risk in Diabetes Study G, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59. doi:10.​1056/​NEJMoa0802743.CrossRef
22.
go back to reference Zhang QJ, Holland WL, Wilson L, Tanner JM, Kearns D, Cahoon JM, et al. Ceramide mediates vascular dysfunction in diet-induced obesity by PP2A-mediated dephosphorylation of the eNOS-Akt complex. Diabetes. 2012;61(7):1848–59. doi:10.2337/db11-1399.PubMedCentralPubMedCrossRef Zhang QJ, Holland WL, Wilson L, Tanner JM, Kearns D, Cahoon JM, et al. Ceramide mediates vascular dysfunction in diet-induced obesity by PP2A-mediated dephosphorylation of the eNOS-Akt complex. Diabetes. 2012;61(7):1848–59. doi:10.​2337/​db11-1399.PubMedCentralPubMedCrossRef
24.
go back to reference Di Paola M, Cocco T, Lorusso M. Ceramide interaction with the respiratory chain of heart mitochondria. Biochemistry. 2000;39(22):6660–8.PubMedCrossRef Di Paola M, Cocco T, Lorusso M. Ceramide interaction with the respiratory chain of heart mitochondria. Biochemistry. 2000;39(22):6660–8.PubMedCrossRef
25.
go back to reference Smith ME, Tippetts TS, Brassfield ES, Tucker BJ, Ockey A, Swensen AC, et al. Mitochondrial fission mediates ceramide-induced metabolic disruption in skeletal muscle. Biochem J. 2013;456(3):427–39. doi:10.1042/BJ20130807.PubMedCrossRef Smith ME, Tippetts TS, Brassfield ES, Tucker BJ, Ockey A, Swensen AC, et al. Mitochondrial fission mediates ceramide-induced metabolic disruption in skeletal muscle. Biochem J. 2013;456(3):427–39. doi:10.​1042/​BJ20130807.PubMedCrossRef
31.
go back to reference Biessels GJ, Kappelle LJ, Utrecht Diabetic Encephalopathy Study G. Increased risk of Alzheimer’s disease in Type II diabetes: insulin resistance of the brain or insulin-induced amyloid pathology? Biochem Soc Trans. 2005;33(Pt 5):1041–4. doi:10.1042/BST20051041.PubMedCrossRef Biessels GJ, Kappelle LJ, Utrecht Diabetic Encephalopathy Study G. Increased risk of Alzheimer’s disease in Type II diabetes: insulin resistance of the brain or insulin-induced amyloid pathology? Biochem Soc Trans. 2005;33(Pt 5):1041–4. doi:10.​1042/​BST20051041.PubMedCrossRef
32.
go back to reference Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84(1):165–9. doi:10.1210/jcem.84.1.5393.PubMed Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84(1):165–9. doi:10.​1210/​jcem.​84.​1.​5393.PubMed
33.
34.
go back to reference Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229–34. doi:10.1056/NEJM199807233390404.PubMedCrossRef Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229–34. doi:10.​1056/​NEJM199807233390​404.PubMedCrossRef
35.
go back to reference Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001;86(5):1930–5. doi:10.1210/jcem.86.5.7463.PubMedCrossRef Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab. 2001;86(5):1930–5. doi:10.​1210/​jcem.​86.​5.​7463.PubMedCrossRef
36.
go back to reference Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The Evidence Report. National Institutes of Health. Obesity Res. 1998;6 Suppl 2:51S–209S. Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The Evidence Report. National Institutes of Health. Obesity Res. 1998;6 Suppl 2:51S–209S.
37.
go back to reference Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet. 1992;340(8825):925–9.PubMedCrossRef Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet. 1992;340(8825):925–9.PubMedCrossRef
39.
go back to reference Parra V, Verdejo HE, Iglewski M, Del Campo A, Troncoso R, Jones D, et al. Insulin stimulates mitochondrial fusion and function in cardiomyocytes via the Akt-mTOR-NFkappaB-Opa-1 signaling pathway. Diabetes. 2014;63(1):75–88. doi:10.2337/db13-0340.PubMedCentralPubMedCrossRef Parra V, Verdejo HE, Iglewski M, Del Campo A, Troncoso R, Jones D, et al. Insulin stimulates mitochondrial fusion and function in cardiomyocytes via the Akt-mTOR-NFkappaB-Opa-1 signaling pathway. Diabetes. 2014;63(1):75–88. doi:10.​2337/​db13-0340.PubMedCentralPubMedCrossRef
40.
go back to reference Pontiroli AE, Alberetto M, Pozza G. Patients with insulinoma show insulin resistance in the absence of arterial hypertension. Diabetologia. 1992;35(3):294–5.PubMedCrossRef Pontiroli AE, Alberetto M, Pozza G. Patients with insulinoma show insulin resistance in the absence of arterial hypertension. Diabetologia. 1992;35(3):294–5.PubMedCrossRef
41.
go back to reference Henry RR, Gumbiner B, Ditzler T, Wallace P, Lyon R, Glauber HS. Intensive conventional insulin therapy for type II diabetes. Metabolic effects during a 6-mo outpatient trial. Diabetes Care. 1993;16(1):21–31.PubMedCrossRef Henry RR, Gumbiner B, Ditzler T, Wallace P, Lyon R, Glauber HS. Intensive conventional insulin therapy for type II diabetes. Metabolic effects during a 6-mo outpatient trial. Diabetes Care. 1993;16(1):21–31.PubMedCrossRef
42.
go back to reference Del Prato S, Leonetti F, Simonson DC, Sheehan P, Matsuda M, DeFronzo RA. Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man. Diabetologia. 1994;37(10):1025–35.PubMedCrossRef Del Prato S, Leonetti F, Simonson DC, Sheehan P, Matsuda M, DeFronzo RA. Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man. Diabetologia. 1994;37(10):1025–35.PubMedCrossRef
44.
go back to reference Reaven GM. Insulin resistance and compensatory hyperinsulinemia: role in hypertension, dyslipidemia, and coronary heart disease. Am Heart J. 1991;121(4 Pt 2):1283–8.PubMedCrossRef Reaven GM. Insulin resistance and compensatory hyperinsulinemia: role in hypertension, dyslipidemia, and coronary heart disease. Am Heart J. 1991;121(4 Pt 2):1283–8.PubMedCrossRef
45.
go back to reference Pyorala M, Miettinen H, Laakso M, Pyorala K. Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Circulation. 1998;98(5):398–404.PubMedCrossRef Pyorala M, Miettinen H, Laakso M, Pyorala K. Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Circulation. 1998;98(5):398–404.PubMedCrossRef
46.
go back to reference Weyer C, Hanson RL, Tataranni PA, Bogardus C, Pratley RE. A high fasting plasma insulin concentration predicts type 2 diabetes independent of insulin resistance: evidence for a pathogenic role of relative hyperinsulinemia. Diabetes. 2000;49(12):2094–101.PubMedCrossRef Weyer C, Hanson RL, Tataranni PA, Bogardus C, Pratley RE. A high fasting plasma insulin concentration predicts type 2 diabetes independent of insulin resistance: evidence for a pathogenic role of relative hyperinsulinemia. Diabetes. 2000;49(12):2094–101.PubMedCrossRef
47.
go back to reference Kekalainen P, Sarlund H, Pyorala K, Laakso M. Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes. Diabetes Care. 1999;22(1):86–92.PubMedCrossRef Kekalainen P, Sarlund H, Pyorala K, Laakso M. Hyperinsulinemia cluster predicts the development of type 2 diabetes independently of family history of diabetes. Diabetes Care. 1999;22(1):86–92.PubMedCrossRef
48.
go back to reference Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA J Am Med Assoc. 1990;263(21):2893–8.CrossRef Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA J Am Med Assoc. 1990;263(21):2893–8.CrossRef
53.
go back to reference Abbasi F, Chu JW, McLaughlin T, Lamendola C, Leary ET, Reaven GM. Effect of metformin treatment on multiple cardiovascular disease risk factors in patients with type 2 diabetes mellitus. Metab Clin Exp. 2004;53(2):159–64.PubMedCrossRef Abbasi F, Chu JW, McLaughlin T, Lamendola C, Leary ET, Reaven GM. Effect of metformin treatment on multiple cardiovascular disease risk factors in patients with type 2 diabetes mellitus. Metab Clin Exp. 2004;53(2):159–64.PubMedCrossRef
55.
go back to reference Soler NG, Bennett MA, Pentecost BL, Fitzgerald MG, Malins JM. Myocardial infarction in diabetics. Q J Med. 1975;44(173):125–32.PubMed Soler NG, Bennett MA, Pentecost BL, Fitzgerald MG, Malins JM. Myocardial infarction in diabetics. Q J Med. 1975;44(173):125–32.PubMed
56.
go back to reference Ulvenstam G, Aberg A, Bergstrand R, Johansson S, Pennert K, Vedin A, et al. Long-term prognosis after myocardial infarction in men with diabetes. Diabetes. 1985;34(8):787–92.PubMedCrossRef Ulvenstam G, Aberg A, Bergstrand R, Johansson S, Pennert K, Vedin A, et al. Long-term prognosis after myocardial infarction in men with diabetes. Diabetes. 1985;34(8):787–92.PubMedCrossRef
57.
59.
Metadata
Title
Insulin treatment increases myocardial ceramide accumulation and disrupts cardiometabolic function
Authors
Aimee E. Hodson
Trevor S. Tippetts
Benjamin T. Bikman
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0316-y

Other articles of this Issue 1/2015

Cardiovascular Diabetology 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine