Skip to main content
Top
Published in: Diabetologia 6/2007

01-06-2007 | Article

C3H/HeJ mice carrying a toll-like receptor 4 mutation are protected against the development of insulin resistance in white adipose tissue in response to a high-fat diet

Authors: M. Poggi, D. Bastelica, P. Gual, M. A. Iglesias, T. Gremeaux, C. Knauf, F. Peiretti, M. Verdier, I. Juhan-Vague, J. F. Tanti, R. Burcelin, M. C. Alessi

Published in: Diabetologia | Issue 6/2007

Login to get access

Abstract

Aims/hypothesis

Inflammation is associated with obesity and has been implicated in the development of diabetes and atherosclerosis. During gram-negative bacterial infection, lipopolysaccharide causes an inflammatory reaction via toll-like receptor 4 (TLR4), which has an essential function in the induction of innate and adaptative immunity. Our aim was to determine what role TLR4 plays in the development of metabolic phenotypes during high-fat feeding.

Materials and methods

We evaluated metabolic consequences of a high-fat diet in TLR4 mutant mice (C3H/HeJ) and their respective controls.

Results

TLR4 inactivation reduced food intake without significant modification of body weight, but with higher epididymal adipose tissue mass and adipocyte hypertrophy. It also attenuated the inflammatory response and increased glucose transport and the expression levels of adiponectin and lipogenic markers in white adipose tissue. In addition, TLR4 inactivation blunted insulin resistance induced by lipopolysaccharide in differentiated adipocytes. Increased feeding efficiency in TLR4 mutant mice was associated with lower mass and lower expression of uncoupling protein 1 gene in brown adipose tissue. Finally, TLR4 inactivation slowed the development of hepatic steatosis, reducing the liver triacylglycerol content and also expression levels of lipogenic and fibrosis markers.

Conclusions/interpretation

TLR4 influences white adipose tissue inflammation and insulin sensitivity, as well as liver fat storage, and is important in the regulation of metabolic phenotype during a fat-enriched diet.
Appendix
Available only for authorised users
Literature
1.
go back to reference Festa A, D’Agostino R Jr, Howard G et al (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47PubMed Festa A, D’Agostino R Jr, Howard G et al (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47PubMed
2.
go back to reference Wellen KE, Hotamisligil GS (2005) Inflammation, stress, and diabetes. J Clin Invest 115:1111–1119PubMedCrossRef Wellen KE, Hotamisligil GS (2005) Inflammation, stress, and diabetes. J Clin Invest 115:1111–1119PubMedCrossRef
3.
go back to reference Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCrossRef Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCrossRef
5.
go back to reference Nolan JP, Hare DK, McDevitt JJ, Ali MV (1977) In vitro studies of intestinal endotoxin absorption. I. Kinetics of absorption in the isolated everted gut sac. Gastroenterology 72:434–439PubMed Nolan JP, Hare DK, McDevitt JJ, Ali MV (1977) In vitro studies of intestinal endotoxin absorption. I. Kinetics of absorption in the isolated everted gut sac. Gastroenterology 72:434–439PubMed
6.
go back to reference Wiedermann CJ, Kiechl S, Dunzendorfer S et al (1999) Association of endotoxemia with carotid atherosclerosis and cardiovascular disease: prospective results from the bruneck study. J Am Coll Cardiol 34:1975–1981PubMedCrossRef Wiedermann CJ, Kiechl S, Dunzendorfer S et al (1999) Association of endotoxemia with carotid atherosclerosis and cardiovascular disease: prospective results from the bruneck study. J Am Coll Cardiol 34:1975–1981PubMedCrossRef
7.
go back to reference Stoll LL, Denning GM, Weintraub NL (2004) Potential role of endotoxin as a proinflammatory mediator of atherosclerosis. Arterioscler Thromb Vasc Biol 24:2227–2236PubMedCrossRef Stoll LL, Denning GM, Weintraub NL (2004) Potential role of endotoxin as a proinflammatory mediator of atherosclerosis. Arterioscler Thromb Vasc Biol 24:2227–2236PubMedCrossRef
8.
go back to reference Van der Poll T, Braxton CC, Coyle SM et al (1995) Effect of hypertriglyceridemia on endotoxin responsiveness in humans. Infect Immun 63:3396–3400PubMed Van der Poll T, Braxton CC, Coyle SM et al (1995) Effect of hypertriglyceridemia on endotoxin responsiveness in humans. Infect Immun 63:3396–3400PubMed
9.
go back to reference McClain C, Hill D, Schmidt J, Diehl AM (1993) Cytokines and alcoholic liver disease. Semin Liver Dis 13:170–182PubMedCrossRef McClain C, Hill D, Schmidt J, Diehl AM (1993) Cytokines and alcoholic liver disease. Semin Liver Dis 13:170–182PubMedCrossRef
10.
go back to reference Vyberg M, Ravn V, Andersen B (1987) Pattern of progression in liver injury following jejunoileal bypass for morbid obesity. Liver 7:271–276PubMed Vyberg M, Ravn V, Andersen B (1987) Pattern of progression in liver injury following jejunoileal bypass for morbid obesity. Liver 7:271–276PubMed
11.
go back to reference Roden M (2006) Mechanisms of disease: hepatic steatosis in type 2 diabetes-pathogenesis and clinical relevance. Nat Clin Pract Endocrinol Metab 2:335–348PubMedCrossRef Roden M (2006) Mechanisms of disease: hepatic steatosis in type 2 diabetes-pathogenesis and clinical relevance. Nat Clin Pract Endocrinol Metab 2:335–348PubMedCrossRef
12.
go back to reference Yang SQ, Lin HZ, Lane MD, Clemens M, Diehl AM (1997) Obesity increases sensitivity to endotoxin liver injury: implications for the pathogenesis of steatohepatitis. Proc Natl Acad Sci USA 94:2557–2562PubMedCrossRef Yang SQ, Lin HZ, Lane MD, Clemens M, Diehl AM (1997) Obesity increases sensitivity to endotoxin liver injury: implications for the pathogenesis of steatohepatitis. Proc Natl Acad Sci USA 94:2557–2562PubMedCrossRef
13.
go back to reference Pappo I, Becovier H, Berry EM, Freund HR (1991) Polymyxin B reduces cecal flora, TNF production and hepatic steatosis during total parenteral nutrition in the rat. J Surg Res 51:106–112PubMedCrossRef Pappo I, Becovier H, Berry EM, Freund HR (1991) Polymyxin B reduces cecal flora, TNF production and hepatic steatosis during total parenteral nutrition in the rat. J Surg Res 51:106–112PubMedCrossRef
14.
go back to reference Li Z, Soloski MJ, Diehl AM (2005) Dietary factors alter hepatic innate immune system in mice with nonalcoholic fatty liver disease. Hepatology 42:880–885PubMedCrossRef Li Z, Soloski MJ, Diehl AM (2005) Dietary factors alter hepatic innate immune system in mice with nonalcoholic fatty liver disease. Hepatology 42:880–885PubMedCrossRef
15.
go back to reference Kolek MJ, Carlquist JF, Muhlestein JB et al (2004) Toll-like receptor 4 gene Asp299Gly polymorphism is associated with reductions in vascular inflammation, angiographic coronary artery disease, and clinical diabetes. Am Heart J 148:1034–1040PubMedCrossRef Kolek MJ, Carlquist JF, Muhlestein JB et al (2004) Toll-like receptor 4 gene Asp299Gly polymorphism is associated with reductions in vascular inflammation, angiographic coronary artery disease, and clinical diabetes. Am Heart J 148:1034–1040PubMedCrossRef
16.
go back to reference Illig T, Bongardt F, Schopfer A et al (2003) The endotoxin receptor TLR4 polymorphism is not associated with diabetes or components of the metabolic syndrome. Diabetes 52:2861–2864PubMedCrossRef Illig T, Bongardt F, Schopfer A et al (2003) The endotoxin receptor TLR4 polymorphism is not associated with diabetes or components of the metabolic syndrome. Diabetes 52:2861–2864PubMedCrossRef
17.
go back to reference Takeda K (2005) Evolution and integration of innate immune recognition systems: the toll-like receptors. J Endotoxin Res 11:51–55PubMedCrossRef Takeda K (2005) Evolution and integration of innate immune recognition systems: the toll-like receptors. J Endotoxin Res 11:51–55PubMedCrossRef
18.
go back to reference Lin Y, Lee H, Berg AH et al (2000) The lipopolysaccharide-activated toll-like receptor (TLR)-4 induces synthesis of the closely related receptor TLR-2 in adipocytes. J Biol Chem 275:24255–24263PubMedCrossRef Lin Y, Lee H, Berg AH et al (2000) The lipopolysaccharide-activated toll-like receptor (TLR)-4 induces synthesis of the closely related receptor TLR-2 in adipocytes. J Biol Chem 275:24255–24263PubMedCrossRef
19.
go back to reference Bes-Houtmann S, Roche R, Hoareau L et al (2007) Presence of functional TLR2 and TLR4 on human adipocytes. Histochem Cell Biol 127:131–137PubMedCrossRef Bes-Houtmann S, Roche R, Hoareau L et al (2007) Presence of functional TLR2 and TLR4 on human adipocytes. Histochem Cell Biol 127:131–137PubMedCrossRef
20.
go back to reference Poltorak A, He X, Smirnova I et al (1998) Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: mutations in Tlr4 gene. Science 282:2085–2088PubMedCrossRef Poltorak A, He X, Smirnova I et al (1998) Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: mutations in Tlr4 gene. Science 282:2085–2088PubMedCrossRef
21.
go back to reference Declerck PJ, Verstreken M, Collen D (1995) Immunoassay of murine t-PA, u-PA and PAI-1 using monoclonal antibodies raised in gene-inactivated mice. Thromb Haemost 74:1305–1309PubMed Declerck PJ, Verstreken M, Collen D (1995) Immunoassay of murine t-PA, u-PA and PAI-1 using monoclonal antibodies raised in gene-inactivated mice. Thromb Haemost 74:1305–1309PubMed
22.
go back to reference Folch J, Lees M, Sloane Stanley GH (1957) A simple method for the isolation and purification of total lipids from animal tissues. J Biol Chem 226:497–509PubMed Folch J, Lees M, Sloane Stanley GH (1957) A simple method for the isolation and purification of total lipids from animal tissues. J Biol Chem 226:497–509PubMed
23.
go back to reference Burcelin R, Dolci W, Thorens B (2000) Portal glucose infusion in the mouse induces hypoglycemia: evidence that the hepatoportal glucose sensor stimulates glucose utilization. Diabetes 49:1635–1642PubMedCrossRef Burcelin R, Dolci W, Thorens B (2000) Portal glucose infusion in the mouse induces hypoglycemia: evidence that the hepatoportal glucose sensor stimulates glucose utilization. Diabetes 49:1635–1642PubMedCrossRef
24.
go back to reference Burcelin R, Crivelli V, Dacosta A, Roy-Tirelli A, Thorens B (2002) Heterogeneous metabolic adaptation of C57BL/6J mice to high-fat diet. Am J Physiol Endocrinol Metab 282:E834–E842PubMed Burcelin R, Crivelli V, Dacosta A, Roy-Tirelli A, Thorens B (2002) Heterogeneous metabolic adaptation of C57BL/6J mice to high-fat diet. Am J Physiol Endocrinol Metab 282:E834–E842PubMed
25.
go back to reference Negrel R, Dani C (2001) Cultures of adipose precursor cells and cells of clonal lines from animal white adipose tissue. Methods Mol Biol 155:225–237PubMed Negrel R, Dani C (2001) Cultures of adipose precursor cells and cells of clonal lines from animal white adipose tissue. Methods Mol Biol 155:225–237PubMed
26.
go back to reference Jager J, Gremeaux T, Cormont M, Le Marchand-Brustel Y, Tanti JF (2007) Interleukin-1β-induced insulin resistance in adipocytes through down-regulation of insulin receptor substrate-1 expression. Endocrinology 148:241–251PubMedCrossRef Jager J, Gremeaux T, Cormont M, Le Marchand-Brustel Y, Tanti JF (2007) Interleukin-1β-induced insulin resistance in adipocytes through down-regulation of insulin receptor substrate-1 expression. Endocrinology 148:241–251PubMedCrossRef
27.
go back to reference Johnson GB, Riggs BL, Platt JL (2004) A genetic basis for the “Adonis” phenotype of low adiposity and strong bones. FASEB J 18:1282–1284PubMed Johnson GB, Riggs BL, Platt JL (2004) A genetic basis for the “Adonis” phenotype of low adiposity and strong bones. FASEB J 18:1282–1284PubMed
28.
go back to reference Bruun JM, Helge JW, Richelsen B, Stallknecht B (2006) Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects. Am J Physiol Endocrinol Metab 290:E961–E967PubMedCrossRef Bruun JM, Helge JW, Richelsen B, Stallknecht B (2006) Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects. Am J Physiol Endocrinol Metab 290:E961–E967PubMedCrossRef
29.
go back to reference Norris AW, Chen L, Fisher SJ et al (2003) Muscle-specific PPARgamma-deficient mice develop increased adiposity and insulin resistance but respond to thiazolidinediones. J Clin Invest 112:608–618PubMedCrossRef Norris AW, Chen L, Fisher SJ et al (2003) Muscle-specific PPARgamma-deficient mice develop increased adiposity and insulin resistance but respond to thiazolidinediones. J Clin Invest 112:608–618PubMedCrossRef
30.
go back to reference Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS (1997) Protection from obesity-induced insulin resistance in mice lacking TNF-alpha function. Nature 389:610–614PubMedCrossRef Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS (1997) Protection from obesity-induced insulin resistance in mice lacking TNF-alpha function. Nature 389:610–614PubMedCrossRef
31.
go back to reference Moraes RC, Blondet A, Birkenkamp-Demtroeder K et al (2003) Study of the alteration of gene expression in adipose tissue of diet-induced obese mice by microarray and reverse transcription-polymerase chain reaction analyses. Endocrinology 144:4773–4782PubMedCrossRef Moraes RC, Blondet A, Birkenkamp-Demtroeder K et al (2003) Study of the alteration of gene expression in adipose tissue of diet-induced obese mice by microarray and reverse transcription-polymerase chain reaction analyses. Endocrinology 144:4773–4782PubMedCrossRef
32.
go back to reference Somm E, Henrichot E, Pernin A et al (2005) Decreased fat mass in interleukin-1 receptor antagonist-deficient mice: impact on adipogenesis, food intake, and energy expenditure. Diabetes 54:3503–3509PubMedCrossRef Somm E, Henrichot E, Pernin A et al (2005) Decreased fat mass in interleukin-1 receptor antagonist-deficient mice: impact on adipogenesis, food intake, and energy expenditure. Diabetes 54:3503–3509PubMedCrossRef
33.
go back to reference McCullough AJ (2004) The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease. Clin Liver Dis 8:521–533 (viii)PubMedCrossRef McCullough AJ (2004) The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease. Clin Liver Dis 8:521–533 (viii)PubMedCrossRef
34.
go back to reference Shi H, Kokoeva MV, Inouye K et al (2006) TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest 116:3015–3025PubMedCrossRef Shi H, Kokoeva MV, Inouye K et al (2006) TLR4 links innate immunity and fatty acid-induced insulin resistance. J Clin Invest 116:3015–3025PubMedCrossRef
35.
go back to reference Song MJ, Kim KH, Yoon JM, Kim JB (2006) Activation of toll-like receptor 4 is associated with insulin resistance in adipocytes. Biochem Biophys Res Commun 346:739–745PubMedCrossRef Song MJ, Kim KH, Yoon JM, Kim JB (2006) Activation of toll-like receptor 4 is associated with insulin resistance in adipocytes. Biochem Biophys Res Commun 346:739–745PubMedCrossRef
36.
go back to reference Suganami T, Tanimoto-Koyama K, Nishida J et al (2007) Role of the toll-like receptor 4/NF-kappaB pathway in saturated fatty acid-induced inflammatory changes in the interaction between adipocytes and macrophages. Arterioscler Thromb Vasc Biol 27:84–91PubMedCrossRef Suganami T, Tanimoto-Koyama K, Nishida J et al (2007) Role of the toll-like receptor 4/NF-kappaB pathway in saturated fatty acid-induced inflammatory changes in the interaction between adipocytes and macrophages. Arterioscler Thromb Vasc Biol 27:84–91PubMedCrossRef
37.
go back to reference Xu H, Sethi JK, Hotamisligil GS (1999) Transmembrane tumor necrosis factor (TNF)-alpha inhibits adipocyte differentiation by selectively activating TNF receptor 1. J Biol Chem 274:26287–26295PubMedCrossRef Xu H, Sethi JK, Hotamisligil GS (1999) Transmembrane tumor necrosis factor (TNF)-alpha inhibits adipocyte differentiation by selectively activating TNF receptor 1. J Biol Chem 274:26287–26295PubMedCrossRef
38.
go back to reference Petruschke T, Hauner H (1993) Tumor necrosis factor-alpha prevents the differentiation of human adipocyte precursor cells and causes delipidation of newly developed fat cells. J Clin Endocrinol Metab 76:742–747PubMedCrossRef Petruschke T, Hauner H (1993) Tumor necrosis factor-alpha prevents the differentiation of human adipocyte precursor cells and causes delipidation of newly developed fat cells. J Clin Endocrinol Metab 76:742–747PubMedCrossRef
39.
go back to reference Ruan H, Hacohen N, Golub TR, Van Parijs L, Lodish HF (2002) Tumor necrosis factor-alpha suppresses adipocyte-specific genes and activates expression of preadipocyte genes in 3T3-L1 adipocytes: nuclear factor-kappaB activation by TNF-alpha is obligatory. Diabetes 51:1319–1336PubMedCrossRef Ruan H, Hacohen N, Golub TR, Van Parijs L, Lodish HF (2002) Tumor necrosis factor-alpha suppresses adipocyte-specific genes and activates expression of preadipocyte genes in 3T3-L1 adipocytes: nuclear factor-kappaB activation by TNF-alpha is obligatory. Diabetes 51:1319–1336PubMedCrossRef
40.
go back to reference Gual P, Le Marchand-Brustel Y, Tanti JF (2005) Positive and negative regulation of insulin signaling through IRS-1 phosphorylation. Biochimie 87:99–109PubMedCrossRef Gual P, Le Marchand-Brustel Y, Tanti JF (2005) Positive and negative regulation of insulin signaling through IRS-1 phosphorylation. Biochimie 87:99–109PubMedCrossRef
41.
go back to reference Hotamisligil GS, Peraldi P, Budavari A et al (1996) IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha- and obesity-induced insulin resistance. Science 271:665–668PubMedCrossRef Hotamisligil GS, Peraldi P, Budavari A et al (1996) IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha- and obesity-induced insulin resistance. Science 271:665–668PubMedCrossRef
42.
43.
go back to reference Meier CA, Bobbioni E, Gabay C et al (2002) IL-1 receptor antagonist serum levels are increased in human obesity: a possible link to the resistance to leptin? J Clin Endocrinol Metab 87:1184–1188PubMedCrossRef Meier CA, Bobbioni E, Gabay C et al (2002) IL-1 receptor antagonist serum levels are increased in human obesity: a possible link to the resistance to leptin? J Clin Endocrinol Metab 87:1184–1188PubMedCrossRef
44.
go back to reference Juge-Aubry CE, Somm E, Giusti V et al (2003) Adipose tissue is a major source of interleukin-1 receptor antagonist: upregulation in obesity and inflammation. Diabetes 52:1104–1110PubMedCrossRef Juge-Aubry CE, Somm E, Giusti V et al (2003) Adipose tissue is a major source of interleukin-1 receptor antagonist: upregulation in obesity and inflammation. Diabetes 52:1104–1110PubMedCrossRef
45.
go back to reference Matsuki T, Horai R, Sudo K, Iwakura Y (2003) IL-1 plays an important role in lipid metabolism by regulating insulin levels under physiological conditions. J Exp Med 198:877–888PubMedCrossRef Matsuki T, Horai R, Sudo K, Iwakura Y (2003) IL-1 plays an important role in lipid metabolism by regulating insulin levels under physiological conditions. J Exp Med 198:877–888PubMedCrossRef
46.
go back to reference Di Gregorio GB, Yao-Borengasser A, Rasouli N et al (2005) Expression of CD68 and macrophage chemoattractant protein-1 genes in human adipose and muscle tissues: association with cytokine expression, insulin resistance, and reduction by pioglitazone. Diabetes 54:2305–2313PubMedCrossRef Di Gregorio GB, Yao-Borengasser A, Rasouli N et al (2005) Expression of CD68 and macrophage chemoattractant protein-1 genes in human adipose and muscle tissues: association with cytokine expression, insulin resistance, and reduction by pioglitazone. Diabetes 54:2305–2313PubMedCrossRef
47.
go back to reference Chawla A, Schwarz EJ, Dimaculangan DD, Lazar MA (1994) Peroxisome proliferator-activated receptor (PPAR) gamma: adipose-predominant expression and induction early in adipocyte differentiation. Endocrinology 135:798–800PubMedCrossRef Chawla A, Schwarz EJ, Dimaculangan DD, Lazar MA (1994) Peroxisome proliferator-activated receptor (PPAR) gamma: adipose-predominant expression and induction early in adipocyte differentiation. Endocrinology 135:798–800PubMedCrossRef
48.
go back to reference Somm E, Cettour-Rose P, Asensio C et al (2006) Interleukin-1 receptor antagonist is upregulated during diet-induced obesity and regulates insulin sensitivity in rodents. Diabetologia 387–393 Somm E, Cettour-Rose P, Asensio C et al (2006) Interleukin-1 receptor antagonist is upregulated during diet-induced obesity and regulates insulin sensitivity in rodents. Diabetologia 387–393
49.
go back to reference Keshavarzian A, Choudhary S, Holmes EW et al (2001) Preventing gut leakiness by oats supplementation ameliorates alcohol-induced liver damage in rats. J Pharmacol Exp Ther 299:442–448PubMed Keshavarzian A, Choudhary S, Holmes EW et al (2001) Preventing gut leakiness by oats supplementation ameliorates alcohol-induced liver damage in rats. J Pharmacol Exp Ther 299:442–448PubMed
50.
go back to reference Starkel P, Sempoux C, Leclercq I et al (2003) Oxidative stress, KLF6 and transforming growth factor-beta up-regulation differentiate non-alcoholic steatohepatitis progressing to fibrosis from uncomplicated steatosis in rats. J Hepatol 39:538–546PubMedCrossRef Starkel P, Sempoux C, Leclercq I et al (2003) Oxidative stress, KLF6 and transforming growth factor-beta up-regulation differentiate non-alcoholic steatohepatitis progressing to fibrosis from uncomplicated steatosis in rats. J Hepatol 39:538–546PubMedCrossRef
51.
Metadata
Title
C3H/HeJ mice carrying a toll-like receptor 4 mutation are protected against the development of insulin resistance in white adipose tissue in response to a high-fat diet
Authors
M. Poggi
D. Bastelica
P. Gual
M. A. Iglesias
T. Gremeaux
C. Knauf
F. Peiretti
M. Verdier
I. Juhan-Vague
J. F. Tanti
R. Burcelin
M. C. Alessi
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 6/2007
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-007-0654-8

Other articles of this Issue 6/2007

Diabetologia 6/2007 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