Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2008

Open Access 01-12-2008 | Original investigation

Uteroplacental insufficiency down regulates insulin receptor and affects expression of key enzymes of long-chain fatty acid (LCFA) metabolism in skeletal muscle at birth

Authors: Daniela Germani, Antonella Puglianiello, Stefano Cianfarani

Published in: Cardiovascular Diabetology | Issue 1/2008

Login to get access

Abstract

Background

Epidemiological studies have revealed a relationship between early growth restriction and the subsequent development of insulin resistance and type 2 diabetes. Ligation of the uterine arteries in rats mimics uteroplacental insufficiency and serves as a model of intrauterine growth restriction (IUGR) and subsequent developmental programming of impaired glucose tolerance, hyperinsulinemia and adiposity in the offspring. The objective of this study was to investigate the effects of uterine artery ligation on the skeletal muscle expression of insulin receptor and key enzymes of LCFA metabolism.

Methods

Bilateral uterine artery ligation was performed on day 19 of gestation in Sprague-Dawley pregnant rats. Muscle of the posterior limb was dissected at birth and processed by real-time RT-PCR to analyze the expression of insulin receptor, ACCα, ACCβ (acetyl-CoA carboxylase alpha and beta subunits), ACS (acyl-CoA synthase), AMPK (AMP-activated protein kinase, alpha2 catalytic subunit), CPT1B (carnitine palmitoyltransferase-1 beta subunit), MCD (malonyl-CoA decarboxylase) in 14 sham and 8 IUGR pups.
Muscle tissue was treated with lysis buffer and Western immunoblotting was performed to assay the protein content of insulin receptor and ACC.

Results

A significant down regulation of insulin receptor protein (p < 0.05) and reduced expression of ACS and ACCα mRNA (p < 0.05) were observed in skeletal muscle of IUGR newborns. Immunoblotting showed no significant change in ACCα content.

Conclusion

Our data suggest that uteroplacental insufficiency may affect skeletal muscle metabolism down regulating insulin receptor and reducing the expression of key enzymes involved in LCFA formation and oxidation.
Appendix
Available only for authorised users
Literature
1.
go back to reference Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ: Weight in infancy and death from ischaemic heart disease. Lancet. 1989, 2: 577-580. 10.1016/S0140-6736(89)90710-1.CrossRefPubMed Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ: Weight in infancy and death from ischaemic heart disease. Lancet. 1989, 2: 577-580. 10.1016/S0140-6736(89)90710-1.CrossRefPubMed
2.
go back to reference Barker DJ, Osmond C, Golding J, Kuh D, Wadsworth ME: Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ. 1989, 298: 564-567.PubMedCentralCrossRefPubMed Barker DJ, Osmond C, Golding J, Kuh D, Wadsworth ME: Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ. 1989, 298: 564-567.PubMedCentralCrossRefPubMed
3.
go back to reference Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM: Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993, 36: 62-67. 10.1007/BF00399095.CrossRefPubMed Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM: Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993, 36: 62-67. 10.1007/BF00399095.CrossRefPubMed
5.
go back to reference Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ: Early growth and coronary heart disease in later life: a longitudinal study. Br Med J. 2001, 322: 949-953. 10.1136/bmj.322.7292.949.CrossRef Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ: Early growth and coronary heart disease in later life: a longitudinal study. Br Med J. 2001, 322: 949-953. 10.1136/bmj.322.7292.949.CrossRef
6.
7.
go back to reference Fowden AL, Giussani DA, Forhead AJ: Endocrine and metabolic programming during intrauterine development. Early Hum Dev. 2005, 81: 723-734. 10.1016/j.earlhumdev.2005.06.007.CrossRefPubMed Fowden AL, Giussani DA, Forhead AJ: Endocrine and metabolic programming during intrauterine development. Early Hum Dev. 2005, 81: 723-734. 10.1016/j.earlhumdev.2005.06.007.CrossRefPubMed
8.
go back to reference Unterman T, Lascon R, Gotway M, Oehler D, Gounis A, Simmons RA, Ogata ES: Circulating levels of insulin-like growth factor binding protein-1 (IGFBP-1) and hepatic mRNA are increased in the small for gestational age fetal rat. Endocrinology. 1990, 127: 2035-2037.CrossRefPubMed Unterman T, Lascon R, Gotway M, Oehler D, Gounis A, Simmons RA, Ogata ES: Circulating levels of insulin-like growth factor binding protein-1 (IGFBP-1) and hepatic mRNA are increased in the small for gestational age fetal rat. Endocrinology. 1990, 127: 2035-2037.CrossRefPubMed
9.
go back to reference Simmons RA, Templeton LJ, Gertz SJ: Intrauterine growth retardation leads to the development of type 2 diabetes in rat. Diabetes. 2001, 50: 2279-2286. 10.2337/diabetes.50.10.2279.CrossRefPubMed Simmons RA, Templeton LJ, Gertz SJ: Intrauterine growth retardation leads to the development of type 2 diabetes in rat. Diabetes. 2001, 50: 2279-2286. 10.2337/diabetes.50.10.2279.CrossRefPubMed
10.
go back to reference Puglianiello A, Germani D, Antignani S, Scalia Tomba G, Cianfarani S: Changes in the expression of hypothalamic lipid sensing genes in rat model of intrauterine growth retardation (IUGR). Pediatr Res. 2007, 61: 433-437. 10.1203/pdr.0b013e3180332d4e.CrossRefPubMed Puglianiello A, Germani D, Antignani S, Scalia Tomba G, Cianfarani S: Changes in the expression of hypothalamic lipid sensing genes in rat model of intrauterine growth retardation (IUGR). Pediatr Res. 2007, 61: 433-437. 10.1203/pdr.0b013e3180332d4e.CrossRefPubMed
11.
go back to reference Kelley DE, Mandarino LJ: Hyperglycemia normalizes insulin stimulated skeletal muscle glucose oxidation and storage in non insulin dependent diabetes mellitus. J Clin Invest. 1990, 86: 1999-2007. 10.1172/JCI114935.PubMedCentralCrossRefPubMed Kelley DE, Mandarino LJ: Hyperglycemia normalizes insulin stimulated skeletal muscle glucose oxidation and storage in non insulin dependent diabetes mellitus. J Clin Invest. 1990, 86: 1999-2007. 10.1172/JCI114935.PubMedCentralCrossRefPubMed
12.
go back to reference Mandarino LJ, Consoli A, Kelley DE: Effects of obesity and NIDDM on glucose and insulin regulation of substrate oxidation in skeletal muscle. Am J Physiol. 1996, 270: E463-E470.PubMed Mandarino LJ, Consoli A, Kelley DE: Effects of obesity and NIDDM on glucose and insulin regulation of substrate oxidation in skeletal muscle. Am J Physiol. 1996, 270: E463-E470.PubMed
13.
go back to reference Kelley DE, Goodpaster BH: Skeletal muscle triglyceride. An aspect of regional adiposity and insulin resistance. Diabetes Care. 2001, 24: 933-941. 10.2337/diacare.24.5.933.CrossRefPubMed Kelley DE, Goodpaster BH: Skeletal muscle triglyceride. An aspect of regional adiposity and insulin resistance. Diabetes Care. 2001, 24: 933-941. 10.2337/diacare.24.5.933.CrossRefPubMed
14.
go back to reference Pan DA, Lillioja S, Kriketos AD, Milner MR, Baur LA, Bogardus C, Jenkins AB, Storlien LH: Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes. 1997, 46: 983-988. 10.2337/diabetes.46.6.983.CrossRefPubMed Pan DA, Lillioja S, Kriketos AD, Milner MR, Baur LA, Bogardus C, Jenkins AB, Storlien LH: Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes. 1997, 46: 983-988. 10.2337/diabetes.46.6.983.CrossRefPubMed
15.
go back to reference Oak SA, Tran C, Pan G, Tramotharan M, Devaskar SU: Perturbed skeletal muscle insulin signaling in the adult female intrauterine growth-restricted rat. Am J Physiol Endocrinol Metab. 2006, 290: E1321-E1330. 10.1152/ajpendo.00437.2005.CrossRefPubMed Oak SA, Tran C, Pan G, Tramotharan M, Devaskar SU: Perturbed skeletal muscle insulin signaling in the adult female intrauterine growth-restricted rat. Am J Physiol Endocrinol Metab. 2006, 290: E1321-E1330. 10.1152/ajpendo.00437.2005.CrossRefPubMed
16.
go back to reference Simoneau J-A, Kelley DE: Altered glycolytic and oxidative capacities of skeletal muscle contribute to insulin resistance in NIDDM. J Appl Physiol. 1997, 83: 166-171.PubMed Simoneau J-A, Kelley DE: Altered glycolytic and oxidative capacities of skeletal muscle contribute to insulin resistance in NIDDM. J Appl Physiol. 1997, 83: 166-171.PubMed
17.
go back to reference Lane RH, Maclennan NK, Daood MJ, Hsu JL, Janke SM, Pham TD, Puri AR, Watchko JF: IUGR alters postnatal rat skeletal muscle peroxisome proliferator-activated receptor-γ coactivator-1 gene expression in a fiber specific manner. Pediatr Res. 2003, 53: 994-1000. 10.1203/01.PDR.0000064583.40495.51.CrossRefPubMed Lane RH, Maclennan NK, Daood MJ, Hsu JL, Janke SM, Pham TD, Puri AR, Watchko JF: IUGR alters postnatal rat skeletal muscle peroxisome proliferator-activated receptor-γ coactivator-1 gene expression in a fiber specific manner. Pediatr Res. 2003, 53: 994-1000. 10.1203/01.PDR.0000064583.40495.51.CrossRefPubMed
18.
go back to reference Selak MA, Storey BT, Peterside I, Simmons RA: Impaired oxidative phosphorylation in skeletal muscle of intrauterine growth-retarded rats. Am J Physiol Endocrinol Metab. 2003, 285: E130-E137.CrossRefPubMed Selak MA, Storey BT, Peterside I, Simmons RA: Impaired oxidative phosphorylation in skeletal muscle of intrauterine growth-retarded rats. Am J Physiol Endocrinol Metab. 2003, 285: E130-E137.CrossRefPubMed
19.
go back to reference Nusken K-D, Dotsch J, Rauh M, Rascher W, Schneider H: Uteroplacental insufficiency after bilateral uterine artery ligation in the rat: impact on postnatal glucose and lipid metabolism and evidence for metabolic programming of the offspring by sham operation. Endocrinology. Nusken K-D, Dotsch J, Rauh M, Rascher W, Schneider H: Uteroplacental insufficiency after bilateral uterine artery ligation in the rat: impact on postnatal glucose and lipid metabolism and evidence for metabolic programming of the offspring by sham operation. Endocrinology.
20.
go back to reference Ozanne SE, Olsen GS, Hansen LL, Tingey KJ, Nave BT, Wang CL, Hartil K, Petry CJ, Buckley AJ, Mosthaf-Seedorf L: Early growth restriction leads to down regulation of protein kinase C zeta and insulin resistance in skeletal muscle. J Endocrinol. 2003, 177: 235-241. 10.1677/joe.0.1770235.CrossRefPubMed Ozanne SE, Olsen GS, Hansen LL, Tingey KJ, Nave BT, Wang CL, Hartil K, Petry CJ, Buckley AJ, Mosthaf-Seedorf L: Early growth restriction leads to down regulation of protein kinase C zeta and insulin resistance in skeletal muscle. J Endocrinol. 2003, 177: 235-241. 10.1677/joe.0.1770235.CrossRefPubMed
21.
go back to reference Jaquet D, Vidal H, Hankard R, Czernichow P, Levy-Marchal C: Impaired regulation of glucose transporter 4 gene expression in insulin resistance associated with in utero malnutrition. J Clin Endocrinol Metab. 2001, 86: 3266-3271. 10.1210/jc.86.7.3266.PubMed Jaquet D, Vidal H, Hankard R, Czernichow P, Levy-Marchal C: Impaired regulation of glucose transporter 4 gene expression in insulin resistance associated with in utero malnutrition. J Clin Endocrinol Metab. 2001, 86: 3266-3271. 10.1210/jc.86.7.3266.PubMed
22.
go back to reference Brownsey RW, Boone AN, Elliott JE, Kulpa JE, Lee WM: Regulation of acetyl-CoA carboxylase. Biochem Soc Trans. 2006, 34: 223-227. 10.1042/BST20060223.CrossRefPubMed Brownsey RW, Boone AN, Elliott JE, Kulpa JE, Lee WM: Regulation of acetyl-CoA carboxylase. Biochem Soc Trans. 2006, 34: 223-227. 10.1042/BST20060223.CrossRefPubMed
23.
go back to reference Britton CH, Schulz RA, Zhang B, Esser V, Foster DW, McGarry JD: Human liver mitochondrial carnitine palmitoyltransferase I: characterization of its cDNA and chromosomal localization and partial analysis of the gene. Proc Natl Acad Sci USA. 1995, 92: 1984-1988. 10.1073/pnas.92.6.1984.PubMedCentralCrossRefPubMed Britton CH, Schulz RA, Zhang B, Esser V, Foster DW, McGarry JD: Human liver mitochondrial carnitine palmitoyltransferase I: characterization of its cDNA and chromosomal localization and partial analysis of the gene. Proc Natl Acad Sci USA. 1995, 92: 1984-1988. 10.1073/pnas.92.6.1984.PubMedCentralCrossRefPubMed
24.
go back to reference Yamazaki N, Shinohara Y, Shima A, Yamanaka Y, Terada H: Isolation and characterization of cDNA and genomic clones encoding human muscle type carnitine palmitoyltransferase I. Biochim Biophys Acta. 1996, 1307: 157-161.CrossRefPubMed Yamazaki N, Shinohara Y, Shima A, Yamanaka Y, Terada H: Isolation and characterization of cDNA and genomic clones encoding human muscle type carnitine palmitoyltransferase I. Biochim Biophys Acta. 1996, 1307: 157-161.CrossRefPubMed
25.
go back to reference Price N, Leij van der F, Jackson V, Corstorphine C, Thomson R, Sorensen A, Zammit V: A novel brain-expressed protein related to carnitine palmitoyltransferase I. Genomics. 2002, 80: 433-442. 10.1006/geno.2002.6845.CrossRefPubMed Price N, Leij van der F, Jackson V, Corstorphine C, Thomson R, Sorensen A, Zammit V: A novel brain-expressed protein related to carnitine palmitoyltransferase I. Genomics. 2002, 80: 433-442. 10.1006/geno.2002.6845.CrossRefPubMed
26.
go back to reference Kiens B: Skeletal muscle lipid metabolism in exercise and insulin resistance. Physiol Rev. 2006, 86: 205-243. 10.1152/physrev.00023.2004.CrossRefPubMed Kiens B: Skeletal muscle lipid metabolism in exercise and insulin resistance. Physiol Rev. 2006, 86: 205-243. 10.1152/physrev.00023.2004.CrossRefPubMed
27.
go back to reference Rasmussen BB, Holmbäck UC, Volpi E, Morio-Liondore B, Paddon-Jones D, Wolfe RR: Malonyl coenzyme A and the regulation of functional carnitine palmitoyltransferase-1 activity and fat oxidation in human skeletal muscle. J Clin Invest. 2002, 110: 1687-1693.PubMedCentralCrossRefPubMed Rasmussen BB, Holmbäck UC, Volpi E, Morio-Liondore B, Paddon-Jones D, Wolfe RR: Malonyl coenzyme A and the regulation of functional carnitine palmitoyltransferase-1 activity and fat oxidation in human skeletal muscle. J Clin Invest. 2002, 110: 1687-1693.PubMedCentralCrossRefPubMed
28.
go back to reference Colberg SR, Simoneau JA, Thaete FL, Kelley DE: Skeletal muscle utilization of free fatty acids in women with visceral obesity. J Clin Invest. 1995, 95: 1846-1853. 10.1172/JCI117864.PubMedCentralCrossRefPubMed Colberg SR, Simoneau JA, Thaete FL, Kelley DE: Skeletal muscle utilization of free fatty acids in women with visceral obesity. J Clin Invest. 1995, 95: 1846-1853. 10.1172/JCI117864.PubMedCentralCrossRefPubMed
29.
go back to reference Goodpaster BH, Theriault R, Watkins SC, Kelley DE: Intramuscular lipid content is increased in obesity and decreased by weight loss. Metabolism. 2000, 49: 467-472. 10.1016/S0026-0495(00)80010-4.CrossRefPubMed Goodpaster BH, Theriault R, Watkins SC, Kelley DE: Intramuscular lipid content is increased in obesity and decreased by weight loss. Metabolism. 2000, 49: 467-472. 10.1016/S0026-0495(00)80010-4.CrossRefPubMed
30.
go back to reference Kelley DE, He J, Menshikova EV, Ritov VB: Dysfunction of mitochondria in human skeletal muscle in type 2 diabetes. Diabetes. 2002, 51: 2944-2950. 10.2337/diabetes.51.10.2944.CrossRefPubMed Kelley DE, He J, Menshikova EV, Ritov VB: Dysfunction of mitochondria in human skeletal muscle in type 2 diabetes. Diabetes. 2002, 51: 2944-2950. 10.2337/diabetes.51.10.2944.CrossRefPubMed
31.
go back to reference Ritov VB, Menshikova EV, He J, Ferrell RE, Goodpaster BH, Kelley DE: Deficiency of subsarcolemmal mitochondria in obesity and type 2 diabetes. Diabetes. 2005, 54: 8-14. 10.2337/diabetes.54.1.8.CrossRefPubMed Ritov VB, Menshikova EV, He J, Ferrell RE, Goodpaster BH, Kelley DE: Deficiency of subsarcolemmal mitochondria in obesity and type 2 diabetes. Diabetes. 2005, 54: 8-14. 10.2337/diabetes.54.1.8.CrossRefPubMed
32.
go back to reference Simoneau JA, Veerkamp JH, Turcotte LP, Kelley DE: Markers of capacity to utilize fatty acids in human skeletal muscle: relation to insulin resistance and obesity and effects of weight loss. FASEB J. 1999, 13: 2051-2060.PubMed Simoneau JA, Veerkamp JH, Turcotte LP, Kelley DE: Markers of capacity to utilize fatty acids in human skeletal muscle: relation to insulin resistance and obesity and effects of weight loss. FASEB J. 1999, 13: 2051-2060.PubMed
33.
go back to reference Lane RH, Kelley DE, Ritov VH, Tsirka AE, Gruetzmacher EM: Altered expression and function of mitochondrial beta-oxidation enzymes in juvenile intrauterine-growth-retarded rat skeletal muscle. Pediatr Res. 2001, 50: 83-90. 10.1203/00006450-200107000-00016.CrossRefPubMed Lane RH, Kelley DE, Ritov VH, Tsirka AE, Gruetzmacher EM: Altered expression and function of mitochondrial beta-oxidation enzymes in juvenile intrauterine-growth-retarded rat skeletal muscle. Pediatr Res. 2001, 50: 83-90. 10.1203/00006450-200107000-00016.CrossRefPubMed
34.
go back to reference Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI: Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. N Engl J Med. 2004, 350: 664-671. 10.1056/NEJMoa031314.PubMedCentralCrossRefPubMed Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI: Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. N Engl J Med. 2004, 350: 664-671. 10.1056/NEJMoa031314.PubMedCentralCrossRefPubMed
35.
go back to reference Thompson AL, Cooney GJ: Acyl-CoA inhibition of hexokinase in rat and human skeletal muscle is a potential mechanism of lipid-induced insulin resistance. Diabetes. 2000, 49: 1761-1765. 10.2337/diabetes.49.11.1761.CrossRefPubMed Thompson AL, Cooney GJ: Acyl-CoA inhibition of hexokinase in rat and human skeletal muscle is a potential mechanism of lipid-induced insulin resistance. Diabetes. 2000, 49: 1761-1765. 10.2337/diabetes.49.11.1761.CrossRefPubMed
36.
go back to reference Turinsky J, O'Sullivan DM, Bayly BP: 1,2-Diacylglycerol and ceramide levels in insulin-resistant tissues of the rat in vivo. J Biol Chem. 1990, 265: 16880-16885.PubMed Turinsky J, O'Sullivan DM, Bayly BP: 1,2-Diacylglycerol and ceramide levels in insulin-resistant tissues of the rat in vivo. J Biol Chem. 1990, 265: 16880-16885.PubMed
37.
go back to reference Itani SI, Zhou Q, Pories WJ, MacDonald KG, Dohm GL: Involvement of protein kinase C in human skeletal muscle insulin resistance and obesity. Diabetes. 2000, 49: I1353-1358. 10.2337/diabetes.49.8.1353.CrossRef Itani SI, Zhou Q, Pories WJ, MacDonald KG, Dohm GL: Involvement of protein kinase C in human skeletal muscle insulin resistance and obesity. Diabetes. 2000, 49: I1353-1358. 10.2337/diabetes.49.8.1353.CrossRef
38.
go back to reference Takayama S, White MF, Kahn CR: Phorbol ester-induced serine phosphorylation of the insulin receptor decreases its tyrosine kinase activity. J Biol Chem. 1988, 263: 3440-3447.PubMed Takayama S, White MF, Kahn CR: Phorbol ester-induced serine phosphorylation of the insulin receptor decreases its tyrosine kinase activity. J Biol Chem. 1988, 263: 3440-3447.PubMed
39.
go back to reference Ravichandran LV, Esposito DL, Chen J, Quon MJ: Protein kinase C-zeta phosphorylates insulin receptor substrate-1 and impairs its ability to activate phosphatidylinositol 3-kinase in response to insulin. J Biol Chem. 2001, 276: 3543-3549. 10.1074/jbc.M007231200.CrossRefPubMed Ravichandran LV, Esposito DL, Chen J, Quon MJ: Protein kinase C-zeta phosphorylates insulin receptor substrate-1 and impairs its ability to activate phosphatidylinositol 3-kinase in response to insulin. J Biol Chem. 2001, 276: 3543-3549. 10.1074/jbc.M007231200.CrossRefPubMed
40.
go back to reference Itani SI, Pories WJ, MacDonald KG, Dohm GL: Increased protein kinase C theta in skeletal muscle of diabetic patients. Metabolism. 2001, 50: 553-557. 10.1053/meta.2001.22512.CrossRefPubMed Itani SI, Pories WJ, MacDonald KG, Dohm GL: Increased protein kinase C theta in skeletal muscle of diabetic patients. Metabolism. 2001, 50: 553-557. 10.1053/meta.2001.22512.CrossRefPubMed
Metadata
Title
Uteroplacental insufficiency down regulates insulin receptor and affects expression of key enzymes of long-chain fatty acid (LCFA) metabolism in skeletal muscle at birth
Authors
Daniela Germani
Antonella Puglianiello
Stefano Cianfarani
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2008
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-7-14

Other articles of this Issue 1/2008

Cardiovascular Diabetology 1/2008 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

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.