Key result
Inhibition of adipocyte lipolysis largely abolished acute stress-induced insulin resistance and hyperglycemia in mice, demonstrating its essential role in the metabolic response to injury.
Why the study?
Stress hyperglycemia and insulin resistance impair recovery from severe injury, but the contributions of adipocyte lipolysis to this acute metabolic response were unclear.
Does inhibition of adipocyte lipolysis prevent acute stress-induced insulin resistance and hyperglycemia in rodent models?
Does inhibition of adipocyte lipolysis prevent acute stress-induced insulin resistance and hyperglycemia in rodent models?
Adipocyte lipolysis is a critical driver of acute stress-induced insulin resistance and hyperglycemia, highlighting a potential therapeutic target to improve metabolic outcomes in trauma and surgery patients.
Answers are grounded in this paper and cite their sources.
May support lipolysis inhibition for stress hyperglycemia; leaves open translation to human critical illness.
Stress hyperglycemia and insulin resistance are evolutionarily conserved metabolic adaptations to severe injury including major trauma, burns, or hemorrhagic shock (HS). In response to injury, the neuroendocrine system increases secretion of counterregulatory hormones that promote rapid mobilization of nutrient stores, impair insulin action, and ultimately cause hyperglycemia, a condition known to impair recovery from injury in the clinical setting. We investigated the contributions of adipocyte lipolysis to the metabolic response to acute stress. Both surgical injury with HS and counterregulatory hormone (epinephrine) infusion profoundly stimulated adipocyte lipolysis and simultaneously triggered insulin resistance and hyperglycemia. When lipolysis was inhibited, the stress-induced insulin resistance and hyperglycemia were largely abolished demonstrating an essential requirement for adipocyte lipolysis in promoting stress-induced insulin resistance. Interestingly, circulating non-esterified fatty acid levels did not increase with lipolysis or correlate with insulin resistance during acute stress. Instead, we show that impaired insulin sensitivity correlated with circulating levels of the adipokine resistin in a lipolysis-dependent manner. Our findings demonstrate the central importance of adipocyte lipolysis in the metabolic response to injury. This insight suggests new approaches to prevent insulin resistance and stress hyperglycemia in trauma and surgery patients and thereby improve outcomes.
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Raje et al. (2020) studied Acute stress-induced insulin resistance. Inhibition of adipocyte lipolysis (genetic or pharmacological) vs. Wild-type or vehicle-treated mice was evaluated on Insulin resistance and hyperglycemia during acute stress. Inhibition of adipocyte lipolysis largely abolished acute stress-induced insulin resistance and hyperglycemia in mice, demonstrating its essential role in the metabolic response to injury.
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