胰岛α细胞胰岛素抵抗与炎症通路激活的关系及机制

目的探讨高脂饲养大鼠胰岛α细胞炎症通路分子基因的表达变化及吡格列酮干预的影响。方法8周龄雄性SD大鼠随机分为3组（每组15只）：正常饲养组（NC）、高脂饲养组（HF）、高脂＋吡格列酮组（HP）。喂养20周后检测空腹血胰岛素（Fins）、胰高血糖素（Glc）、游离脂肪酸（FFA）、高敏C反应蛋白（hsCRP）水平;正常血糖高胰岛素钳夹试验评价外周胰岛素抵抗程度;离体胰岛细胞表面灌注检测高糖状态Glc分泌的动态变化,同时3组大鼠各随机人组8只给予大剂量链脲菌素去β细胞处理,分为正常去β细胞组（NC-B）,高脂去β细胞组（HF-B）,高脂＋吡格列酮去母细胞组（HP—B）,采用定量PCR方法比较3组去母细胞大鼠α细胞NF-κB、NF-κB抑制蛋白α（IκBα）mRNA表达的情况。结果（1）HF组葡萄糖输注率（GIR）明显低于NC组,血Fins、Glc、FFA及hsCRP水平均显著高于NC组;而HP组以上各项指标较HF组均明显改善。（2）胰岛细胞表面灌注,HF组基础Glc的分泌高于NC组（P〈0．01）,16．7mmol／L葡萄糖灌注后HF组胰岛的Glc分泌未受抑制,HP组与NC组比较差异无统计学意义。（3）与NC-B组相比,HF-B组α细胞NF-κB mRNA的表达增高20．5％,IκBα mRNA表达降低24．3％（P值均〈0．01）。HP-B组较HF．B组NF-κB、IκBα mRNA分别改善78．3％、58．8％。（4）HF组血FFA水平与GIR呈负相关（r=-0．675,P〈0．01）;与NF-κB mRNA表达呈正相关（r=0．775,P〈0．05）。结论高脂饲养导致胰岛α细胞胰岛素抵抗,同时激活了α细胞炎症通路基因的表达且与FFA升高有关。吡格列酮干预能改善上述变化。

The relationship between islet alpha cell insulin resistance and inflammatory pathway activation and its mechanism

OBJECTIVE: To study the changes of inflammatory path molecules in the islet alpha cells in high-fat-diet fed plus beta cell-deleted rat models and the effects of pioglitazone intervention. METHODS: Forty five normal male SD rats, 8 week old, were randomly divided into 3 groups, i.e., a normal diet group (NC), a high fat diet fed group (HF), and a high fat diet fed and pioglitazone treated group (HP, pioglitazone 15 mg kg(-1) d(-1)). At the end of twenty weeks of feeding, fasting serum insulin (FIns), glucagon, free fatty acid (FFA) and high sensitive C reactive protein (hsCRP) were determined. Glucose infusion rate (GIR) was measured by using euglycemic hyperinsulinemia clamp to evaluate the peripheral insulin resistance. The contents of glucagon in perfusion medium during islet cell perfusion was measured with RIA. At the same time, beta cell-deleted rat models were established by injecting large dose streptozocin (100 mg/kg) in 8 rats in each of the three groups, i.e., HF-B group, P-B group and NC-B group. Five days later, the rats were sacrificed and the pancreatic islets were isolated and collected. The expression of NF-kappaB and inhibitor kappaBalpha (IkappaBalpha) gene in the islets was detected with real-time PCR. RESULTS: (1) GIR was decreased significantly in HF group as compared with NC group (P < 0.01). The concentrations of serum FIns, glucagon, FFA and hsCRP in HF group were higher than those in NC group. Pioglitazone intervention could reverse these effects. (2) 16.7 mmol/L glucose could inhibit the glucagon secretion by the islet alpha cells of the NC group rats, but not of the HF group rats. Pioglitazone intervention could reverse these effects. (3) The gene expression of NF-kappaB was significantly increased by 20.5% in the HF-B group than in the NC-B group (P < 0.01). In contrast, the expression of IkappaBalpha was significantly decreased by 24.3% (P < 0.01). The expression of NF-kappaB and IkappaBalpha mRNAs in HP-B group, when compared with that of HF-B group, was improved 78.3% and 58.8%, respectively. CONCLUSIONS: High-fat-diet feeding induces islet alpha cell insulin resistance and activates the mRNA expression of inflammatory path molecules in beta cell-deleted rat models and it may relate with the increased plasma FFA concentration. Pioglitazone intervention can reverse these effects.