Question:
The main risk factors for developing non alcoholic fatty liver disease (NAFLD) are
overweight, diabetes, and metabolic syndrome. About 30 – 50% of type II diabetics
suffer from NAFLD. Findings suggest that the development of NAFLD is not only an accompanying
phenomenon of type II diabetes. Rather, the increased accumulation of fats in the
hepatocytes appears to be directly related to the development of insulin resistance
and pathological glucose tolerance. Accordingly, recent findings suggest that the
NAFLD plays a pathogenically relevant role in the development of type II diabetes.
The molecular mechanisms underlying this observation are poorly understood, some studies
suggest that certain messengers (adipokines) are of particular importance in this
context. The G protein-coupled thrombin receptor PAR4 is expressed on various cell
types, e.g. thrombocytes, endothelial cells, smooth muscle cells, but also on adipocytes.
Increased thrombin activity in adipose tissue has been associated with inflammatory
macrophage recruitment and development of insulin resistance in mice. The contribution
of PAR4 to metabolic and inflammatory changes in the course of diabetes and NAFLD
development has not been reported to date.
Methods:
Six week-old male PAR4-/- mice and wildtype controls (C57Bl/6J) were fed for up to
8 weeks with a high-fat diet (HFD) or standard chow. Body weight was recorded weekly.
For glucose tolerance and insulin sensitivity tests mice were challenged p.o. with glucose (1 g/kg) or i.p. insulin (0.75 U/kg) after a 6h fast, followed by measurement of tail vein blood glucose.
PBS-perfused liver was weighed and snap-frozen at -80 °C for RNA analysis by real
time PCR or fixed in formaldehyde for histochemical analysis.
Results:
We reveal that HFD-fed wildtype mice showed 10-fold upregulated PAR4 expression, particularly
in WAT, compared to chow-fed controls. In PAR4-deficient mice, HFD resulted in less
weight gain, lower body fat mass and smaller WAT fat pads than in wildtype mice. Average
adipocyte areas in both WAT and BAT was also reduced in PAR4-/- vs. wildtype mice
fed HFD, as were CLS by 85%. HFD-induced impairment of glucose tolerance and insulin
sensitivity was significantly worse in wildtype vs. PAR4-/- mice. These alterations
coincided with a significant reduction of lipid accumulation in the liver in PAR4-/-
mice. Both in liver and WAT expression of the proinflammatory cytokine MCP-1 is downregulated
in PAR4-/- mice compared to wildtype controls.
Conclusion:
This preliminary study highlights PAR4 as a candidate regulator of adipose tissue
inflammation and metabolic dysfunction in the development of diabetes and NAFLD.