SUMMARY Impaired insulin-mediated suppression of hepatic glucose production (HGP) plays a major role in the pathogenesis of type 2 diabetes (T2D), yet the molecular mechanism by which this occurs remains unknown. Using a novel in vivo metabolomics approach, we show that the major mechanism by which insulin suppresses HGP is through reductions in hepatic acetyl CoA by suppression of lipolysis in white adipose tissue (WAT) leading to reductions in pyruvate carboxylase flux. This mechanism was confirmed in mice and rats with genetic ablation of insulin signaling and mice lacking adipose triglyceride lipase. Insulin’s ability to suppress hepatic acetyl CoA, PC activity, and lipolysis was lost in high-fat-fed rats, a phenomenon reversible by IL-6 neutralization and inducible by IL-6 infusion. Taken together, these data identify WAT-derived hepatic acetyl CoA as the main regulator of HGP by insulin and link it to inflammation-induced hepatic insulin resistance associated with obesity and T2D.

Blood glucose levels are tightly controlled by the coordinated action of at least four cell types constituting pancreatic islets. Changes in the proportion and/or function of these cells are associated with genetic and molecular pathophysiology of monogenic, type 1, and type 2 (T2D) diabetes. Cellular heterogeneity impedes precise understanding of the molecular components of each islet cell type that govern islet (dys)function, particularly the less abundant delta and gamma/pancreatic polypeptide (PP) cells. Here, we report single-cell transcriptomes for 638 cells from nondiabetic (ND) and T2D human islet samples. Analyses of ND single-cell transcriptomes identified distinct alpha, beta, delta, and PP/gamma cell-type signatures. Genes linked to rare and common forms of islet dysfunction and diabetes were expressed in the delta and PP/gamma cell types. Moreover, this study revealed that delta cells specifically express receptors that receive and coordinate systemic cues from the leptin, ghrelin, and dopamine signaling pathways implicating them as integrators of central and peripheral metabolic signals into the pancreatic islet. Finally, single-cell transcriptome profiling revealed genes differentially regulated between T2D and ND alpha, beta, and delta cells that were undetectable in paired whole islet analyses. This study thus identifies fundamental cell-type-specific features of pancreatic islet (dys)function and provides a critical resource for comprehensive understanding of islet biology and diabetes pathogenesis.[Supplemental material is available for this article.]Pancreatic islets of Langerhans are clusters of at least four different hormone-secreting endocrine cell types that elicit coordinatedbut distinct-responses to maintain glucose homeostasis. As such, they are central to diabetes pathophysiology. On average, human islets consist mostly of beta (54%), alpha (35%), and delta (11%) cells; up to a few percent gamma/pancreatic polypeptide (PP) cells; and very few epsilon cells (Brissova et al. 2005;Cabrera et al. 2006;Blodgett et al. 2015). Human islet composition is neither uniform nor static but varies between individuals and across regions of the pancreas (Brissova et al. 2005;Cabrera et al. 2006;Blodgett et al. 2015). Cellular heterogeneity complicates molecular studies of whole human islets and may mask important role(s) for less common cells in the population (Dorrell et al. 2011b;Bramswig et al. 2013;Nica et al. 2013;Blodgett et al. 2015;Liu and Trapnell 2016). Moreover, it complicates attempts to identify epigenetic and transcriptional signatures distinguishing diabetic from nondiabetic (ND) islets, leading to inconsistent reports of genes and pathways affected (Gunton et al. 2005;Marselli et al. 2010;Taneera et al. 2012;Dayeh et al. 2014). Conventional sorting and enrichment techniques are unable to specifically purify each human islet cell type (Dorrell et al. 2008;Nica et al. 2013;Bramswig et al. 2013;Hrvatin et al. 2014;Blodgett et al. 2015), thus a precise understanding of the transcriptiona...

Genome-wide association studies (GWAS) have identified >100 independent SNPs that modulate the risk of type 2 diabetes (T2D) and related traits. However, the pathogenic mechanisms of most of these SNPs remain elusive. Here, we examined genomic, epigenomic, and transcriptomic profiles in human pancreatic islets to understand the links between genetic variation, chromatin landscape, and gene expression in the context of T2D. We first integrated genome and transcriptome variation across 112 islet samples to produce dense cis-expression quantitative trait loci (cis-eQTL) maps. Additional integration with chromatin-state maps for islets and other diverse tissue types revealed that cis-eQTLs for islet-specific genes are specifically and significantly enriched in islet stretch enhancers. High-resolution chromatin accessibility profiling using assay for transposase-accessible chromatin sequencing (ATACseq) in two islet samples enabled us to identify specific transcription factor (TF) footprints embedded in active regulatory elements, which are highly enriched for islet cis-eQTL. Aggregate allelic bias signatures in TF footprints enabled us de novo to reconstruct TF binding affinities genetically, which support the high-quality nature of the TF footprint predictions. Interestingly, we found that T2D GWAS loci were strikingly and specifically enriched in islet Regulatory Factor X (RFX) footprints. Remarkably, within and across independent loci, T2D risk alleles that overlap with RFX footprints uniformly disrupt the RFX motifs at high-information content positions. Together, these results suggest that common regulatory variations have shaped islet TF footprints and the transcriptome and that a confluent RFX regulatory grammar plays a significant role in the genetic component of T2D predisposition.chromatin | diabetes | eQTL | epigenome | footprint T ype 2 diabetes (T2D) is a complex disease characterized by pancreatic islet dysfunction and insulin resistance in peripheral tissues; >90% of T2D SNPs identified through genome-wide association studies (GWASs) reside in nonprotein coding regions and are likely to perturb gene expression rather than alter protein function (1). In support of this finding, we and others recently showed that T2D GWAS SNPs are significantly enriched in enhancer elements that are specific to pancreatic islets (2-4). The critical next steps to translate these islet enhancer T2D genetic associations into mechanistic biological knowledge are (i) identifying the putative functional SNP(s) from all of those that are in tight linkage disequilibrium (LD), (ii) localizing their target gene(s), and (iii) understanding the direction of effect (increased or decreased target gene expression) conferred by the risk allele. Two recent studies analyzed genome variation and gene expression variation across human islet samples to identify cis-expression quantitative trait loci (cis-eQTLs) that linked T2D GWAS SNPs to target genes (5, 6). However, the transcription factor (TF) molecular mediators of the islet cis-eQTLs...

OBJECTIVEMacrophage recruitment to adipose tissue is a reproducible feature of obesity. However, the events that result in chemokine production and macrophage recruitment to adipose tissue during states of energetic excess are not clear. Sirtuin 1 (SirT1) is an essential nutrient-sensing histone deacetylase, which is increased by caloric restriction and reduced by overfeeding. We discovered that SirT1 depletion causes anorexia by stimulating production of inflammatory factors in white adipose tissue and thus posit that decreases in SirT1 link overnutrition and adipose tissue inflammation.RESEARCH DESIGN AND METHODSWe used antisense oligonucleotides to reduce SirT1 to levels similar to those seen during overnutrition and studied SirT1-overexpressing transgenic mice and fat-specific SirT1 knockout animals. Finally, we analyzed subcutaneous adipose tissue biopsies from two independent cohorts of human subjects.RESULTSWe found that inducible or genetic reduction of SirT1 in vivo causes macrophage recruitment to adipose tissue, whereas overexpression of SirT1 prevents adipose tissue macrophage accumulation caused by chronic high-fat feeding. We also found that SirT1 expression in human subcutaneous fat is inversely related to adipose tissue macrophage infiltration.CONCLUSIONSReduction of adipose tissue SirT1 expression, which leads to histone hyperacetylation and ectopic inflammatory gene expression, is identified as a key regulatory component of macrophage influx into adipose tissue during overnutrition in rodents and humans. Our results suggest that SirT1 regulates adipose tissue inflammation by controlling the gain of proinflammatory transcription in response to inducers such as fatty acids, hypoxia, and endoplasmic reticulum stress.

Background Recently the SNP identified as rs1260326, in the glucokinase regulatory protein (GCKR) was associated with hypertriglyceridemia in adults. Since accumulation of triglycerides in hepatocytes represents the hallmark of the steatosis, we aimed to investigate whether this variant might be associated with fatty liver (hepatic fat content, HFF%). Moreover, since recently rs738409 in the PNPLA3 and rs2854116 in the APOC3 were associated with fatty liver recently, we explored how the GCKR SNP and these two variants jointly influence hepatosteatosis. Methods and Results We studied 455 obese children and adolescents (181 Caucasians, 139 African Americans and 135 Hispanics). All underwent an OGTT and fasting lipoprotein subclasses measurement by proton NMR. A subset of 142 children underwent a fast gradient MRI to measure the HFF%. The rs1260326 was associated with elevated triglycerides (Caucasians p=0.00014; African Americans p=0.00417) large VLDL (Caucasians p=0.001; African Americans p=0.03) and with fatty liver (Caucasians p= 0.034; African Americans p= 0.00002; and Hispanics p= 0.016). The PNPLA3, but not the APOC3 rs2854116 SNP, was associated with fatty liver but not with triglycerides levels. There was a joint effect between the PNPLA3 and GCKR SNPs, explaining 32% of HFF% variance Caucasians (p=0.00161), 39.0% in African Americans (p=0.00000496), and 15% in Hispanics (p=0.00342). Conclusions The rs1260326 in GCKR is associated with hepatic fat accumulation along with large VLDL, and triglycerides levels. GCKR and PNPLA3 act together to convey susceptibility to fatty liver in obese youths.