Heemskerk MM, van den Berg SA, Pronk AC, van Klinken JB, Boon MR, Havekes LM, Rensen PC, Willems van Dijk K, van Harmelen V. Long-term niacin treatment induces insulin resistance and adrenergic responsiveness in adipocytes by adaptive downregulation of phosphodiesterase 3B. Am J Physiol Endocrinol Metab 306: E808 -E813, 2014. First published January 28, 2014; doi:10.1152/ajpendo.00641.2013.-The lipid-lowering effect of niacin has been attributed to the inhibition of cAMP production in adipocytes, thereby inhibiting intracellular lipolysis and release of nonesterified fatty acids (NEFA) to the circulation. However, long-term niacin treatment leads to a normalization of plasma NEFA levels and induces insulin resistance, for which the underlying mechanisms are poorly understood. The current study addressed the effects of long-term niacin treatment on insulin-mediated inhibition of adipocyte lipolysis and focused on the regulation of cAMP levels. APOE*3-Leiden.CETP transgenic mice treated with niacin for 15 wk were subjected to an insulin tolerance test and showed whole body insulin resistance. Similarly, adipocytes isolated from niacin-treated mice were insulin resistant and, interestingly, exhibited an increased response to cAMP stimulation by 8Br-cAMP, 1-and 2-adrenergic stimulation. Gene expression analysis of the insulin and -adrenergic pathways in adipose tissue indicated that all genes were downregulated, including the gene encoding the cAMPdegrading enzyme phosphodiesterase 3B (PDE3B). In line with this, we showed that insulin induced a lower PDE3B response in adipocytes isolated from niacin-treated mice. Inhibiting PDE3B with cilostazol increased lipolytic responsiveness to cAMP stimulation in adipocytes. These data show that long-term niacin treatment leads to a downregulation of PDE3B in adipocytes, which could explain part of the observed insulin resistance and the increased responsiveness to cAMP stimulation. adipose tissue; lipolysis; adenosine 3=,5=-cyclic monophosphate; phosphodiesterases NIACIN, ALSO KNOWN AS VITAMIN B 3 , is required for the synthesis of the cofactor nicotinamide adenine dinucleotide and is therefore essential for oxidative phosphorylation in energy metabolism (8). It has been used for more than 50 years for the treatment of dyslipidemias, since it decreases plasma triglycerides, low-density lipoprotein-cholesterol, and hepatic very low density lipoprotein (VLDL) triglyceride production (25), in addition to increasing high-density lipoprotein-cholesterol. Supplementation with niacin was shown to decrease risk of cardiovascular disease and atherosclerosis in dyslipidemic humans (1) and in dyslipidemic mouse models (23), using the APOE*3-Leiden.CETP cholesteryl ester transfer protein (CETP) transgenic female mouse.The molecular mechanism by which niacin conveys its lipid-lowering effects is mostly unknown. The receptor for niacin, HCA 2 (formerly known as GPR109A), has been shown to play an important role in acute antilipolytic effects (21) (10), but is not required for the long-t...