Coate KC, Scott M, Farmer B, Moore MC, Smith M, Roop J, Neal DW, Williams P, Cherrington AD. Chronic consumption of a high-fat/ high-fructose diet renders the liver incapable of net hepatic glucose uptake. Am J Physiol Endocrinol Metab 299: E887-E898, 2010. First published September 7, 2010; doi:10.1152/ajpendo.00372.2010.-The objective of this study was to assess the response of a large animal model to high dietary fat and fructose (HFFD). Three different metabolic assessments were performed during 13 wk of feeding an HFFD (n ϭ 10) or chow control (CTR, n ϭ 4) diet: oral glucose tolerance tests (OGTTs; baseline, 4 and 8 wk), hyperinsulinemic-euglycemic clamps (HIEGs; baseline and 10 wk) and hyperinsulinemic-hyperglycemic clamps (HIHGs, 13 wk). The ⌬AUC for glucose during the OGTTs more than doubled after 4 and 8 wk of HFFD feeding, and the average glucose infusion rate required to maintain euglycemia during the HIEG clamps decreased by Ϸ30% after 10 wk of HFFD feeding. These changes did not occur in the CTR group. The HIHG clamps included experimental periods 1 (P1, 0 -90 min) and 2 (P2, 90 -180 min). During P1, somatostatin, basal intraportal glucagon, 4 ϫ basal intraportal insulin, and peripheral glucose (to double the hepatic glucose load) were infused; during P2, glucose was also infused intraportally (4.0 mg·kg Ϫ1 ·min
Ϫ1). Net hepatic glucose uptake during P1 and P2 was Ϫ0.4 Ϯ 0.1 [output] and 0.2 Ϯ 0.8 mg · kg Ϫ1 · min Ϫ1 in the HFFD group, respectively, and 1.8 Ϯ 0.8 and 3.5 Ϯ 1.0 mg · kg Ϫ1 · min Ϫ1 in the CTR group, respectively (P Ͻ 0.05 vs. HFFD during P1 and P2). Glycogen synthesis through the direct pathway was 0.5 Ϯ 0.2 and 1.5 Ϯ 0.4 mg·kg Ϫ1 · min Ϫ1 in the HFFD and CTR groups, respectively (P Ͻ 0.05 vs. HFFD). In conclusion, chronic consumption of an HFFD diminished the sensitivity of the liver to hormonal and glycemic cues and resulted in a marked impairment in NHGU and glycogen synthesis. impaired glucose tolerance; glycogen synthesis; hyperinsulinemic euglycemic clamp; hyperinsulinemic hyperglycemic clamp; portal signal CHRONIC CONSUMPTION OF A WESTERN DIET, characterized by foods rich in sugar and abundant in total and saturated fat, has been suggested to play a role in the development of type 2 diabetes (9, 37, 38). Numerous studies have delineated the effects of dietary fat on whole body insulin sensitivity. For example, 3 days of high-fat feeding (59% of kcal from fat) was sufficient to produce hepatic insulin resistance in rats, as evidenced by a diminished ability of hyperinsulinemia to suppress hepatic glucose production (HGP) in the absence of an alteration in peripheral (skeletal muscle and white adipose tissue) insulin sensitivity (20,22,31). These findings were supported in a canine model, in which hepatic insulin resistance was also found to be the primary metabolic consequence associated with 12 wk of moderate-fat (44% of kcal from fat) feeding (18). However, other studies have demonstrated that peripheral insulin resistance precedes liver resistance in response to high dietar...