Type 2 diabetes (T2D) is hallmarked by insulin resistance, impaired insulin secretion, and increased hepatic glucose production. The worldwide increasing prevalence of T2D calls for efforts to understand its pathogenesis in order to improve disease prevention and management. Recent genome-wide association studies have revealed strong associations between the CDKN2A/B locus and T2D risk. The CDKN2A/B locus contains genes encoding cell cycle inhibitors, including p16
Ink4a, which have not yet been implicated in the control of hepatic glucose homeostasis. Here, we show that p16Ink4a deficiency enhances fasting-induced hepatic glucose production in vivo by increasing the expression of key gluconeogenic genes. p16Ink4a downregulation leads to an activation of PKA-CREB-PGC1a signaling through increased phosphorylation of PKA regulatory subunits. Taken together, these results provide evidence that p16Ink4a controls fasting glucose homeostasis and could as such be involved in T2D development.Type 2 diabetes (T2D) is a complex metabolic disorder involving a combination of insulin resistance, impaired insulin secretion, and increased hepatic glucose production (1,2). The pathogenesis of T2D is multifactorial, involving both genetic and environmental susceptibility factors (3). During these last few years, the search for genetic determinants of T2D greatly progressed, identifying new loci contributing to T2D. A better understanding of the function of the gene products of these loci is required to identify new strategies for the prevention and treatment of T2D (3,4). Hence, recent human genomewide association studies (GWAS) have identified a polymorphism on chromosome 9p21 (rs10811661), located 125 kb upstream of the CDKN2B and CDKN2A genes, that is strongly and reproducibly linked to T2D (5-7), establishing genes on the CDKN2A/B locus among the strongest candidates for conferring susceptibility to T2D across different ethnicities (4).The gene products are the cyclin-dependent kinase (CDK) inhibitors p16Ink4a and p14 ARF for the CDKN2A locus and p15Ink4b for the CDKN2B locus, which are tumor suppressors acting as cell cycle inhibitors (8,9). The p15Ink4b and p16 Ink4a proteins bind to either CDK4 or CDK6, thus inhibiting the action of cyclin D and preventing retinoblastoma protein phosphorylation and subsequent release of the E2F1 transcription factor. As a consequence, the transcription of genes required for cell cycle progression to the S phase is restrained.However, how the CDKN2A/B gene products modulate glucose metabolism is less clear. In murine models, increased expression of p15Ink4b in pancreatic islets is associated with islet hypoplasia and impaired glucose-induced insulin secretion (10). Moreover, p16Ink4a plays a crucial role in senescence and aging. p16Ink4a expression increases with age in pancreatic b-cells and promotes an agedependent decline in islet regenerative potential (11). Additionally, other cell cycle regulators, like CDK4, E2F1, and cyclin D, also play roles in glucose homeostasis through