Agonists for the nuclear receptor peroxisomal proliferator-activated receptor-â„ (PPARâ„) and its heterodimeric partner, retinoid X receptor (RXR), are effective agents for the treatment of type 2 diabetes. To gain insight into the antidiabetic action of these compounds, we treated female Zucker diabetic rats (ZFF) with AGN194204, which we show to be a homodimer-specific RXR agonist, or the PPARâ„ agonist, troglitazone. Hyperinsulinemic-euglycemic clamps in ZFF showed that troglitazone and AGN194204 reduced basal endogenous glucose production (EGP) Ïł30% and doubled the insulin suppression of EGP. AGN194204 had no effect on peripheral glucose utilization, whereas troglitazone increased insulin-stimulated glucose utilization by 50%, glucose uptake into skeletal muscle by 85%, and de novo skeletal muscle glycogen synthesis by 300%. Troglitazone increased skeletal muscle Irs-1 and phospho-Akt levels following in vivo insulin treatment, whereas AGN194204 increased hepatic Irs-2 and insulin stimulated phospho-Akt in liver. Gene profiles of AGN194204-treated mouse liver analyzed by Ingenuity Pathway Analysis identified increases in fatty acid synthetic genes, including Srebp-1 and fatty acid synthase, a pathway previously shown to be induced by RXR agonists. A network of down-regulated genes containing Foxa2, Foxa3, and G-protein subunits was identified, and decreases in these mRNA levels were confirmed by quantitative reverse transcription-PCR. Treatment of HepG2 cells with AGN194204 resulted in inhibition of glucagon-stimulated cAMP accumulation suggesting the G-protein down-regulation may provide an additional mechanism for hepatic insulin sensitization by RXR. These studies demonstrate distinct molecular events lead to insulin sensitization by high affinity RXR and PPARâ„ agonists.
Thiazolidinediones (TZDs)2 and other compounds that bind and enhance the transcriptional activity of peroxisomal proliferator-activated receptor â„ (PPARâ„) have proven to be effective treatments for insulin-resistant diabetes (1, 2). The increase in insulin sensitivity that occurs after treatment with TZDs likely involves actions in adipose tissue, muscle, and liver (3-6), although the complete set of genes that are modulated to result in improved insulin action by TZDs remains unknown. The heterodimeric partner of PPARâ„ receptor is the retinoid X receptor (RXR) (7). In overexpression studies, binding of ligand to the RXR receptor has been reported to result in the recruitment of coactivators to the RXR/PPARâ„ heterodimer (8) and increased transcription from idealized peroxisomal proliferator response elements (PPREs). Some RXR activators can increase transcription of genes in vitro that are also increased by PPARâ„ ligands (8, 9). Like TZDs, RXR agonists can differentiate 3T3-L1 adipocytes (10), and administration of specific, high affinity RXR agonists to hyperglycemic ob/ob (11) and db/db (12) mice is effective in lowering glucose levels. These results have led to the hypothesis that the antihyperglycemic effect of RXR agonists is due to tra...