2016
DOI: 10.1111/acel.12481
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Ultrastructure of the liver microcirculation influences hepatic and systemic insulin activity and provides a mechanism for age‐related insulin resistance

Abstract: SummaryWhile age‐related insulin resistance and hyperinsulinemia are usually considered to be secondary to changes in muscle, the liver also plays a key role in whole‐body insulin handling and its role in age‐related changes in insulin homeostasis is largely unknown. Here, we show that patent pores called ‘fenestrations’ are essential for insulin transfer across the liver sinusoidal endothelium and that age‐related loss of fenestrations causes an impaired insulin clearance and hyperinsulinemia, induces hepatic… Show more

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Cited by 64 publications
(65 citation statements)
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“…Whereas increased adiposity was the main driver of reduced insulin turnover in aging Mexican Americans, diminished insulin clearance in aged C57BL/6J mice was independent of body composition. This observation is consistent with the recent demonstration of age-related loss of hepatic endothelial fenestrations and diminished insulin uptake associated with reduced insulin clearance in aged mice and rats (42). Our results also raise the question of whether age-related changes in insulin clearance are the consequence of insulin resistance or other aspects of aging.…”
Section: Discussionsupporting
confidence: 93%
“…Whereas increased adiposity was the main driver of reduced insulin turnover in aging Mexican Americans, diminished insulin clearance in aged C57BL/6J mice was independent of body composition. This observation is consistent with the recent demonstration of age-related loss of hepatic endothelial fenestrations and diminished insulin uptake associated with reduced insulin clearance in aged mice and rats (42). Our results also raise the question of whether age-related changes in insulin clearance are the consequence of insulin resistance or other aspects of aging.…”
Section: Discussionsupporting
confidence: 93%
“…This observation is consistent with the recent demonstration of age-related loss of hepatic endothelial fenestrations and diminished insulin uptake associated with reduced insulin clearance in mice and rats [46]. Our results also raise the question of whether age-related changes in insulin clearance are the consequence of aging per se or secondary to insulin resistance.…”
Section: Discussionsupporting
confidence: 93%
“…Whereas age-related hyperinsulinaemia, insulin resistance and visceral obesity [4143] are commonly associated with reduced glucose uptake in skeletal muscle in parallel with a reduction in metabolically active lean mass [33], decreased fenestration in the liver sinusoidal endothelium and other structural changes that reduce insulin uptake by hepatocytes, and hence reduce insulin clearance, have recently emerged as mechanisms underlying age-related hyperinsulinaemia and insulin resistance [44]. The current study provides an alternative mechanism of hyperinsulinaemia in older Cc2 −/− male mutant mice, implicating a progressive reduction in hepatic CEACAM1-mediated insulin clearance that fails to counter persistent GLP-1-mediated release of insulin in older mutant mice.…”
Section: Discussionmentioning
confidence: 99%