Restoration of adipose function in obese glucose-tolerant men following pioglitazone treatment is associated with CCAAT enhancer-binding protein β up-regulation.
Obese AT (adipose tissue) exhibits increased macrophage number. Pro-inflammatory CD16+ peripheral monocyte numbers are also reported to increase with obesity. The present study was undertaken to simultaneously investigate obesity-associated changes in CD16+ monocytes and ATMs (AT macrophages). In addition, a pilot randomized placebo controlled trial using the PPAR (peroxisome-proliferator-activated receptor) agonists, pioglitazone and fenofibrate was performed to determine their effects on CD14+/CD16+ monocytes, ATM and cardiometabolic and adipose dysfunction indices. Obese glucose-tolerant men (n=28) were randomized to placebo, pioglitazone (30 mg/day) and fenofibrate (160 mg/day) for 12 weeks. A blood sample was taken to assess levels of serum inflammatory markers and circulating CD14+/CD16+ monocyte levels via flow cytometry. A subcutaneous AT biopsy was performed to determine adipocyte cell surface and ATM number, the latter was determined via assessment of CD68 expression by IHC (immunohistochemistry) and real-time PCR. Subcutaneous AT mRNA expression of CEBPβ (CCAAT enhancer-binding protein β), SREBP1c (sterol-regulatory-element-binding protein 1c), PPARγ2, IRS-1 (insulin receptor substrate-1), GLUT4 (glucose transporter type 4) and TNFα (tumour necrosis factor α) were also assessed. Comparisons were made between obese and lean controls (n=16) at baseline, and pre- and post-PPAR agonist treatment. Obese individuals had significantly increased adipocyte cell surface, percentage CD14+/CD16+ monocyte numbers and ATM number (all P=0.0001). Additionally, serum TNF-α levels were significantly elevated (P=0.017) and adiponectin levels reduced (total: P=0.0001; high: P=0.022) with obesity. ATM number and percentage of CD14+/CD16+ monocytes correlated significantly (P=0.05). Pioglitazone improved adiponectin levels significantly (P=0.0001), and resulted in the further significant enlargement of adipocytes (P=0.05), without effect on the percentage CD14+/CD16+ or ATM number. Pioglitazone treatment also significantly increased subcutaneous AT expression of CEBPβ mRNA. The finding that improvements in obesity-associated insulin resistance following pioglitazone were associated with increased adipocyte cell surface and systemic adiponectin levels, supports the centrality of AT to the cardiometabolic derangement underlying the development of T2D (Type 2 diabetes) and CVD (cardiovascular disease).
Nutrition and Metabolism Group, Centre for Public Health, Queen's University Belfast, and Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK.
Lesley A
LA
Powell
Paul
P
Crowe
Chenchi
C
Kankara
Jennifer
J
McPeake
David R
DR
McCance
Ian S
IS
Young
Elisabeth R
ER
Trimble
Ann
A
McGinty
D017667:Adipocytes / Q000187:drug effects / Q000378:metabolism; D052242:Adiponectin / Q000378:metabolism; D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000886:Anthropometry; D015415:Biomarkers / Q000378:metabolism; D022782:CCAAT-Enhancer-Binding Protein-beta / Q000235:genetics* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000473:pathology; D002452:Cell Count; D002462:Cell Membrane / Q000187:drug effects / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D011345:Fenofibrate / Q000494:pharmacology / Q000627:therapeutic use; D005951:Glucose Tolerance Test; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D009765:Obesity / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D000077205:Pioglitazone; D020127:Recovery of Function / Q000187:drug effects; D012307:Risk Factors; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*; D015854:Up-Regulation / Q000187:drug effects / Q000235:genetics*
D052242:Adiponectin; D015415:Biomarkers; D022782:CCAAT-Enhancer-Binding Protein-beta; D016207:Cytokines; D018836:Inflammation Mediators; D045162:Thiazolidinediones; D011345:Fenofibrate; D000077205:Pioglitazone