Effect of IL-6 on the insulin sensitivity in patients with type 2 diabetes.
Elevated interleukin-6 (IL-6) levels are associated with type 2 diabetes, but its role in glucose metabolism is controversial. We investigated the effect of IL-6 on insulin-stimulated glucose metabolism in type 2 diabetes patients and hypothesized that an acute, moderate IL-6 elevation would increase the insulin-mediated glucose uptake. Men with type 2 diabetes not treated with insulin [n = 9, age 54.9 ± 9.7 (mean ± SD) yr, body mass index 34.8 ± 6.1 kg/m(2), HbA1c 7.0 ± 1.0%] received continuous intravenous infusion with either recombinant human IL-6 (rhIL-6) or placebo. After 1 h with placebo or rhIL-6, a 3-h hyperinsulinemic-isoglycemic clamp was initiated. Whole body glucose metabolism was measured using stable isotope-labeled tracers. Signal transducer and activator of transcription 3 (STAT3) phosphorylation and suppressor of cytokine signaling 3 (SOCS3) expression were measured in muscle biopsies. Whole body energy expenditure was measured using indirect calorimetry. In response to the infusion of rhIL-6, circulating levels of IL-6 (P < 0.001), neutrophils (P < 0.001), and cortisol (P < 0.001) increased while lymphocytes decreased (P < 0.01). However, IL-6 infusion did not change glucose infusion rate, rate of appearance, or rate of disappearance during the clamp. While IL-6 enhanced phosphorylation of STAT3 in skeletal muscle (P = 0.041), the expression of SOCS3 remained unchanged. Whole body oxygen uptake (P < 0.01) and expired carbon dioxide (P < 0.01) increased during rhIL-6 infusion. In summary, although IL-6 induced local and systemic responses, the insulin-stimulated glucose uptake was not affected. While different contributing factors may be involved, our results are in contrast to our hypothesis and previous findings in young, healthy men.
Faculty of Health Sciences, Department of Infectious Diseases and CMRC, The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;
N M
NM
Harder-Lauridsen
R
R
Krogh-Madsen
J J
JJ
Holst
P
P
Plomgaard
L
L
Leick
B K
BK
Pedersen
C P
CP
Fischer
D000368:Aged; D002151:Calorimetry; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism; D015309:Glucose Clamp Technique; D006728:Hormones / Q000097:blood; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011994:Recombinant Proteins / Q000097:blood / Q000494:pharmacology
D006728:Hormones; D015850:Interleukin-6; D010919:Placebos; D011994:Recombinant Proteins; D005947:Glucose
biopsy; clamp technique; humans; inflammation; insulin resistance; interleukin-6; metabolism; muscle; signal transducer and activator of transcription 3; skeletal