Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats

Frank A. Duca, Clémence D. Côté, Brittany A. Rasmussen, Melika Zadeh-Tahmasebi, Guy A. Rutter, Beatrice M. Filippi, Tony K T Lam

Research output: Contribution to journalArticle

149 Citations (Scopus)

Abstract

Metformin is a first-line therapeutic option for the treatment of type 2 diabetes, even though its underlying mechanisms of action are relatively unclear. Metformin lowers blood glucose levels by inhibiting hepatic glucose production (HGP), an effect originally postulated to be due to a hepatic AMP-activated protein kinase (AMPK)-dependent mechanism. However, studies have questioned the contribution of hepatic AMPK to the effects of metformin on lowering hyperglycemia, and a gut-brain-liver axis that mediates intestinal nutrient- and hormone-induced lowering of HGP has been identified. Thus, it is possible that metformin affects HGP through this inter-organ crosstalk. Here we show that intraduodenal infusion of metformin for 50 min activated duodenal mucosal Ampk and lowered HGP in a rat 3 d high fat diet (HFD)-induced model of insulin resistance. Inhibition of duodenal Ampk negated the HGP-lowering effect of intraduodenal metformin, and both duodenal glucagon-like peptide-1 receptor (Glp-1r)-protein kinase A (Pka) signaling and a neuronal-mediated gut-brain-liver pathway were required for metformin to lower HGP. Preabsorptive metformin also lowered HGP in rat models of 28 d HFD-induced obesity and insulin resistance and nicotinamide (NA)-streptozotocin (STZ)-HFD-induced type 2 diabetes. In an unclamped setting, inhibition of duodenal Ampk reduced the glucose-lowering effects of a bolus metformin treatment in rat models of diabetes. These findings show that, in rat models of both obesity and diabetes, metformin activates a previously unappreciated duodenal Ampk-dependent pathway to lower HGP and plasma glucose levels.

Original languageEnglish (US)
Pages (from-to)506-511
Number of pages6
JournalNature Medicine
Volume21
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Metformin
Rats
Glucose
Liver
Medical problems
Nutrition
High Fat Diet
AMP-Activated Protein Kinases
Fats
Brain
Type 2 Diabetes Mellitus
Insulin Resistance
Insulin
Obesity
Niacinamide
Gastrointestinal Hormones
Streptozocin
Crosstalk
Cyclic AMP-Dependent Protein Kinases
Nutrients

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Duca, F. A., Côté, C. D., Rasmussen, B. A., Zadeh-Tahmasebi, M., Rutter, G. A., Filippi, B. M., & Lam, T. K. T. (2015). Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. Nature Medicine, 21(5), 506-511. https://doi.org/10.1038/nm.3787

Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. / Duca, Frank A.; Côté, Clémence D.; Rasmussen, Brittany A.; Zadeh-Tahmasebi, Melika; Rutter, Guy A.; Filippi, Beatrice M.; Lam, Tony K T.

In: Nature Medicine, Vol. 21, No. 5, 01.05.2015, p. 506-511.

Research output: Contribution to journalArticle

Duca, FA, Côté, CD, Rasmussen, BA, Zadeh-Tahmasebi, M, Rutter, GA, Filippi, BM & Lam, TKT 2015, 'Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats', Nature Medicine, vol. 21, no. 5, pp. 506-511. https://doi.org/10.1038/nm.3787
Duca FA, Côté CD, Rasmussen BA, Zadeh-Tahmasebi M, Rutter GA, Filippi BM et al. Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. Nature Medicine. 2015 May 1;21(5):506-511. https://doi.org/10.1038/nm.3787
Duca, Frank A. ; Côté, Clémence D. ; Rasmussen, Brittany A. ; Zadeh-Tahmasebi, Melika ; Rutter, Guy A. ; Filippi, Beatrice M. ; Lam, Tony K T. / Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. In: Nature Medicine. 2015 ; Vol. 21, No. 5. pp. 506-511.
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