Insulin resistance is not conserved in myotubes established from women with PCOS

Mette Eriksen, Ann Dorte Pørneki, Vibe Skov, Jorge S Burns, Henning Beck-Nielsen, Dorte Glintborg, Michael Gaster, Mette Eriksen, Ann Dorte Pørneki, Vibe Skov, Jorge S Burns, Henning Beck-Nielsen, Dorte Glintborg, Michael Gaster

Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among premenopausal women, who often develop insulin resistance. We tested the hypothesis that insulin resistance in skeletal muscle of patients with polycystic ovary syndrome (PCOS) is an intrinsic defect, by investigating the metabolic characteristics and gene expression of in vitro differentiated myotubes established from well characterized PCOS subjects.

Methods: Using radiotracer techniques, RT-PCR and enzyme kinetic analysis we examined myotubes established from PCOS subjects with or without pioglitazone treatment, versus healthy control subjects who had been extensively metabolically characterized in vivo. Results. Myotubes established from PCOS and matched control subjects comprehensively expressed all insulin-sensitive biomarkers; glucose uptake and oxidation, glycogen synthesis and lipid uptake. There were no significant differences between groups either at baseline or during acute insulin stimulation, although in vivo skeletal muscle was insulin resistant. In particular, we found no evidence for defects in insulin-stimulated glycogen synthase activity between groups. Myotubes established from PCOS patients with or without pioglitazone treatment also showed no significant differences between groups, neither at baseline nor during acute insulin stimulation, although in vivo pioglitazone treatment significantly improved insulin sensitivity. Consistently, the myotube cultures failed to show differences in mRNA levels of genes previously demonstrated to differ in PCOS patients with or without pioglitazone treatment (PLEK, SLC22A16, and TTBK).

Conclusion: These results suggest that the mechanisms governing insulin resistance in skeletal muscle of PCOS patients in vivo are not primary, but rather adaptive.

Trial registration: ClinicalTrials.gov NCT00145340.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, et al. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83:3078–3082.
    1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, et al. The Prevalence and Features of the Polycystic Ovary Syndrome in an Unselected Population. J Clin Endocrinol Metab. 2004;89:2745–2749.
    1. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25.
    1. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223–1236.
    1. Glintborg D, Henriksen JE, Andersen M, Hagen C, Hangaard J, et al. Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril. 2004;82:1570–1579.
    1. Glintborg D, Andersen M. An update on the pathogenesis, inflammation, and metabolism in hirsutism and polycystic ovary syndrome. Gynecol Endocrinol. 2010;26:281–296.
    1. Shulman GI. Cellular mechanisms of insulin resistance. J Clin Invest. 2000;106:171–176.
    1. Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8:41.
    1. Glintborg D, Hermann AP, Andersen M, Hagen C, Beck-Nielsen H, et al. Effect of pioglitazone on glucose metabolism and luteinizing hormone secretion in women with polycystic ovary syndrome. Fertil Steril. 2006;86:385–397.
    1. Højlund K, Glintborg D, Andersen NR, Birk JB, Treebak JT, et al. Impaired insulin-stimulated phosphorylation of Akt and AS160 in skeletal muscle of women with polycystic ovary syndrome is reversed by pioglitazone treatment. Diabetes. 2008;57:357–366.
    1. Venkatesan AM, Dunaif A, Corbould A. Insulin resistance in polycystic ovary syndrome: progress and paradoxes. Recent Prog Horm Res. 2001;56:295–308.
    1. Dunaif A, Xia J, Book CB, Schenker E, Tang Z. Excessive insulin receptor serine phosphorylation in cultured fibroblasts and in skeletal muscle. A potential mechanism for insulin resistance in the polycystic ovary syndrome. J Clin Invest. 1995;96:801–810.
    1. Glintborg D, Højlund K, Andersen NR, Hansen BF, Beck-Nielsen H, et al. Impaired insulin activation and dephosphorylation of glycogen synthase in skeletal muscle of women with polycystic ovary syndrome is reversed by pioglitazone treatment. J Clin Endocrinol Metab. 2008;93:3618–3626.
    1. Deligeoroglou E, Kouskouti C, Christopoulos P. The role of genes in the polycystic ovary syndrome: predisposition and mechanisms. Gynecol Endocrinol. 2009;25:603–609.
    1. Kahsar-Miller MD, Nixon C, Boots LR, Go RC, Azziz R. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertil Steril. 2001;75:53–58.
    1. Zhuo G, Feng G, Leng J, Yu L, Jiang Y. A 9-bp deletion homoplasmy in women with polycystic ovary syndrome revealed by mitochondrial genome-mutation screen. Biochem Genet. 2010;48:157–163.
    1. Xita N, Georgiou I, Tsatsoulis A. The genetic basis of polycystic ovary syndrome. Eur J Endocrinol. 2002;147:717–725.
    1. Skov V, Glintborg D, Knudsen S, Jensen T, Kruse TA, et al. Reduced expression of nuclear-encoded genes involved in mitochondrial oxidative metabolism in skeletal muscle of insulin-resistant women with polycystic ovary syndrome. Diabetes. 2007;56:2349–2355.
    1. Skov V, Glintborg D, Knudsen S, Tan Q, Jensen T, et al. Pioglitazone enhances mitochondrial biogenesis and ribosomal protein biosynthesis in skeletal muscle in polycystic ovary syndrome. PLoS One. 2008;3:e2466.
    1. Gaster M, Petersen I, Højlund K, Poulsen P, Beck-Nielsen H. The diabetic phenotype is conserved in myotubes established from diabetic subjects: evidence for primary defects in glucose transport and glycogen synthase activity. Diabetes. 2002;51:921–927.
    1. Henry RR, Ciaraldi TP, Mudaliar S, Abrams L, Nikoulina SE. Acquired defects of glycogen synthase activity in cultured human skeletal muscle cells: influence of high glucose and insulin levels. Diabetes. 1996;45:400–407.
    1. Henry RR, Ciaraldi TP, Abrams-Carter L, Mudaliar S, Park KS, et al. Glycogen synthase activity is reduced in cultured skeletal muscle cells of non-insulin-dependent diabetes mellitus subjects. Biochemical and molecular mechanisms. J Clin Invest. 1996;98:1231–1236.
    1. Gaster M, Beck-Nielsen H. The reduced insulin-mediated glucose oxidation in skeletal muscle from type 2 diabetic subjects may be of genetic origin–evidence from cultured myotubes. Biochim Biophys Acta. 2004;1690:85–91.
    1. Gaster M. Reduced TCA flux in diabetic myotubes: A governing influence on the diabetic phenotype? Biochem Biophys Res Commun. 2009;387:651–655.
    1. Ortenblad N, Mogensen M, Petersen I, Højlund K, Levin K, et al. Reduced insulin-mediated citrate synthase activity in cultured skeletal muscle cells from patients with type 2 diabetes: evidence for an intrinsic oxidative enzyme defect. Biochim Biophys Acta. 2005;1741:206–214.
    1. Gaster M, Rustan AC, Aas V, Beck-Nielsen H. Reduced lipid oxidation in skeletal muscle from type 2 diabetic subjects may be of genetic origin: evidence from cultured myotubes. Diabetes. 2004;53:542–548.
    1. Gaster M, Rustan AC, Beck-Nielsen H. Differential utilization of saturated palmitate and unsaturated oleate: evidence from cultured myotubes. Diabetes. 2005;54:648–656.
    1. Wensaas AJ, Rustan AC, Just M, Berge RK, Drevon CA, et al. Fatty acid incubation of myotubes from humans with type 2 diabetes leads to enhanced release of beta-oxidation products because of impaired fatty acid oxidation: effects of tetradecylthioacetic acid and eicosapentaenoic acid. Diabetes. 2009;58:527–535.
    1. Corbould A, Kim YB, Youngren JF, Pender C, Kahn BB, et al. Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling. Am J Physiol Endocrinol Metab. 2005;288:E1047–E1054.
    1. Ciaraldi TP, Aroda V, Mudaliar S, Chang RJ, Henry RR. Polycystic ovary syndrome is associated with tissue-specific differences in insulin resistance. J Clin Endocrinol Metab. 2009;94:157–163.
    1. Damsbo P, Vaag A, Hother-Nielsen O, Beck-Nielsen H. Reduced glycogen synthase activity in skeletal muscle from obese patients with and without type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1991;34:239–245.
    1. Beck-Nielsen H, Groop LC. Metabolic and genetic characterization of prediabetic states. Sequence of events leading to non-insulin-dependent diabetes mellitus. J Clin Invest. 1994;94:1714–1721.
    1. Glintborg D, Højlund K, Andersen M, Henriksen JE, Beck-Nielsen H, et al. Soluble CD36 and risk markers of insulin resistance and atherosclerosis are elevated in polycystic ovary syndrome and significantly reduced during pioglitazone treatment. Diabetes Care. 2008;31:328–334.
    1. Glintborg D, Frystyk J, Højlund K, Andersen KK, Henriksen JE, et al. Total and high molecular weight (HMW) adiponectin levels and measures of glucose and lipid metabolism following pioglitazone treatment in a randomized placebo-controlled study in polycystic ovary syndrome. Clin Endocrinol (Oxf) 2008;68:165–174.
    1. Gaster M, Kristensen SR, Beck-Nielsen H, Schroder HD. A cellular model system of differentiated human myotubes. APMIS. 2001;109:735–744.
    1. Corbould A, Dunaif A. The adipose cell lineage is not intrinsically insulin resistant in polycystic ovary syndrome. Metabolism. 2007;56:716–722.
    1. Corbould A, Kim YB, Youngren JF, Pender C, Kahn BB, et al. Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling. Am J Physiol Endocrinol Metab. 2005;288:E1047–E1054.
    1. Book CB, Dunaif A. Selective insulin resistance in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1999;84:3110–3116.
    1. Ciaraldi TP, Morales AJ, Hickmann MG, Odem-Ford R, Yen SSC, et al. Lack of insulin resistance in fibroblasts from subjects with polycystic ovary syndrome. Metabolism. 1998;47:940–946.
    1. Gaster M, Beck-Nielsen H. Triacylglycerol accumulation is not primarily affected in myotubes established from type 2 diabetic subjects. Biochim Biophys Acta. 2006;1761:100–110.
    1. Björntorp P. The android woman–a risky condition. J Intern Med. 1996;239:105–110.
    1. Olefsky JM, Saltiel AR. PPAR gamma and the treatment of insulin resistance. Trends Endocrinol Metab. 2000;11:362–368.
    1. Feinstein DL, Spagnolo A, Akar C, Weinberg G, Murphy P, et al. Receptor-independent actions of PPAR thiazolidinedione agonists: is mitochondrial function the key? Biochem Pharmacol. 2005;70:177–188.
    1. Mayerson AB, Hundal RS, Dufour S, Lebon V, Befroy D, et al. The effects of rosiglitazone on insulin sensitivity, lipolysis, and hepatic and skeletal muscle triglyceride content in patients with type 2 diabetes. Diabetes. 2002;51:797–802.
    1. Miyazaki Y, Mahankali A, Matsuda M, Mahankali S, Hardies J, et al. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab. 2002;87:2784–2791.
    1. Boden G, Cheung P, Mozzoli M, Fried SK. Effect of thiazolidinediones on glucose and fatty acid metabolism in patients with type 2 diabetes. Metabolism. 2003;52:753–759.
    1. Stoffers DA, Desai BM, DeLeon DD, Simmons RA. Neonatal exendin-4 prevents the development of diabetes in the intrauterine growth retarded rat. Diabetes. 2003;52:734–740.
    1. Park JH, Stoffers DA, Nicholls RD, Simmons RA. Development of type 2 diabetes following intrauterine growth retardation in rats is associated with progressive epigenetic silencing of Pdx1. J Clin Invest. 2008;118:2316–2324.
    1. Xita N, Tsatsoulis A. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical, and genetic association studies. J Clin Endocrinol Metab. 2006;91:1660–1666.
    1. Li Z, Huang H. Epigenetic abnormality: a possible mechanism underlying the fetal origin of polycystic ovary syndrome. Med Hypotheses. 2008;70:638–642.
    1. Xu N, Azziz R, Goodarzi MO. Epigenetics in polycystic ovary syndrome: a pilot study of global DNA methylation. Fertil Steril. 2010;94:781–783.
    1. Bird A. DNA methylation patterns and epigenetic memory. Genes Dev. 2002;16:6–21.
    1. Ban A, Yamanouchi K, Matsuwaki T, Nishihara M. In vivo gene transfer of PPAR gamma is insufficient to induce adipogenesis in skeletal muscle. J Vet Med Sci. 2008;70:761–767.
    1. Liu S, Navarro G, Mauvais-Jarvis F. Androgen excess produces systemic oxidative stress and predisposes to beta-cell failure in female mice. PLoS One. 2010;5:e11302.
    1. Allemand MC, Irving BA, Asmann YW, Klaus KA, Tatpati L, et al. Effect of testosterone on insulin stimulated IRS1 Ser phosphorylation in primary rat myotubes–a potential model for PCOS-related insulin resistance. PLoS One. 2009;4:e4274.
    1. San Millan JL, Corton M, Villuendas G, Sancho J, Peral B, et al. Association of the polycystic ovary syndrome with genomic variants related to insulin resistance, type 2 diabetes mellitus, and obesity. J Clin Endocrinol Metab. 2004;89:2640–2646.
    1. Lykkesfeldt G, Bennett P, Lykkesfeldt AE, Micic S, Moller S, et al. Abnormal androgen and oestrogen metabolism in men with steroid sulphatase deficiency and recessive X-linked ichthyosis. Clin Endocrinol (Oxf) 1985;23:385–393.
    1. Hother-Nielsen O, Henriksen JE, Staehr P, Beck-Nielsen H. Labelled glucose infusate technique in clamp studies. Is precise matching of glucose specific activity important? Endocrinol Metab. 1995;2:275–287.
    1. Gaster M, Beck-Nielsen H, Schroder HD. Proliferation conditions for human satellite cells. The fractional content of satellite cells. APMIS. 2001;109:726–734.
    1. Gaster M, Schroder HD, Handberg A, Beck-Nielsen H. The basal kinetic parameters of glycogen synthase in human myotube cultures are not affected by chronic high insulin exposure. Biochim Biophys Acta. 2001;1537:211–221.
    1. Henry RR, Abrams L, Nikoulina S, Ciaraldi TP. Insulin action and glucose metabolism in nondiabetic control and NIDDM subjects. Comparison using human skeletal muscle cell cultures. Diabetes. 1995;44:936–946.
    1. Gaster M. Metabolic flexibility is conserved in diabetic myotubes. J Lipid Res. 2007;48:207–217.
    1. Gaster M. Insulin resistance and the mitochondrial link. Lessons from cultured human myotubes. Biochim Biophys Acta. 2007;1772:755–765.
    1. Gaster M. Reduced lipid oxidation in myotubes established from obese and type 2 diabetic subjects. Biochem Biophys Res Commun. 2009;382:766–770.
    1. Mandarino LJ, Wright KS, Verity LS, Nichols J, Bell JM, et al. Effects of insulin infusion on human skeletal muscle pyruvate dehydrogenase, phosphofructokinase, and glycogen synthase. Evidence for their role in oxidative and nonoxidative glucose metabolism. J Clin Invest. 1987;80:655–663.
    1. Lebouvier T, Scales TM, Williamson R, Noble W, Duyckaerts C, et al. The microtubule-associated protein tau is also phosphorylated on tyrosine. J Alzheimers Dis. 2009;18:1–9.
    1. Koepsell H, Lips K, Volk C. Polyspecific organic cation transporters: structure, function, physiological roles, and biopharmaceutical implications. Pharm Res. 2007;24:1227–1251.
    1. Baig A, Bao X, Haslam RJ. Proteomic identification of pleckstrin-associated proteins in platelets: possible interactions with actin. Proteomics. 2009;9:4254–4258.
    1. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) Method. Methods. 2001;25:402–408.
    1. Frederiksen CM, Hojlund K, Hansen L, Oakeley EJ, Hemmings B, et al. Transcriptional profiling of myotubes from patients with type 2 diabetes: no evidence for a primary defect in oxidative phosphorylation genes. Diabetologia. 2008;51:2068–2077.

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