The farnesoid X receptor (FXR) is a bile acid (BA)-activated nuclear receptor that plays a major role in the regulation of BA and lipid metabolism. Recently, several studies have suggested a potential role of FXR in the control of hepatic carbohydrate metabolism, but its contribution to the maintenance of peripheral glucose homeostasis remains to be established. FXR-deficient mice display decreased adipose tissue mass, lower serum leptin concentrations, and elevated plasma free fatty acid levels. Glucose and insulin tolerance tests revealed that FXR deficiency is associated with impaired glucose tolerance and insulin resistance. Moreover, whole-body glucose disposal during a hyperinsulinemic euglycemic clamp is decreased in FXR-deficient mice. In parallel, FXR deficiency alters distal insulin signaling, as reflected by decreased insulin-dependent Akt phosphorylation in both white adipose tissue and skeletal muscle. Whereas FXR is not expressed in skeletal muscle, it was detected at a low level in white adipose tissue in vivo and induced during adipocyte differentiation in vitro. Moreover, mouse embryonic fibroblasts derived from FXR-deficient mice displayed impaired adipocyte differentiation, identifying a direct role for FXR in adipocyte function. Treatment of differentiated 3T3-L1 adipocytes with the FXR-specific synthetic agonist GW4064 enhanced insulin signaling and insulin-stimulated glucose uptake. Finally, treatment with GW4064 improved insulin resistance in genetically obese ob/ob mice in vivo. Although the underlying molecular mechanisms remain to be unraveled, these results clearly identify a novel role of FXR in the regulation of peripheral insulin sensitivity and adipocyte function. This unexpected function of FXR opens new perspectives for the treatment of type 2 diabetes.The farnesoid X receptor (FXR) 4 (NR1H4) is a nuclear receptor that is activated by bile acids (BAs) (1). A major physiological role of FXR is to protect liver cells from the deleterious effect of BA overload by decreasing their endogenous production and by accelerating BA biotransformation and excretion (1). In addition, the generation and characterization of FXR-deficient (FXR Ϫ/Ϫ ) mice has also established a critical role of FXR in lipid metabolism, since these mice display elevated serum levels of triglycerides and high density lipoprotein cholesterol (2). Recently, several studies have suggested that FXR might also regulate hepatic carbohydrate metabolism (3). The first indication came from the observation that hepatic FXR expression is reduced in several rodent models of diabetes (4). FXR expression also varies in mouse liver during nutritional changes, being increased during fasting and decreased upon refeeding (5, 6). Moreover, FXR activation by BAs or the synthetic nonsteroidal specific agonist GW4064 (7) modulates the expression of the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (3). However, conflicting data report either a positive (8) or a negative effect (9, 10) of BA and/or GW4064 on phosphoenolpyruvate...

No abstract