We examined rodent models with altered levels of mitoNEET, a protein residing in the mitochondrial outer membrane. Adipocyte-specific overexpression of mitoNEET enhances lipid-uptake and storage, leading to an expansion of adipose tissue mass. Despite the resulting massive obesity, benign aspects of adipose tissue expansion prevail and insulin sensitivity is preserved. MitoNEET inhibits mitochondrial iron transport into the matrix. Since iron is a rate-limiting component for electron transport, mitoNEET reduces β-oxidation rates. This is associated with reduced mitochondrial membrane potential and reduced reactive oxygen species damage, along with higher levels of adiponectin production. Conversely, the reduction of mitoNEET enhances mitochondrial respiratory capacity through enhanced iron content in the matrix, with reduced weight gain on a high fat diet. However, a reduction of mitoNEET also causes heightened oxidative-stress and glucose-intolerance. MitoNEET is therefore a potent regulator of mitochondrial function that profoundly impacts the dynamics of cellular and whole-body lipid homeostasis.

Iron overload is a risk factor for diabetes. The link between iron and diabetes was first recognized in pathologic conditions—hereditary hemochromatosis and thalassemia—but high levels of dietary iron also impart diabetes risk. Iron plays a direct and causal role in diabetes pathogenesis mediated both by β-cell failure and insulin resistance. Iron is also a factor in the regulation of metabolism in most tissues involved in fuel homeostasis, with the adipocyte in particular serving an iron-sensing role. The underlying molecular mechanisms mediating these effects are numerous and incompletely understood, but include oxidant stress and modulation of adipokines and intracellular signal transduction pathways.

Iron overload is associated with increased diabetes risk. We therefore investigated the effect of iron on adiponectin, an insulin-sensitizing adipokine that is decreased in diabetic patients. In humans, normal-range serum ferritin levels were inversely associated with adiponectin, independent of inflammation. Ferritin was increased and adiponectin was decreased in type 2 diabetic and in obese diabetic subjects compared with those in equally obese individuals without metabolic syndrome. Mice fed a high-iron diet and cultured adipocytes treated with iron exhibited decreased adiponectin mRNA and protein. We found that iron negatively regulated adiponectin transcription via FOXO1-mediated repression. Further, loss of the adipocyte iron export channel, ferroportin, in mice resulted in adipocyte iron loading, decreased adiponectin, and insulin resistance. Conversely, organismal iron overload and increased adipocyte ferroportin expression because of hemochromatosis are associated with decreased adipocyte iron, increased adiponectin, improved glucose tolerance, and increased insulin sensitivity. Phlebotomy of humans with impaired glucose tolerance and ferritin values in the highest quartile of normal increased adiponectin and improved glucose tolerance. These findings demonstrate a causal role for iron as a risk factor for metabolic syndrome and a role for adipocytes in modulating metabolism through adiponectin in response to iron stores. IntroductionIncreased iron stores are associated with increased risk of type 2 diabetes (1-4), gestational diabetes (5), prediabetes (6), metabolic syndrome (MetS) (7), central adiposity (8), and cardiovascular disease (9, 10). The mechanisms underlying these associations are poorly understood. The commonly used marker for total body iron stores, serum ferritin, is also responsive to inflammatory stress (11, 12), so increased ferritin in diabetes could simply reflect the inflammatory component of that disease (13). On the other hand, phlebotomy improves glycemia and MetS traits (14-17), arguing that iron may play a causal role in diabetes.The possible mediators of the association between iron and diabetes risk are not known. Decreases in both insulin secretion and sensitivity have been linked to iron. Excess iron impairs pancreatic β cell function and causes β cell apoptosis (18-21). Recent studies have also found a negative correlation between serum ferritin and the insulin-sensitizing adipokine, adiponectin (3,(22)(23)(24). The hypothesis that adiponectin links iron and insulin resistance is appealing, as decreased adiponectin levels are associated with obesity and type 2 diabetes (25) and are causally linked with insulin resistance (26).We therefore investigated the mechanisms underlying the relationships among serum ferritin, adiponectin, and MetS in mice and humans. We demonstrate in humans that the association between serum ferritin and adiponectin is independent of inflammation and that serum ferritin, even within its normal ranges, is among the best predictors of serum adiponec...

Summary Cold induced thermogenesis is an energy demanding process that protects endotherms against a reduction in ambient temperature. Using non-targeted LC-MS based lipidomics, we identified elevated levels of plasma acylcarnitines in response to the cold. We found that the liver undergoes a metabolic switch to provide fuel for brown fat thermogenesis by producing acylcarnitines. Cold stimulates white adipocytes to release free fatty acids that activate the nuclear receptor HNF4α, which is required for acylcarnitine production in the liver and adaptive thermogenesis. Once in circulation, acylcarnitines are transported to brown adipose tissue, while uptake into white adipose tissue and liver is blocked. Finally, a bolus of L-carnitine or palmitoylcarnitine rescues the cold sensitivity seen with aging. Our data highlights an elegant mechanism whereby white adipose tissue provides long chain fatty acids for hepatic carnitilation to generate plasma acylcarnitines as a fuel source for peripheral tissues in mice.

Iron overload can cause insulin deficiency, but in some cases this may be insufficient to result in diabetes. We hypothesized that the protective effects of decreased iron would be more significant with increased beta-cell demand and stress. Therefore, we treated the ob/ob mouse model of type 2 diabetes with an iron-restricted diet (35 mg/kg iron) or with an oral iron chelator. Control mice were fed normal chow containing 500 mg/kg iron. Neither treatment resulted in iron deficiency or anemia. The low-iron diet significantly ameliorated diabetes in the mice. The effect was long lasting and reversible. Ob/ob mice on the low-iron diet exhibited significant increases in insulin sensitivity and beta-cell function, consistent with the phenotype in mouse models of hereditary iron overload. The effects were not accounted for by changes in weight or feeding behavior. Treatment with iron chelation had a more dramatic effect, allowing the ob/ob mice to maintain normal glucose tolerance for at least 10.5 wk despite no effect on weight. Although dietary iron restriction preserved beta-cell function in ob/ob mice fed a high-fat diet, the effects on overall glucose levels were less apparent due to a loss of the beneficial effects of iron on insulin sensitivity. Beneficial effects of iron restriction were minimal in wild-type mice on normal chow but were apparent in mice on high-fat diets. We conclude that, even at "normal" levels, iron exerts detrimental effects on beta-cell function that are reversible with dietary restriction or pharmacotherapy.