Franekova V, Angin Y, Hoebers NT, Coumans WA, Simons PJ, Glatz JF, Luiken JJ, Larsen TS. Marine omega-3 fatty acids prevent myocardial insulin resistance and metabolic remodeling as induced experimentally by high insulin exposure. Am J Physiol Cell Physiol 308: C297-C307, 2015. First published December 4, 2014 doi:10.1152/ajpcell.00073.2014.-Insulin resistance is an important risk factor for the development of several cardiac pathologies, thus advocating strategies for restoring insulin sensitivity of the heart in these conditions. Omega-3 polyunsaturated fatty acids (-3 PUFAs), mainly eicosapentaenoic acid (EPA, C20:5n-3) and docosahexaenoic acid (DHA, C22:6n-3), have been shown to improve insulin sensitivity in insulin-sensitive tissues, but their direct effect on insulin signaling and metabolic parameters in the myocardium has not been reported previously. The aim of this study was therefore to examine the ability of EPA and DHA to prevent insulin resistance in isolated rat cardiomyocytes. Primary rat cardiomyocytes were made insulin resistant by 48 h incubation in high insulin (HI) medium. Parallel incubations were supplemented by 200 M EPA or DHA. Addition of EPA or DHA to the medium prevented the induction of insulin resistance in cardiomyocytes by preserving the phosphorylation state of key proteins in the insulin signaling cascade and by preventing persistent relocation of fatty acid transporter CD36 to the sarcolemma. Only cardiomyocytes incubated in the presence of EPA, however, exhibited improvements in glucose and fatty acid uptake and cell shortening. We conclude that -3 PUFAs protect metabolic and functional properties of cardiomyocytes subjected to insulin resistance-evoking conditions. omega-3 PUFAs; cardiac metabolism; insulin resistance; CD36; adipose triglyceride lipase; sarcomere shortening AN ELEVATED SUPPLY of lipids in obesity and type 2 diabetes leads to alterations of myocardial substrate metabolism, manifested insulin resistance with reduced glucose utilization, and increased long-chain fatty acid (LCFA) utilization (2, 3, 39). Thus isolated cardiomyocytes from various diabetic/obese rodent models show impaired insulin signaling, including reduced activation of protein kinase B (Akt/PKB), reduced glucose transporter 4 (GLUT4) translocation from intracellular compartments to the sarcolemma, as well as impaired insulininduced glucose uptake (10,35,37). Glucose and LCFA are the major substrates for the heart, and GLUT4 and CD36 the major substrate transporters, which are regulated by reversible insulin-induced translocation (48). Notably, increased LCFA supply to cardiomyocytes will evoke persistent relocation of CD36 from intracellular stores to the sarcolemma, followed by chronically elevated LCFA uptake and lipid accumulation, eventually resulting in insulin resistance (5, 36). Additionally, sustained hyperinsulinemia itself has also been shown to chronically stimulate CD36 translocation in cardiomyocytes and, consequently, lead to insulin resistance in a very similar manner to cardiom...