Klieverik LP, Sauerwein HP, Ackermans MT, Boelen A, Kalsbeek A, Fliers E. Effects of thyrotoxicosis and selective hepatic autonomic denervation on hepatic glucose metabolism in rats. Am J Physiol Endocrinol Metab 294: E513-E520, 2008. First published January 8, 2008 doi:10.1152/ajpendo.00659.2007.-Thyrotoxicosis is known to induce a broad range of changes in carbohydrate metabolism. Recent studies have identified the sympathetic and parasympathetic nervous system as major regulators of hepatic glucose metabolism. The present study aimed to investigate the pathogenesis of altered endogenous glucose production (EGP) in rats with mild thyrotoxicosis. Rats were treated with methimazole in drinking water and L-thyroxine (T4) from osmotic minipumps to either reinstate euthyroidism or induce thyrotoxicosis. Euthyroid and thyrotoxic rats underwent either a sham operation, a selective hepatic sympathetic denervation (Sx), or a parasympathetic denervation (Px). After 10 days of T4 administration, all animals were submitted to a hyperinsulinemic euglycemic clamp combined with stable isotope dilution to measure EGP. Plasma triiodothyronine (T3) showed a fourfold increase in thyrotoxic compared with euthyroid animals. EGP was increased by 45% in thyrotoxic compared with euthyroid rats and correlated significantly with plasma T3. In thyrotoxic rats, hepatic PEPCK mRNA expression was increased 3.5-fold. Relative suppression of EGP during hyperinsulinemia was 34% less in thyrotoxic than in euthyroid rats, indicating hepatic insulin resistance. During thyrotoxicosis, Sx attenuated the increase in EGP, whereas Px resulted in increased plasma insulin with unaltered EGP compared with intact animals, compatible with a further decrease in hepatic insulin sensitivity. We conclude that chronic, mild thyrotoxicosis in rats increases EGP, whereas it decreases hepatic insulin sensitivity. Sympathetic hepatic innervation contributes only to a limited extent to increased EGP during thyrotoxicosis, whereas parasympathetic hepatic innervation may function to restrain EGP in this condition. thyroid hormone; autonomic nervous system; sympathetic; parasympathetic THYROTOXICOSIS IS ASSOCIATED WITH A BROAD RANGE of alterations in metabolism and energy homeostasis. Endogenous glucose production (EGP), lipolysis, and proteolysis are increased during thyrotoxicosis, providing the substrates needed for the concomitant increase in energy expenditure (12). Thyrotoxic patients exhibit increased EGP and hepatic insulin resistance, i.e., hampered suppressive action of insulin on EGP (6, 12). It is widely assumed that the metabolic alterations during thyrotoxicosis represent direct effects of thyroid hormone (TH) on the expression of TH-responsive genes, mediated by binding of triiodothyronine (T 3 ) to TH receptors in peripheral organs (39). Indeed, one of the main target organs for metabolic effects of TH is the liver, which has a key role in maintaining glucose homeostasis.Until quite recently, the role of the central nervous system (CNS) as a focus of...