OBJECTIVE-Obesity is characterized by an overgrowth of adipose tissue that leads to the formation of hypoxic areas within this tissue. We investigated whether this phenomenon could be responsible for insulin resistance by studying the effect of hypoxia on the insulin signaling pathway in adipocytes.
RESEARCH DESIGN AND METHODS-The hypoxic signaling pathway was modulated in adipocytes from human and murine origins through incubation under hypoxic conditions (1% O 2 ) or modulation of hypoxia-inducible factor (HIF) expression. Insulin signaling was monitored through the phosphorylation state of several key partners of the pathway and glucose transport.RESULTS-In both human and murine adipocytes, hypoxia inhibits insulin signaling as revealed by a decrease in the phosphorylation of insulin receptor. In 3T3-L1 adipocytes, this inhibition of insulin receptor phosphorylation is followed by a decrease in the phosphorylation state of protein kinase B and AS160, as well as an inhibition of glucose transport in response to insulin. These processes were reversible under normoxic conditions. The mechanism of inhibition seems independent of protein tyrosine phosphatase activities. Overexpression of HIF-1␣ or -2␣ or activation of HIF transcription factor with CoCl 2 mimicked the effect of hypoxia on insulin signaling, whereas downregulation of HIF-1␣ and -2␣ by small interfering RNA inhibited it.CONCLUSIONS-We have demonstrated that hypoxia creates a state of insulin resistance in adipocytes that is dependent upon HIF transcription factor expression. Hypoxia could be envisioned as a new mechanism that participates in insulin resistance in adipose tissue of obese patients. Diabetes 58:95-103, 2009 O besity results from an imbalance between energy intake and energy expenditure. Abdominal obesity and adipose tissue dysfunction are major risk factors for chronic diseases, such as insulin resistance, type 2 diabetes, and cardiovascular diseases. Insulin resistance is associated with alterations in glucose and lipid homeostasis. At the molecular level, insulin resistance is triggered by a dysregulation of the insulin signaling cascade. Insulin stimulates the tyrosine kinase activity of its receptor, leading to tyrosine phosphorylation of its substrates, such as insulin receptor substrate (IRS)-1 and -2 or Shc. They are upstream of two major signaling pathways: the phosphatidylinositol 3-kinase/protein kinase B (PKB) pathway, responsible for most of the metabolic actions of insulin, and the Rasextracellular signal-related kinase pathway, which regulates gene expression (1).During the genesis of obesity, adipose tissue is one of the first tissues affected by insulin resistance. This phenomenon is closely associated with the development of a proinflammatory state within the adipose tissue. In addition to this proinflammatory state, obesity is associated with the formation of hypoxic areas within the tissue. This has been demonstrated in obese mice (ob/ob and dietary induced obesity) using various methods, such as immunohistochemistry ...