To further explore the nature of the mitochondrial dysfunction and insulin resistance that occur in the muscle of young, lean, normoglycemic, insulin-resistant offspring of parents with type 2 diabetes (IR offspring), we measured mitochondrial content by electron microscopy and insulin signaling in muscle biopsy samples obtained from these individuals before and during a hyperinsulinemic-euglycemic clamp. The rate of insulin-stimulated muscle glucose uptake was approximately 60% lower in the IR offspring than the control subjects and was associated with an approximately 60% increase in the intramyocellular lipid content as assessed by 1 H magnetic resonance spectroscopy. Muscle mitochondrial density was 38% lower in the IR offspring. These changes were associated with a 50% increase in IRS-1 Ser312 and IRS-1 Ser636 phosphorylation and an approximately 60% reduction in insulin-stimulated Akt activation in the IR offspring. These data provide new insights into the earliest defects that may be responsible for the development of type 2 diabetes and support the hypothesis that reductions in mitochondrial content result in decreased mitochondrial function, which predisposes IR offspring to intramyocellular lipid accumulation, which in turn activates a serine kinase cascade that leads to defects in insulin signaling and action in muscle.
IntroductionRecent magnetic resonance spectroscopy (MRS) studies have revealed increased intramyocellular lipid content associated with reduced mitochondrial phosphorylation activity in the muscle of young, lean, normoglycemic, insulin-resistant offspring of parents with type 2 diabetes (IR offspring) (1). These data suggest a potential role of mitochondrial dysfunction in the pathogenesis of insulin resistance and type 2 diabetes; however, the underlying mechanism responsible for this reduced mitochondrial activity remains unknown.Increases in the intramyocellular concentration of fatty acid metabolites have been postulated to activate a serine kinase cascade, causing increased phosphorylation of IRS-1 on critical serine sites, which blocks insulin receptor phosphorylation of IRS-1 on tyrosine sites. This results in reduced insulin-stimulated IRS-1-associated PI3K activity (2-5), decreased insulin-stimulated glucose transport activity (3), and reduced muscle glycogen synthesis (6, 7). However, there is currently little evidence that serine phosphorylation of IRS-1 is a key molecular event for this process in humans or whether or not there are associated alterations in insu-