The nuclear receptors liver X receptor (LXR)␣ and LXR are sensors of cholesterol metabolism and lipid biosynthesis. They have recently been found to be regulators of inflammatory cytokines, suppressors of hepatic glucose production, and involved in different cellsignaling pathways. LXR␣ is a target gene of the peroxisome proliferator-activated receptor-␥, a target of drugs used in treating elevated levels of glucose seen in diabetes. Furthermore, insulin induces LXR␣ in hepatocytes, resulting in increased expression of lipogenic enzymes and suppression of key enzymes in gluconeogenesis, including PEPCK. LXR seems to have an important role in the regulation of glucocorticoid action and a role in the overall energy homeostasis suggested by its putative regulatory effect on leptin and uncoupling protein 1. The physiological roles of LXR indicate that it is an interesting potential target for drug treatment of diabetes. Diabetes 53 (Suppl. 1):S36 -S42, 2004 T ype 2 diabetes accounts for Ͼ90% of the cases of diabetes and is caused by defective insulin secretion and insulin resistance. Type 2 diabetes is often of polygenic origin, but the molecular defects are still not fully known. However, the genetic background of maturity-onset type diabetes of the young is known.A class of nuclear receptors has recently become the focus for its important role in cholesterol, lipid, and carbohydrate metabolism, namely the liver X receptor (LXR). A number of recent studies have shown that LXR is a key player in these biological functions. The main target tissues for LXR action are liver and adipose tissue, where its function has been carefully studied, but LXR has recently been suggested to be involved in lipid and carbohydrate metabolism in muscle as well. Important target tissues of insulin action are also liver, muscle, and adipose tissue, where insulin stimulates the uptake of excess glucose from blood and inhibits hepatic glucose production. A salient feature of type 2 diabetes is insulin resistance in these tissues, which leads to hyperglycemia and hyperlipidemia, both pathological conditions where, based on recent studies, LXR may be a key player. The LXR subfamily consists of two members, LXR␣ and LXR, which are activated by oxysterols. Whereas LXR is ubiquitously expressed, high expression of LXR␣ is restricted to liver, adipose tissue, small intestine, and macrophages. LXR target genes have been shown to be involved in lipid and cholesterol metabolism, glucose homeostasis, and inflammatory response (Table 1). This review will focus on physiological roles of LXR and highlight why LXR could be an important potential target for drug treatment of lipid and carbohydrate disorders.
LXR IN CHOLESTEROL AND LIPID METABOLISMThe phenotypes of LXR knockout mice generated in our laboratory and by Mangelsdorf and colleagues have shown that LXR is important for cholesterol and lipid metabolism (1,2). These were the first of many articles reporting LXR as a sensor for metabolites of lipid and cholesterol metabolism. Thus, Mangelsdorf ...