Isthmin-1 is an adipokine that promotes glucose uptake and improves glucose tolerance and hepatic steatosis

• DOI: 10.1016/j.cmet.2021.07.010
• Publication Date: 2021-08-03T15:19:57Z
• Authors: Zewen Jiang; Meng Zhao; Laetitia Voilquin; Yunshin Jung; Mari A. Aikio; Tanushi Sahai; Florence Y. Dou; Alexander M. Roche; Ivan Carcamo-Orive; Joshua W. Knowles; Martin Wabitsch; Eric A. Appel; Caitlin L. Maikawa; Joao Paulo Camporez; Gerald I. Shulman; Linus Tsai; Evan D. Rosen; Christopher D. Ga...; Bruce M. Spiegelman; Katrin J. Svensson
• Keywords: 0301 basic medicine; 1.1 Normal biological development and functioning; Chronic Liver Disease and Cirrhosis; Medical Biochemistry and Metabolomics; Inbred C57BL; Diet, High-Fat; Endocrinology & Metabolism; Mice; Phosphatidylinositol 3-Kinases; 03 medical and health sciences; Adipokines; Diabetes Mellitus; 2.1 Biological and endogenous factors; Medical biochemistry and metabolomics; Animals; Obesity; Metabolic and endocrine; lipogenesis; Nutrition; adipokine; diabetes; Liver Disease; hepatic steatosis; Lipogenesis; Diabetes; Biological Sciences; Lipid Metabolism; Diet; glucose uptake; 3. Good health; Fatty Liver; Mice, Inbred C57BL; High-Fat; Glucose; Diabetes Mellitus, Type 2; Liver; Biochemistry and cell biology; Intercellular Signaling Peptides and Proteins; Biochemistry and Cell Biology; cellular signaling; Insulin Resistance; Digestive Diseases; Type 2

With the increasing prevalence of type 2 diabetes and fatty liver disease, there is still an unmet need to better treat hyperglycemia and hyperlipidemia. Here, we identify isthmin-1 (Ism1) as an adipokine and one that has a dual role in increasing adipose glucose uptake while suppressing hepatic lipid synthesis. Ism1 ablation results in impaired glucose tolerance, reduced adipose glucose uptake, and reduced insulin sensitivity, demonstrating an endogenous function for Ism1 in glucose regulation. Mechanistically, Ism1 activates a PI3K-AKT signaling pathway independently of the insulin and insulin-like growth factor receptors. Notably, while the glucoregulatory function is shared with insulin, Ism1 counteracts lipid accumulation in the liver by switching hepatocytes from a lipogenic to a protein synthesis state. Furthermore, therapeutic dosing of recombinant Ism1 improves diabetes in diet-induced obese mice and ameliorates hepatic steatosis in a diet-induced fatty liver mouse model. These findings uncover an unexpected, bioactive protein hormone that might have simultaneous therapeutic potential for diabetes and fatty liver disease.