Two phases of palmitate-induced insulin resistance in skeletal muscle: impaired GLUT4 translocation is followed by a reduced GLUT4 intrinsic activity

Two phases of palmitate-induced insulin resistance in skeletal muscle: impaired GLUT4 translocation is followed by a reduced GLUT4 intrinsic activity. Am J Physiol Endocrinol Metab 293: E783-E793, 2007. First published June 5, 2007; doi:10.1152/ajpendo.00685.2006.- We examined, in soleus muscle, the effects of prolonged palmitate exposure ( 0, 6, 12, 18 h) on insulin-stimulated glucose transport, intramuscular lipid accumulation and oxidation, activation of selected insulin-signaling proteins, and the insulin-stimulated translocation of GLUT4. Insulin-stimulated glucose transport was progressively reduced after 6 h (- 33%), 12 h (-66%), and 18 h (- 89%) of palmitate exposure. These decrements were closely associated with concurrent reductions in palmitate oxidation at 6 h (- 40%), 12 h (- 60%), and 18 h (- 67%). In contrast, intramuscular ceramide (- 24%) and diacylglycerol (+ 32%) concentrations, insulin-stimulated AS160 (- 36%) and PRAS40 (- 33%) phosphorylations, and Akt (- 40%), PKC theta p ( -50%), and GLUT4 translocation (- 40%) to the plasma membrane were all maximally altered within the first 6 h of palmitate treatment. No further changes were observed in any of these parameters after 12 and 18 h of palmitate exposure. Thus, the intrinsic activity of GLUT4 was markedly reduced after 12 and 18 h of palmitate treatment. During this reduced GLUT4 intrinsic activity phase at 12 and 18 h, the reduction in glucose transport was twofold greater compared with the early phase ( <= 6 h), when only GLUT4 translocation was impaired. Our study indicates that palmitate- induced insulin resistance is provoked by two distinct mechanisms: 1) an early phase (<= 6 h), during which lipid- mediated impairments in insulin signaling and GLUT4 translocation reduce insulin- stimulated glucose transport, followed by 2) a later phase ( 12 and 18 h), during which the intrinsic activity of GLUT4 is markedly reduced independently of any further alterations in intramuscular lipid accumulation, insulin signaling and GLUT4 translocation.