Leucine amplifies the effects of metformin on insulin sensitivity and glycemic control in diet-induced obese mice

Metabolism. 2015 Jul;64(7):845-56. doi: 10.1016/j.metabol.2015.03.007. Epub 2015 Mar 19.

Abstract

Background and objective: The Sirt1/AMPK signaling pathway is a key sensor of energy status and regulates glucose and lipid metabolism. Leucine (Leu) activates Sirt1 by lowering its Km for NAD(+) and potentiates other sirtuin/AMPK-activators, resulting in improvement of insulin sensitivity. Since metformin (Met) converges on this pathway, we hypothesized that leucine would amplify its gluco-regulatory effects.

Materials and methods: The effects of Leu (24 g/kg diet)+Met (0.05-0.5 g/kg diet) combinations were compared to standard therapeutic Met (1.5 g/kg diet; ~300 mg/kg BW) on glycemic control in high fat diet induced insulin resistant mice for 6 weeks. The effects of Leu on Met stimulation of Sirt1 and AMPK activities were further evaluated in adipocytes.

Results: Sub-therapeutic levels of Met combined with Leu resulted in increases in Sirt1 activity and in tissue P-AMPK/AMPK ratio and corresponding dose-responsive improvements in fasting and post-prandial glucose, in glucose response to an insulin tolerance test and in the area under the curve in glucose tolerance tests. Changes were evident within 7 days of treatment and sustained throughout the 6-week study duration. The Leu+Met (0.25 g/kg)-combinations produced a comparable effect to a standard therapeutic Met dose, while the Leu+Met (0.5 g/kg diet) resulted in greater improvements. Since resveratrol also synergizes with leucine to augment sirtuin signaling and insulin sensitivity, we tested the addition of resveratrol to Leu-Met and found no additional benefit.

Conclusion: These data demonstrate that adding Leu to Met enables a dose reduction of 66% with improved efficacy and of 83% with comparable efficacy to standard metformin in diet-induced obese mice, and addition of resveratrol does not provide further benefit.

Keywords: AMPK; Diabetes; Leucine; Metformin; Sirt1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AMP-Activated Protein Kinases / metabolism
  • Adipocytes / drug effects
  • Adipocytes / metabolism
  • Animals
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Diet, High-Fat / adverse effects*
  • Fasting / physiology
  • Glucose / metabolism
  • Glucose Tolerance Test / methods
  • Insulin / metabolism
  • Insulin Resistance / physiology*
  • Leucine / metabolism*
  • Male
  • Metformin / pharmacology*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Obese / metabolism*
  • Obesity / drug therapy*
  • Obesity / metabolism
  • Signal Transduction / drug effects
  • Sirtuin 1 / metabolism

Substances

  • Blood Glucose
  • Insulin
  • Metformin
  • AMP-Activated Protein Kinases
  • Sirtuin 1
  • Leucine
  • Glucose