Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo controlled bilaterally infused human leg: increased insulin sensitivity, increased net protein breakdown and increased IL-6 release

Ermina Bach, Bent Roni Ranghøj Nielsen, Mikkel Vendelbo, Andreas Buch Møller, Niels Jessen, Mads Buhl, Thomas Krusenstjerna- Hafstrøm, Lars Holm, Steen B. Pedersen, Henriette Pilegaard, Rasmus Sjørup Biensø, Jens Otto Lunde Jørgensen, Niels Møller

31 Citations (Scopus)

Abstract

Tumor necrosis factor-a (TNF-a) has widespread metabolic actions. Systemic TNF-a administration, however, generates a complex hormonal and metabolic response. Our study was designed to test whether regional, placebo-controlled TNF-a infusion directly affects insulin resistance and protein breakdown. We studied eight healthy volunteers once with bilateral femoral vein and artery catheters during a 3-h basal period and a 3-h hyperinsulinemic-euglycemic clamp. One artery was perfused with saline and one with TNF-a. During the clamp, TNF-a perfusion increased glucose arteriovenous differences (0.91 6 0.17 vs. 0.74 6 0.15 mmol/L, P = 0.012) and leg glucose uptake rates. Net phenylalanine release was increased by TNF-a perfusion with concomitant increases in appearance and disappearance rates. Free fatty acid kinetics was not affected by TNF-a, whereas interleukin-6 (IL-6) release increased. Insulin and protein signaling in muscle biopsies was not affected by TNF-a. TNF-a directly increased net muscle protein loss, which may contribute to cachexia and general protein loss during severe illness. The finding of increased insulin sensitivity, which could relate to IL-6, is of major clinical interest and may concurrently act to provide adequate tissue fuel supply and contribute to the occurrence of systemic hypoglycemia. This distinct metabolic feature places TNF-a among the rare insulin mimetics of human origin.

Original languageEnglish
JournalDiabetes
Volume62
Issue number12
Pages (from-to)4023-4029
Number of pages8
ISSN0012-1797
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Dive into the research topics of 'Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo controlled bilaterally infused human leg: increased insulin sensitivity, increased net protein breakdown and increased IL-6 release'. Together they form a unique fingerprint.

Cite this