AMPK, insulin resistance, and the metabolic syndrome.

Insulin resistance (IR) and hyperinsulinemia are hallmarks of the metabolic syndrome, as are central adiposity, dyslipidemia, and a predisposition to type 2 diabetes, atherosclerotic cardiovascular disease, hypertension, and certain cancers. Regular exercise and calorie restriction have long been known to increase insulin sensitivity and decrease the prevalence of these disorders. The subsequent identification of AMP-activated protein kinase (AMPK) and its activation by exercise and fuel deprivation have led to studies of the effects of AMPK on both IR and metabolic syndrome-related diseases. In this review, we evaluate this body of literature, with special emphasis on the hypothesis that dysregulation of AMPK is both a pathogenic factor for these disorders in humans and a target for their prevention and therapy.

[1]  J. Baur,et al.  Are sirtuins viable targets for improving healthspan and lifespan? , 2012, Nature Reviews Drug Discovery.

[2]  M. Dietrich,et al.  Obesity is associated with hypothalamic injury in rodents and humans. , 2012, The Journal of clinical investigation.

[3]  D. Hardie,et al.  Inactivation of acetyl-CoA carboxylase and activation of AMP-activated protein kinase in muscle during exercise. , 1996, The American journal of physiology.

[4]  Devjit Tripathy,et al.  Pioglitazone for diabetes prevention in impaired glucose tolerance. , 2011, The New England journal of medicine.

[5]  R. Law,et al.  PPARγ-mediated insulin sensitization: the importance of fat versus muscle , 2005 .

[6]  E. Gulve,et al.  Acute and chronic treatment of ob/ob and db/db mice with AICAR decreases blood glucose concentrations. , 2002, Biochemical and biophysical research communications.

[7]  E. Ropelle,et al.  Endurance exercise training ameliorates insulin resistance and reticulum stress in adipose and hepatic tissue in obese rats , 2011, European Journal of Applied Physiology.

[8]  F. Tinahones,et al.  The obese healthy paradox: is inflammation the answer? , 2010, The Biochemical journal.

[9]  B. Kemp,et al.  AMPK in Health and Disease. , 2009, Physiological reviews.

[10]  S. Shoelson,et al.  Type 2 diabetes as an inflammatory disease , 2011, Nature Reviews Immunology.

[11]  Yo Sasaki,et al.  The AMPK β2 Subunit Is Required for Energy Homeostasis during Metabolic Stress , 2012, Molecular and Cellular Biology.

[12]  B. Spiegelman,et al.  The unfolded protein response mediates adaptation to exercise in skeletal muscle through a PGC-1α/ATF6α complex. , 2011, Cell metabolism.

[13]  B. Viollet,et al.  Biguanides suppress hepatic glucagon signaling by decreasing production of cyclic AMP , 2016 .

[14]  B. Viollet,et al.  AMP-Activated Protein Kinase–Deficient Mice Are Resistant to the Metabolic Effects of Resveratrol , 2009, Diabetes.

[15]  C. Apovian,et al.  Decreased AMP-activated protein kinase activity is associated with increased inflammation in visceral adipose tissue and with whole-body insulin resistance in morbidly obese humans. , 2011, Biochemical and biophysical research communications.

[16]  David Carling,et al.  Structure of Mammalian AMPK and its regulation by ADP , 2011, Nature.

[17]  N. LeBrasseur,et al.  Thiazolidinediones can rapidly activate AMP-activated protein kinase in mammalian tissues. , 2006, American journal of physiology. Endocrinology and metabolism.

[18]  J. Shyy,et al.  Statins Activate AMP-Activated Protein Kinase In Vitro and In Vivo , 2006, Circulation.

[19]  M. Desai,et al.  Obesity is associated with macrophage accumulation in adipose tissue. , 2003, The Journal of clinical investigation.

[20]  L. Sjöström,et al.  The effect of physical training on insulin production in obesity. , 1970, Metabolism: clinical and experimental.

[21]  D. Hardie,et al.  AMPK: a nutrient and energy sensor that maintains energy homeostasis , 2012, Nature Reviews Molecular Cell Biology.

[22]  N. Fujii,et al.  Ablation of AMP-Activated Protein Kinase α2 Activity Exacerbates Insulin Resistance Induced by High-Fat Feeding of Mice , 2008, Diabetes.

[23]  Mengwei Zang,et al.  SIRT 1 Regulates Hepatocyte Lipid Metabolism through Activating AMP-activated Protein Kinase * , 2008 .

[24]  P. Neufer,et al.  Transgenic Mouse Models Resistant to Diet-Induced Metabolic Disease: Is Energy Balance the Key? , 2012, Journal of Pharmacology and Experimental Therapeutics.

[25]  Textbook of Endocrinology , 1956 .

[26]  M. Shong,et al.  Upregulated NLRP3 Inflammasome Activation in Patients With Type 2 Diabetes , 2012, Diabetes.

[27]  D. Hardie,et al.  Metabolism of inflammation limited by AMPK and pseudo-starvation , 2013, Nature.

[28]  M. Vivarelli,et al.  Glucagon‐like peptide‐1 receptor activation stimulates hepatic lipid oxidation and restores hepatic signalling alteration induced by a high‐fat diet in nonalcoholic steatohepatitis , 2011, Liver international : official journal of the International Association for the Study of the Liver.

[29]  M. Czech,et al.  Depot-Specific Differences and Insufficient Subcutaneous Adipose Tissue Angiogenesis in Human Obesity , 2011, Circulation.

[30]  D. Hardie,et al.  AMP-activated protein kinase: ancient energy gauge provides clues to modern understanding of metabolism. , 2005, Cell metabolism.

[31]  Demetrios Vavvas,et al.  Malonyl-CoA, fuel sensing, and insulin resistance. , 1999, American journal of physiology. Endocrinology and metabolism.

[32]  J. Rathmell,et al.  Metabolic regulation of T lymphocytes. , 2013, Annual review of immunology.

[33]  J. Suttles,et al.  Adenosine 5′-Monophosphate-Activated Protein Kinase Promotes Macrophage Polarization to an Anti-Inflammatory Functional Phenotype1 , 2008, The Journal of Immunology.

[34]  Eric Ravussin,et al.  Adipose tissue collagen VI in obesity. , 2009, The Journal of clinical endocrinology and metabolism.

[35]  E. Kraegen,et al.  Pioglitazone treatment activates AMP-activated protein kinase in rat liver and adipose tissue in vivo. , 2004, Biochemical and biophysical research communications.

[36]  A. Choi,et al.  Dampening insulin signaling by an NLRP3 'meta-flammasome' , 2011, Nature Immunology.

[37]  Mengwei Zang,et al.  Polyphenols Stimulate AMP-Activated Protein Kinase, Lower Lipids, and Inhibit Accelerated Atherosclerosis in Diabetic LDL Receptor–Deficient Mice , 2006, Diabetes.

[38]  F. Tinahones,et al.  Oxidative Stress in Severely Obese Persons Is Greater in Those With Insulin Resistance , 2009, Obesity.

[39]  N. Ruderman,et al.  What distinguishes adipose tissue of severely obese humans who are insulin sensitive and resistant? , 2013, Current opinion in lipidology.

[40]  Dorothy D. Sears,et al.  Inverse Regulation of Inflammation and Mitochondrial Function in Adipose Tissue Defines Extreme Insulin Sensitivity in Morbidly Obese Patients , 2013, Diabetes.

[41]  O. Pedersen,et al.  Long-term AICAR administration reduces metabolic disturbances and lowers blood pressure in rats displaying features of the insulin resistance syndrome. , 2002, Diabetes.

[42]  Jill M. Schroeder-Gloeckler,et al.  C/EBPβ is AMP kinase sensitive and up-regulates PEPCK in response to ER stress in hepatoma cells , 2011, Molecular and Cellular Endocrinology.

[43]  M. Prentki,et al.  Coordinate Regulation of Malonyl-CoA Decarboxylase,sn-Glycerol-3-phosphate Acyltransferase, and Acetyl-CoA Carboxylase by AMP-activated Protein Kinase in Rat Tissues in Response to Exercise* , 2002, The Journal of Biological Chemistry.

[44]  N. Ruderman,et al.  Leptinomimetic effects of the AMP kinase activator AICAR in leptin-resistant rats: prevention of diabetes and ectopic lipid deposition , 2004, Diabetologia.

[45]  D. Harrison,et al.  Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. , 2000, Circulation research.

[46]  M. Manco Bariatric Surgery and Reversal of Metabolic Disorders , 2012 .

[47]  R. DeFronzo,et al.  Effect of Acute Exercise on AMPK Signaling in Skeletal Muscle of Subjects With Type 2 Diabetes , 2007, Diabetes.

[48]  E. Kraegen,et al.  Malonyl-CoA and AMP-activated protein kinase (AMPK): possible links between insulin resistance in muscle and early endothelial cell damage in diabetes. , 2001, Biochemical Society transactions.

[49]  Qilong Wang,et al.  Activation of AMP-Activated Protein Kinase Is Required for Berberine-Induced Reduction of Atherosclerosis in Mice: The Role of Uncoupling Protein 2 , 2011, PloS one.

[50]  M. Prentki,et al.  Type 2 diabetes across generations: from pathophysiology to prevention and management , 2011, The Lancet.

[51]  C. Apovian,et al.  Insulin sensitive and resistant obesity in humans: AMPK activity, oxidative stress, and depot-specific changes in gene expression in adipose tissue[S] , 2012, Journal of Lipid Research.

[52]  C. Glass,et al.  Inflammation and lipid signaling in the etiology of insulin resistance. , 2012, Cell metabolism.

[53]  Gaochao Zhou,et al.  AMPK: an emerging drug target for diabetes and the metabolic syndrome. , 2009, Cell metabolism.

[54]  J. Pickup Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. , 2004, Diabetes care.

[55]  G. Paolisso,et al.  Insulin resistance is an independent risk factor for atherosclerosis in rheumatoid arthritis , 2007, Diabetes & vascular disease research.

[56]  P. Puigserver,et al.  AMPK regulates energy expenditure by modulating NAD+ metabolism and SIRT1 activity , 2009, Nature.

[57]  M. Prentki,et al.  Intensive insulin for type 2 diabetes: the risk of causing harm. , 2013, The lancet. Diabetes & endocrinology.

[58]  C. Bouchard,et al.  Bariatric surgery and long-term cardiovascular events. , 2012, JAMA.

[59]  D. Wallace,et al.  Energetics, epigenetics, mitochondrial genetics. , 2010, Mitochondrion.

[60]  P. Libby,et al.  Progress and challenges in translating the biology of atherosclerosis , 2011, Nature.

[61]  Zhenggang Yang,et al.  Macrophage α1 AMP-activated Protein Kinase (α1AMPK) Antagonizes Fatty Acid-induced Inflammation through SIRT1* , 2010, The Journal of Biological Chemistry.

[62]  H. Uzun,et al.  Plasma Protein Carbonyl and Thiol Stress Before and After Laparoscopic Gastric Banding in Morbidly Obese Patients , 2007, Obesity surgery.

[63]  M. Prentki,et al.  Saturated fatty acids synergize with elevated glucose to cause pancreatic beta-cell death. , 2003, Endocrinology.

[64]  P. Björntorp,et al.  Carbohydrate and lipid metabolism in middle-aged, physically well-trained men. , 1972, Metabolism: clinical and experimental.

[65]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[66]  S. Gamblin,et al.  AMP-activated protein kinase: also regulated by ADP? , 2011, Trends in biochemical sciences.

[67]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[68]  André Tchernof,et al.  Pathophysiology of human visceral obesity: an update. , 2013, Physiological reviews.

[69]  N. Ruderman,et al.  AMPK and the biochemistry of exercise: implications for human health and disease. , 2009, The Biochemical journal.

[70]  B. S. Mohammed,et al.  Endoplasmic Reticulum Stress Is Reduced in Tissues of Obese Subjects After Weight Loss , 2009, Diabetes.

[71]  G. Arnaldi,et al.  AMP‐activated protein kinase mediates glucocorticoid‐ induced metabolic changes: a novel mechanism in Cushing's syndrome , 2008, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[72]  N. LeBrasseur,et al.  Acute exercise activates AMPK and eNOS in the mouse aorta. , 2011, American Journal of Physiology. Heart and Circulatory Physiology.

[73]  R. Paffenbarger,et al.  Physical activity as an index of heart attack risk in college alumni. , 1978, American journal of epidemiology.

[74]  S. Uchida,et al.  Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase , 2002, Nature Medicine.

[75]  E. Araki,et al.  Activation of AMP-activated protein kinase reduces hyperglycemia-induced mitochondrial reactive oxygen species production and promotes mitochondrial biogenesis in human umbilical vein endothelial cells. , 2006, Diabetes.

[76]  N. Fujii,et al.  Long-term AICAR administration and exercise prevents diabetes in ZDF rats. , 2005, Diabetes.

[77]  D. Carling,et al.  Thrombin Activates AMP-Activated Protein Kinase in Endothelial Cells via a Pathway Involving Ca2+/Calmodulin-Dependent Protein Kinase Kinase β , 2006, Molecular and Cellular Biology.

[78]  N. Ruderman,et al.  SIRT1 Modulation of the Acetylation Status, Cytosolic Localization, and Activity of LKB1 , 2008, Journal of Biological Chemistry.

[79]  David Carling,et al.  The Anti-diabetic Drugs Rosiglitazone and Metformin Stimulate AMP-activated Protein Kinase through Distinct Signaling Pathways* , 2002, The Journal of Biological Chemistry.

[80]  G. Reaven Role of Insulin Resistance in Human Disease , 1988, Diabetes.

[81]  B. Morley,et al.  A time course and dose-response study of the regulation of brain nicotinic receptors by dietary choline , 1987, Brain Research.

[82]  C. Bouchard,et al.  Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. , 2009, The Lancet. Oncology.

[83]  N. Ruderman,et al.  Insulin sensitivity of rat skeletal muscle: effects of starvation and aging. , 1979, The American journal of physiology.

[84]  D. Hardie,et al.  AMPK activity and isoform protein expression are similar in muscle of obese subjects with and without type 2 diabetes. , 2004, American journal of physiology. Endocrinology and metabolism.

[85]  H. Minuk,et al.  Metabolic syndrome. , 2005, Journal of insurance medicine.

[86]  A. Salminen,et al.  AMP-activated protein kinase inhibits NF-κB signaling and inflammation: impact on healthspan and lifespan , 2011, Journal of Molecular Medicine.

[87]  G. Reaven Banting lecture 1988. Role of insulin resistance in human disease. , 1988, Diabetes.

[88]  C. la Vecchia,et al.  Cancer risk associated with use of metformin and sulfonylurea in type 2 diabetes: a meta-analysis. , 2012, The oncologist.

[89]  Arthur Kaser,et al.  Gut microbiome, obesity, and metabolic dysfunction. , 2011, The Journal of clinical investigation.

[90]  P. Scherer Adipose Tissue , 2006, Diabetes.

[91]  R. Law,et al.  PPARgamma-mediated insulin sensitization: the importance of fat versus muscle. , 2005, American journal of physiology. Endocrinology and metabolism.

[92]  C. Thornton,et al.  AMP-activated protein kinase: new regulation, new roles? , 2012, The Biochemical journal.

[93]  B. Viollet,et al.  AMP-activated protein kinase and metabolic control. , 2011, Handbook of experimental pharmacology.

[94]  Margaret S. Wu,et al.  Role of AMP-activated protein kinase in mechanism of metformin action. , 2001, The Journal of clinical investigation.

[95]  Kunihiro Suzuki,et al.  Metformin Inhibits Cytokine-Induced Nuclear Factor &kgr;B Activation Via AMP-Activated Protein Kinase Activation in Vascular Endothelial Cells , 2006, Hypertension.

[96]  A. Salminen,et al.  Mitochondrial dysfunction and oxidative stress activate inflammasomes: impact on the aging process and age-related diseases , 2012, Cellular and Molecular Life Sciences.

[97]  J. Zierath,et al.  5-Aminoimidazole-4-carboxamide ribonucleoside treatment improves glucose homeostasis in insulin-resistant diabetic (ob/ob) mice , 2002, Diabetologia.

[98]  G. Arnaldi,et al.  Changes in adenosine 5'-monophosphate-activated protein kinase as a mechanism of visceral obesity in Cushing's syndrome. , 2008, The Journal of clinical endocrinology and metabolism.

[99]  B. Kemp,et al.  The Ancient Drug Salicylate Directly Activates AMP-Activated Protein Kinase , 2012, Science.

[100]  Fan Lan,et al.  SIRT1 Regulates Hepatocyte Lipid Metabolism through Activating AMP-activated Protein Kinase* , 2008, Journal of Biological Chemistry.

[101]  G. Shulman,et al.  Effect of AMPK activation on muscle glucose metabolism in conscious rats. , 1999, American journal of physiology. Endocrinology and metabolism.

[102]  H. M. O'Neill,et al.  AMPK and Exercise: Glucose Uptake and Insulin Sensitivity , 2013, Diabetes & metabolism journal.

[103]  F. Reis,et al.  Regular Physical Exercise as a Strategy to Improve Antioxidant and Anti-Inflammatory Status: Benefits in Type 2 Diabetes Mellitus , 2012, Oxidative medicine and cellular longevity.

[104]  Marc Prentki,et al.  Glycerolipid/free fatty acid cycle and islet β-cell function in health, obesity and diabetes , 2012, Molecular and Cellular Endocrinology.

[105]  A. Salminen,et al.  AMP-activated protein kinase (AMPK) controls the aging process via an integrated signaling network , 2012, Ageing Research Reviews.

[106]  M. Fasshauer,et al.  Insulin-sensitive obesity. , 2010, American journal of physiology. Endocrinology and metabolism.

[107]  B. Viollet,et al.  Cellular and molecular mechanisms of metformin: an overview. , 2012, Clinical science.

[108]  T. Noda,et al.  Pioglitazone Ameliorates Insulin Resistance and Diabetes by Both Adiponectin-dependent and -independent Pathways* , 2006, Journal of Biological Chemistry.

[109]  T. Kadowaki,et al.  Adiponectin and adiponectin receptors. , 2005, Endocrine reviews.

[110]  B. Kemp,et al.  Contraction-induced Changes in Acetyl-CoA Carboxylase and 5′-AMP-activated Kinase in Skeletal Muscle* , 1997, The Journal of Biological Chemistry.

[111]  L. Guarente,et al.  Unlocking the secrets of longevity genes. , 2006, Scientific American.

[112]  N. Ruderman,et al.  AMPK and SIRT1: a long-standing partnership? , 2010, American journal of physiology. Endocrinology and metabolism.

[113]  David Carling,et al.  A common bicyclic protein kinase cascade inactivates the regulatory enzymes of fatty acid and cholesterol biosynthesis , 1987, FEBS letters.

[114]  H. Lodish,et al.  Enhanced muscle fat oxidation and glucose transport by ACRP30 globular domain: Acetyl–CoA carboxylase inhibition and AMP-activated protein kinase activation , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[115]  B. Viollet,et al.  AMP-activated Protein Kinase α2 Subunit Is Required for the Preservation of Hepatic Insulin Sensitivity by n-3 Polyunsaturated Fatty Acids , 2010, Diabetes.

[116]  H. Choi,et al.  Reduction of AMP-Activated Protein Kinase &agr;2 Increases Endoplasmic Reticulum Stress and Atherosclerosis In Vivo , 2010, Circulation.

[117]  J. Keaney,et al.  AMPK inhibits fatty acid-induced increases in NF-kappaB transactivation in cultured human umbilical vein endothelial cells. , 2004, Biochemical and biophysical research communications.

[118]  P. Ortiz de Montellano,et al.  AMP‐activated protein kinase phosphorylation of endothelial NO synthase , 1999, FEBS letters.

[119]  Eric Ravussin,et al.  Calorie Restriction Increases Muscle Mitochondrial Biogenesis in Healthy Humans , 2007, PLoS medicine.

[120]  Surgeon General's report on physical activity and health. From the Centers for Disease Control and Prevention. , 1996, JAMA.

[121]  Kunihiro Suzuki,et al.  Metformin Inhibits Cytokine-Induced Nuclear Factor , 2006 .

[122]  B. Kemp,et al.  Hematopoietic AMPK β1 reduces mouse adipose tissue macrophage inflammation and insulin resistance in obesity. , 2011, The Journal of clinical investigation.

[123]  R. Frisch,et al.  Lower Prevalence of Diabetes in Female Former College Athletes Compared With Nonathletes , 1986, Diabetes.

[124]  D. Carling,et al.  Hyperglycemia-induced apoptosis in human umbilical vein endothelial cells: inhibition by the AMP-activated protein kinase activation. , 2002, Diabetes.

[125]  P. Puigserver,et al.  The sirtuin family's role in aging and age-associated pathologies. , 2013, The Journal of clinical investigation.

[126]  D. Chisholm,et al.  The metabolically obese, normal-weight individual revisited. , 1998, Diabetes.

[127]  R. de Cabo,et al.  SIRT1 is required for AMPK activation and the beneficial effects of resveratrol on mitochondrial function. , 2012, Cell metabolism.

[128]  R. Ulrich,et al.  Insulin Secretory Defect in Zucker fa/fa Rats Is Improved by Ameliorating Insulin Resistance , 1995, Diabetes.

[129]  Y. Hayashi,et al.  Adiponectin and AdipoR1 regulate PGC-1α and mitochondria by Ca2+ and AMPK/SIRT1 , 2010, Nature.

[130]  R. Burcelin,et al.  Immuno-microbiota cross and talk: the new paradigm of metabolic diseases. , 2012, Seminars in immunology.

[131]  K. Clément,et al.  Increased Adipose Tissue Oxygen Tension in Obese Compared With Lean Men Is Accompanied by Insulin Resistance, Impaired Adipose Tissue Capillarization, and Inflammation , 2011, Circulation.

[132]  A. Farmer,et al.  Cancer outcomes and all-cause mortality in adults allocated to metformin: systematic review and collaborative meta-analysis of randomised clinical trials , 2012, Diabetologia.

[133]  H. Klein,et al.  In vivo metformin treatment ameliorates insulin resistance: evidence for potentiation of insulin-induced translocation and increased functional activity of glucose transporters in obese (fa/fa) Zucker rat adipocytes. , 1993, Endocrinology.

[134]  E. Abel,et al.  Endothelial nitric oxide synthase phosphorylation in treadmill‐running mice: role of vascular signalling kinases , 2009, The Journal of physiology.

[135]  Anita Y. M. Chan,et al.  Resveratrol Prevents the Prohypertrophic Effects of Oxidative Stress on LKB1 , 2009, Circulation.

[136]  M. Yanagisawa,et al.  ETB receptor activation leads to activation and phosphorylation of NHE3. , 1999, American journal of physiology. Cell physiology.

[137]  Karen Gallagher-Dorval,et al.  Body mass index-independent inflammation in omental adipose tissue associated with insulin resistance in morbid obesity. , 2011, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[138]  Dm Berwick,et al.  SURGEON GENERAL'S REPORT ON PHYSICAL ACTIVITY AND HEALTH. , 1996 .

[139]  G. Reaven Banting lecture 1988 , 1997 .

[140]  J. Olefsky,et al.  The Origins and Drivers of Insulin Resistance , 2013, Cell.

[141]  R. Heath,et al.  Defining the Mechanism of Activation of AMP-activated Protein Kinase by the Small Molecule A-769662, a Member of the Thienopyridone Family* , 2007, Journal of Biological Chemistry.

[142]  M. A. Saad,et al.  Modulation of gut microbiota by antibiotics improves insulin signalling in high-fat fed mice , 2012, Diabetologia.

[143]  J. Olefsky,et al.  Increased Malonyl-CoA Levels in Muscle From Obese and Type 2 Diabetic Subjects Lead to Decreased Fatty Acid Oxidation and Increased Lipogenesis; Thiazolidinedione Treatment Reverses These Defects , 2006, Diabetes.

[144]  D. Hardie AMP-activated protein kinase: an energy sensor that regulates all aspects of cell function. , 2011, Genes & development.

[145]  Jeffrey I. Gordon,et al.  Mechanisms underlying the resistance to diet-induced obesity in germ-free mice , 2007, Proceedings of the National Academy of Sciences.

[146]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[147]  T. Kadowaki,et al.  Adiponectin receptor as a key player in healthy longevity and obesity-related diseases. , 2013, Cell metabolism.

[148]  K. Clément,et al.  Expression of NLRP3 inflammasome and T cell population markers in adipose tissue are associated with insulin resistance and impaired glucose metabolism in humans. , 2012, Molecular immunology.

[149]  E. Lander,et al.  Reactive oxygen species have a causal role in multiple forms of insulin resistance , 2006, Nature.

[150]  D. Hardie,et al.  AMP-activated protein kinase, a metabolic master switch: possible roles in Type 2 diabetes. , 1999, American journal of physiology. Endocrinology and metabolism.

[151]  N. Ruderman,et al.  Muscle glucose metabolism following exercise in the rat: increased sensitivity to insulin. , 1982, The Journal of clinical investigation.

[152]  M. Prentki,et al.  AMP kinase and malonyl-CoA: targets for therapy of the metabolic syndrome , 2004, Nature Reviews Drug Discovery.

[153]  N. Ruderman,et al.  Mice Lacking Adiponectin Show Decreased Hepatic Insulin Sensitivity and Reduced Responsiveness to Peroxisome Proliferator-activated Receptor γ Agonists* , 2006, Journal of Biological Chemistry.

[154]  Alexander S. Banks,et al.  Sirtuin 1 and sirtuin 3: physiological modulators of metabolism. , 2012, Physiological reviews.

[155]  A. Means,et al.  Calcium/Calmodulin-dependent Protein Kinase Kinase 2: Roles in Signaling and Pathophysiology* , 2012, The Journal of Biological Chemistry.

[156]  S. Grundy,et al.  Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International As , 2009, Circulation.

[157]  L. Tartaglia,et al.  Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. , 2003, The Journal of clinical investigation.

[158]  D. Bagchi,et al.  Obesity : Epidemiology, Pathophysiology, and Prevention , 2007 .

[159]  A. Chawla,et al.  Cidea is associated with lipid droplets and insulin sensitivity in humans , 2008, Proceedings of the National Academy of Sciences.

[160]  B. Kemp,et al.  AMPK Is a Direct Adenylate Charge-Regulated Protein Kinase , 2011, Science.