help button home button Endocrine Society Endocrinology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Knutson, V. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Knutson, V. P.
Endocrinology Vol. 141, No. 2 693-701
Copyright © 2000 by The Endocrine Society


ARTICLES

The Release of Lipoprotein Lipase from 3T3-L1 Adipocytes Is Regulated by Microvessel Endothelial Cells in an Insulin-Dependent Manner

Victoria P. Knutson

Department of Integrative Biology and Pharmacology, University of Texas Health Science Center, Medical School, Houston, Texas 77225

Address all correspondence and requests for reprints to: Victoria P. Knutson, Ph.D., Department of Integrative Biology, Pharmacology, and Physiology, University of Texas Health Science Center, Medical School, 6431 Fannin, Houston, Texas 77225. E-mail: vknutson{at}farmr1.med.uth.tmc.edu


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Lipoprotein lipase (LPL) is the rate-limiting enzyme in the hydrolysis of serum triglycerides associated with the lipoprotein particles very low density lipoprotein and chylomicrons. The cell biology of LPL is complex. It functions while tethered to the extracellular matrix of the capillary endothelium. LPL is synthesized, however, in the parenchymal cells (for example, adipocytes or muscle cells) subtending the endothelium. Thus, after synthesis in and release by the parenchymal cell, LPL must move to the endothelial cell and across this cell monolayer before expression at its physiologically relevant location. LPL expression on the endothelium is regulated by insulin. The intent of this study was to ascertain the role of microvessel endothelial cells in the release of LPL from 3T3-L1 adipocytes and to ascertain whether insulin regulates the function of the endothelial cells. Endothelial cells were treated with insulin, and the resultant culture medium conditioned by the endothelial cells was placed on 3T3-L1 adipocytes. The release of LPL from the adipocytes induced by the endothelial cell-conditioned medium was then quantitated. Insulin concentrations as low as 100 pM stimulated the release of a factor from the endothelial cells. This factor, when added to adipocytes, caused the quantitative release of LPL from the plasma membrane of the adipocytes. The effect of insulin on the endothelial cells was maximal within 15 min of insulin addition to the endothelial cells. Repeated challenges of the endothelial cells with insulin resulted in the repeated release of the LPL release factor from the endothelial cells if the challenges were separated by periods of 2–3 h. However, if the endothelial cells were chronically stimulated with insulin for 18 h, a subsequent acute stimulation with insulin did not generate any LPL release factor. Thus, microvessel endothelial cells regulate the mobilization of LPL from adipocytes in an insulin-dependent manner.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
LIPOPROTEIN LIPASE (LPL) is the rate-limiting enzyme in the hydrolysis of serum triglycerides derived from the triglyceride-rich lipoprotein particles [very low density lipoproteins (VLDL) and chylomicrons]. The triglycerides liberated by LPL are used by the underlying parenchymal cells for storage or fuel. Thus, LPL is an important enzyme for the metabolic homeostasis of these tissues and a regulator of serum triglycerides (1). LPL is a glycoprotein with a mass of 55 kDa and is catalytically active as a homodimer (2). In a physiological context, LPL is active while anchored to the heparan sulfate proteoglycan (HSP) of the extracellular matrix of endothelial cells in small and large blood vessels. LPL is activated by apolipoprotein C-II, which is found in high density lipoproteins (HDL), VLDL, and chylomicrons. It has multiple domains that are not only responsible for enzymatic activity, but also facilitate the binding of LPL to lipids and proteins (3).

As might be expected for an enzyme that is rate limiting for serum triglyceride hydrolysis, the physiological impact of LPL deficiency or overexpression is dramatic. Familial LPL deficiency is an autosomal recessive disorder characterized by fasting hypertriglyceridemia, accumulation of chylomicrons due to their delayed clearance, and elevated cholesterol levels (4, 5). Patients with this deficiency present in childhood with severe abdominal pain, pancreatitis, and failure to thrive. The lipid and lipoprotein profile of these patients, especially their total cholesterol/HDL ratio, predicts an increased risk for coronary artery disease (4). The targeted disruption of the LPL gene in mice leads to severe hypertriglyceridemia, with death occurring in neonates (6). Muscle-specific (6) or liver-specific (7) replacement of LPL in the knockout animals partially normalized their lipid profiles, but physiological consequences were still apparent. Overexpression of LPL in obese rodents prevented diet-induced obesity (8). Thus, the regulation of LPL expression is critically important for normal lipid-lipoprotein homeostasis.

The cell biology of LPL is complex and unique. Although the enzyme is catalytically active and physiologically relevant while tethered to the glycocalyx on the luminal membrane of endothelial cells, the enzyme is synthesized in the underlying parenchymal cells, especially adipose and muscle cells (9, 10). No messenger RNA for LPL has been detected in endothelial cells (10). Therefore, LPL must be synthesized in and released from the adipocyte/myocyte, move across the interstitial fluid, associate with the basal surface of the endothelial cell, and subsequently move across the endothelial monolayer for ultimate expression on the luminal surface of the endothelial cell. The regulation of these processes is incompletely understood.

LPL synthesis in adipocytes has been shown to be regulated by insulin (11, 12, 13), but with the complex intra- and intercellular itinerary of LPL, there is the potential for the insulin-mediated regulation of this important enzyme at multiple steps of its routing from the adipocyte to the luminal domain of the endothelial cell. The intent of this study was to focus on early steps in the intercellular routing of LPL and determine whether cultured endothelial cells modulate the release of LPL from cultured 3T3-L1 adipocytes in an insulin-regulated manner. The results demonstrate that endothelial cells isolated from adipose tissue are highly insulin responsive, and insulin stimulation of the endothelial cells results in the release from the endothelial cells of a factor that mobilizes LPL from the adipocytes.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Cell culture
3T3-L1 preadipocytes were obtained from Dr. M. Daniel Lane (Johns Hopkins University Medical School, Baltimore, MD) and cultured and differentiated into adipocytes as previously described (14, 15). Unless otherwise noted, the cells were grown in 100-mm dishes (Falcon, Becton Dickinson and Co., Mountain View, CA) to a fully differentiated, insulin-free state. Twenty-four hours before an experiment, the 3T3-L1 adipocytes were switched to a basal medium that had been stripped of endogenous, serum-derived hormones. To achieve this, the medium on the cells was replaced with DMEM containing 1% charcoal-stripped, heat-inactivated FBS. The FBS was charcoal stripped and heat inactivated by adding to FBS 0.25% activated charcoal (Norit-A, Sigma, St. Louis, MO) and 0.0025% Dextran T-70 (Pharmacia Biotech, Piscataway, NJ). The mixture was stirred at 4 C overnight and then incubated at 56 C for 1 h. The charcoal was removed by centrifugation at 18,000 x g for 30 min. The charcoal and heat treatment was then repeated a second time. The FBS was then filter sterilized and stored at -20 C.

Human adipose endothelial (HAE) cells were isolated from abdominal adipose tissue removed by liposuction, as previously described (16, 17). The endothelial cells were further purified from contaminating fibroblasts by incubation in medium 199 formulated with D-valine instead of L-valine (Sigma), as we have previously described for the isolated of bovine aorta endothelial cells (18). For optimal growth, the HAE cells were seeded onto 100-mm plastic dishes (Falcon, Becton Dickinson and Co.) that had been precoated overnight at 37 C with 2.5 ml 5 µg/ml fibronectin (Sigma) in medium 199. The cells were split at a 1:3 ratio and were grown in medium 199 containing 10% FBS and supplemented with 4 mM glutamine, 100 U/ml heparin (Sigma), 12.5 µg/ml endothelial cell growth factor (Collaborative Research, Waltham, MA), 0.1% fungizone (Life Technologies, Inc./BRL, Gaithersburg, MD), 0.1 mM penicillin G and 41 µM streptomycin sulfate. The HAE cells could be serially passaged up to 20 times and maintain endothelial cell characteristics such as lectin binding, vonWillibrand factor production, and the binding and degradation of acetylated LDL (18) (data not shown). All cell monolayers were fully confluent at the time of use.

Bovine aorta endothelial (BAE) cells were isolated and maintained as we have previously described (18). These cells were serially passaged from primary cultures of BAE cells, and the cells used in these experiments were from early passages (passages 8–10) derived from the primary cultures.

LPL assay
LPL activity was quantitated as previously described (19) using rat serum (Pelfreeze Biologicals, Rogers, AR) as a source of the LPL cofactor apolipoprotein CII and [3H]triolein (glycerol tri-[9,10(N)-3H]oleate, NEN Life Science Products, Boston, MA) as substrate in a glycerol emulsion. To each tube, 100 µl cell culture medium from the adipocytes were added to 100 µl substrate emulsion, and after mixing, the samples were incubated at 37 C for 1 h. The reaction was terminated, and the liberated free fatty acids were retained in the aqueous phase after extraction into organic solvents. The aqueous phase was subjected to scintillation counting and quantitated by the method of internal standards. The rate of production of free fatty acids was linear for at least 90 min under these assay conditions. One milliunit of activity is represented by the release of 1 nmol fatty acid/min.

LPL activity associated with the 3T3-L1 adipocytes was quantitated as insulin-releasable activity, heparin-releasable activity, or the residual cell-associated activity. Insulin-releasable activity was determined by incubating 3T3-L1 adipocytes with the indicated concentration of insulin for the indicated periods of time in DMEM-1% charcoal-stripped-FBS. The culture medium was then removed from the monolayers and immediately assayed for LPL activity, or the samples were quick-frozen in a dry ice-acetone slurry and stored at -80 C. Immediately after LPL release by insulin, heparin-releasable LPL activity was determined by replacing fresh medium (DMEM-1% charcoal-stripped FBS) on the cells containing the indicated concentration of heparin for the indicated period of time. The culture medium was then removed from the cells and immediately assayed for LPL activity, or the medium was quick-frozen and stored at -80 C. Residual cell-associated LPL activity was assessed after maximal release of cell surface LPL by insulin and heparin treatment. After heparin release, the monolayers were rapidly washed in PBS, and the adipocytes were delipidated by extraction in acetone, as previously described (12). The resultant dried acetone powders were resuspended in 50 mM NH4Cl (pH 8.1), 0.4% Triton X-100, and 0.04% SDS with a motorized Teflon pestle in a Dounce homogenizer (Kontes Co., Vineland, NJ), and assayed for LPL activity within 30 min of resuspension.

Each experimental point was obtained from two 100-mm dishes of adipocytes, assayed in duplicate. The data are adjusted to represent the LPL activity obtained per 100-mm dish of confluent cells.

LPL release activity from HAE cells
Twenty-four hours before an experiment, the HAE cell monolayers were treated to remove the supplements to the cell culture medium and remove any serum-derived hormones. To achieve this, the cells were washed three times with sterile PBS, and the medium replaced on the cells was DMEM containing 1% charcoal-stripped FBS. Immediately before use, the HAE cells were again washed with PBS before the addition of DMEM and 1% charcoal-stripped FBS in the presence or absence of the indicated concentration of insulin.

Statistical analyses
All data are presented as the average ± the variance of the data. Statistical significance was determined by two-tailed t tests with comparisons between the insulin-treated and insulin-free samples. P < 0.05 is considered significant and is denoted by an asterisk in the figures.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Insulin and heparin treatments of the 3T3-L1 adipocytes were first examined to assess maximal LPL release. To determine the effect of insulin stimulation of the 3T3-L1 adipocytes on LPL release from the cells, the cells were stimulated with 100 nM insulin for variable time periods. The cell culture medium was then collected and assayed for LPL activity. The results, shown in Fig. 1AGo demonstrate that maximal release of LPL activity from the adipocytes required 45–60 min. These results are consistent with data presented by others (20), in which maximal release was found between 30–60 min of stimulation. To determine the insulin concentration dependence of this release, the adipocytes were incubated with variable insulin concentrations for 60 min before harvesting the medium and quantitating LPL activity released from the adipocytes. As shown in Fig. 1BGo, insulin induced a 4.4-fold increase in LPL release from the adipocytes, with an EC50 of approximately 0.25 nM and with maximal stimulation apparent at 1 nM. Further increasing the insulin concentration to 100 nM resulted in the same level of LPL release as that demonstrated with 10 nM insulin (data not shown). Other investigators have reported comparable EC50 values for insulin-induced release of LPL from 3T3-L1 adipocytes and other cultured adipose cells (11, 20).



View larger version (15K):
[in this window]
[in a new window]
 
Figure 1. The insulin-induced release of LPL from 3T3-L1 adipocytes. Fully differentiated 3T3-L1 adipocytes were treated with insulin, and LPL activity released into the cell culture medium was quantitated. A, Time course of insulin-induced release of LPL. Adipocytes were incubated in the absence ({circ}) or presence (•) of 100 nM insulin for the indicated periods of time. The cell culture medium was then collected and assayed for LPL activity. B, Insulin concentration response for the release of LPL from the adipocytes. The adipocytes were incubated with the indicated concentration of insulin for 60 min. The cell culture medium bathing the cells was then collected and assayed for LPL activity.

 
The effect of heparin on the release of LPL from the 3T3-L1 adipocytes is shown in Fig. 2Go. Using a heparin concentration of 100 µg/ml, the time course of LPL release from the adipocyte was rapid (Fig. 2AGo), with maximal release occurring by 15 min, the earliest time point examined. The rapid release of LPL by heparin shown here is consistent with the short periods of heparin release used by other investigators (13). The heparin concentration dependence of LPL release from the adipocytes (Fig. 2BGo) demonstrates that maximal LPL release was achieved with a heparin concentration of 100 µg/ml. These high heparin concentrations were also used by others (13) for maximal release of LPL activity from the adipocytes. In all subsequent experiments, maximal heparin release was achieved with 100 µg/ml heparin for 20 min.



View larger version (16K):
[in this window]
[in a new window]
 
Figure 2. The heparin-induced release of LPL from 3T3-L1 adipocytes. Fully differentiated 3T3-L1 adipocytes were treated with heparin, and the LPL activity released into the cell culture medium was quantitated. A, The time course of heparin-induced release of LPL. Adipocytes were incubated in the absence ({circ}) or presence (•) of 100 µg/ml heparin for the indicated periods of time. The cell culture medium bathing the cells was then collected and assayed for LPL activity. B, Heparin concentration-response profile for the release of LPL from adipocytes. The indicated concentrations of heparin were incubated with the adipocytes for 20 min. The cell culture medium was then collected and assayed for LPL activity.

 
A comparison was then made of the cellular distribution of LPL in 3T3-L1 adipocytes before and after 1 h of insulin stimulation. The comparison was performed in basal, insulin-sensitive adipocytes, or with adipocytes that had been desensitized to insulin stimulation by chronic pretreatment with insulin. We have previously demonstrated that this chronic pretreatment with insulin leads to the desensitization of the adipocytes with respect to insulin-induced lipogenesis, glycogen synthesis, and glucose transport (21). The basal and desensitized cells were treated with or without 100 nM insulin for 60 min, and the medium bathing the cells was collected to determine basal or insulin-releasable LPL activity. Immediately after insulin stimulation, heparin (100 µg/ml) was added to the cells for 20 min, and the medium was collected to assess heparin-releasable LPL activity. After heparin release, the adipocytes were washed with PBS, scraped from the dish, and delipidated through the generation of an acetone powder. As insulin and heparin treatment of the cells should release all LPL activity associated with the plasma membrane of the cell (22), the LPL activity associated with the resuspended acetone powder should represent intracellular lipase. The results of this analysis are shown in Fig. 3Go. In the basal cells, in the absence of insulin stimulation, only 1.6% of the total cellular LPL activity (defined as insulin-releasable plus heparin-releasable plus residual cell-associated LPL activity) was released from the cells into the medium over a 1-h period. The majority (65.7%) of the total cellular activity could be released from the cell by heparin. Upon stimulation of the cells with insulin for 1 h, total cellular LPL activity increased by 1.44-fold, from 76.1 to 109.4 mU/dish. Although insulin increased the release of LPL into the cell culture medium by 6-fold (from 1.2 to 7.1 mU/dish), a large, 1.7-fold increase in heparin-releasable LPL activity was induced by insulin (from 50 mU/dish in the basal cells to 86.6 mU/dish in the stimulated cells). Insulin treatment did not significantly modify the level of intracellular LPL activity.



View larger version (34K):
[in this window]
[in a new window]
 
Figure 3. The subcellular distribution of LPL activity in 3T3-L1 adipocytes. Adipocytes were made insulin resistant (desensitized) by treatment with 100 nM insulin for 18 h. The treated cells were then exhaustively washed to remove the desensitizing dose of insulin. Basal, naive adipocytes (left panel) or desensitized adipocytes (right panel) were treated in the absence (solid bar) or presence (hatched bar) of 100 nM insulin for 60 min. Cell culture medium was collected from the cells and assayed for LPL activity (Medium). Culture medium containing 100 µg/ml heparin was immediately placed upon the cells. After 20 min, the heparin-containing medium was collected and assayed for LPL activity (Hep). The cell monolayers were then washed with PBS, and the residual LPL activity associated with the cells was determined, as described in Materials and Methods (Cell). Statistically significant differences in values obtained from insulin-free and insulin-treated cells are denoted by an asterisk.

 
Chronic treatment of the adipocytes with insulin (desensitized cells) did not lead to notable changes in the distribution of LPL over what was found in the acutely stimulated cells. Total cellular LPL activity after acute stimulation was nearly identical to total cellular LPL activity after chronic stimulation (109.4 and 109.7 mU/dish, respectively).

In summary, a 1-h insulin treatment of the adipocytes led to a 1.8-fold increase in the LPL activity available at the plasma membrane of the adipocyte (insulin-releasable plus heparin-releasable), with no further sizable change upon insulin challenge for 18 h.

Under physiological conditions, insulin released from the pancreas into the blood first encounters the endothelial cells of the microvasculature before moving across the vessel wall and binding to the insulin receptor on the adipocytes. Therefore, it was of interest to ascertain whether insulin stimulation of endothelial cells isolated from adipose tissue would result in the release of a factor from the endothelial cells that would liberate LPL activity from the 3T3-L1 adipocytes. Confluent cultures of HAE cells on a plastic substrate were stimulated in the presence or absence of 10 nM insulin for up to 90 min. This HAE cell-conditioned culture medium (which, for the insulin-treated cells, contained 10 nM insulin) was removed from the HAE cells and placed upon 3T3-L1 adipocytes for 1 h. Medium was then removed from the adipocytes and assayed for LPL activity. The results of this experiment are shown in Fig. 4Go. For the zero time point, the adipocytes were incubated for 1 h with fresh medium in the presence or absence of 10 nM insulin. Thus, the difference in the zero time values is due solely to insulin-induced release of LPL from the adipocytes, with no contribution in the zero time LPL values from HAE cell-derived factors. In the absence of insulin stimulation, the HAE cells released an activity that caused a low level of release of LPL activity from the adipocytes. Maximal release of this activity was attained after 30 min of incubation with the HAE cells, and thereafter was maintained for up to 90 min. Treatment of the HAE cells with 10 nM insulin resulted in the rapid production of a factor that caused high levels of release of LPL from the adipocytes. Maximal LPL release activity was obtained from the HAE cells at 5–20 min of stimulation with insulin. By 30 min of insulin stimulation, this activity had declined to near-basal levels. As insulin was added to the culture medium bathing the HAE cells, and because it is unlikely that all of the added insulin was degraded over the short incubation periods with the HAE cells, this insulin was carried over into the subsequent incubations with the adipocytes. This direct effect of insulin on the adipocytes led to the release of LPL from the adipocytes and contributed a uniform 8–10 mU/dish of LPL activity to each "+Ins" data point shown in Fig. 4Go. From these data, it is apparent that insulin stimulation of the HAE cells results in the rapid, but transient, release of a factor that induces the release of LPL activity from the 3T3-L1 adipocytes.



View larger version (20K):
[in this window]
[in a new window]
 
Figure 4. The insulin-induced release of an LPL release factor from endothelial cells. Confluent HAE cells were incubated with (•) or without ({circ}) 100 nM insulin for the indicated periods of time. The endothelial cell-conditioned cell culture medium was then immediately added to 3T3-L1 adipocytes and incubated for 60 min. The culture medium was then removed from the adipocytes and assayed for LPL activity.

 
The level of LPL activity released from the adipocytes by the HAE cell release factor approximates the LPL activity that can be released by heparin (Fig. 3Go). Therefore, to determine the amount of LPL activity remaining on the adipocytes after stimulation with the HAE cell release factor, HAE cells were incubated with 10 nM insulin for 15 min, and the conditioned cell culture medium was collected from the HAE cells and added to the 3T3-L1 adipocytes for 1 h. The 3T3-L1 cells were then immediately incubated with 100 µg/ml heparin for 30 min, and the collected samples were assayed for LPL activity. It was consistently found that less than 10 mU/dish of LPL activity could be released by heparin from the adipocytes after the release of LPL by the HAE cell-derived factor (data not shown). Therefore, the insulin-induced factor derived from the HAE cells releases most, if not all, of the LPL activity present on the surface of the adipocytes.

To assess the specificity of the release of the insulin-induced LPL release factor, endothelial cells isolated from macrovessels, BAE cells, were incubated in the presence or absence of 100 nM insulin for various periods of time, and the cell culture medium was collected and subsequently added to 3T3-L1 adipocytes for 1 h. The culture medium from the adipocytes was then harvested, and LPL activity released into the medium was quantitated. The results of this experiment are shown in Fig. 5Go. In the absence of insulin stimulation, conditioned media derived from the BAE cells contained no activity that stimulated the release of LPL from the adipocytes. In the presence of insulin, no increase in LPL release activity, above that induced by insulin alone, could be detected for the first 20 min of stimulation. By 45 min, the release of LPL from the adipocytes was stimulated 1.4-fold above that seen with insulin alone. With time, the BAE cells may release greater levels of a LPL release factor, but over the period when HAE cells are highly responsive to insulin, BAE cells are not. Thus, there is a degree of specificity in the expression and/or insulin sensitivity of the release of endothelial cell-derived LPL release factor. The microvessel-derived HAE cells are insulin responsive, whereas the macrovessel-derived BAE cells are not.



View larger version (18K):
[in this window]
[in a new window]
 
Figure 5. The insulin-induced release of an LPL release factor from macrovessel, bovine aorta endothelial cells. Early passage BAE cells were cultured under the conditions described for HAE cells. Confluent cultures were incubated with (•) or without ({circ}) 100 nM insulin for the indicated periods of time. The endothelial cell-conditioned cell culture medium was immediately added to 3T3-L1 adipocytes and incubated for 60 min. The culture medium was then harvested from the adipocytes and assayed for LPL activity.

 
The insulin concentration profile for the production of the HAE cell-derived factor is shown in Fig. 6AGo. The HAE cells were incubated with the indicated concentration of insulin for 20 min, and the conditioned medium was collected from the cell monolayers. Conditioned medium was then added to 3T3-L1 adipocytes for 60 min, and medium was collected and assayed for LPL activity. The insulin concentration that produced half-maximal LPL release was approximately 0.5 nM, and maximal release factor was generated at 5 nM insulin. The open circle demonstrates the release of LPL from the adipocytes incubated with 10 nM insulin in the absence of any endothelial cell-derived factors.



View larger version (17K):
[in this window]
[in a new window]
 
Figure 6. The insulin-induced release of the LPL release factor from microvessel endothelial cells. A, The insulin concentration-response profile of the production of the LPL release factor by endothelial cells. HAE cells were incubated with the indicated concentration of insulin for 20 min. The cell culture medium was removed from the endothelial cells, added to 3T3-L1 adipocytes, and allowed to incubate for 60 min. The cell culture medium was then removed from the adipocytes and assayed for LPL activity. The open circle denotes LPL activity released from the adipocytes by insulin alone, in the absence of the endothelial cell conditioned medium. B, Time course of the release of LPL activity from adipocytes by the endothelial cell-derived LPL release factor. Endothelial cells were incubated with 10 nM insulin for 20 min. The conditioned medium was then removed from the endothelial cells and placed on the adipocytes for the indicated periods of time. The medium was removed from the adipocytes and assayed for LPL activity. The open circle denotes the level of LPL released from the adipocytes by 10 nM insulin alone in the absence of endothelial cell-derived factors.

 
The time course for the release of LPL from adipocytes by the HAE cell-derived factor is shown in Fig. 6BGo. The HAE cells were incubated with 10 nM insulin for 20 min, and the conditioned medium was collected. The conditioned medium was then added to 3T3-L1 adipocytes for the indicated periods of time, and the medium was collected and assayed for LPL activity. The release of LPL from the adipocytes by the HAE cell-derived factor was rapid, attaining maximal release in 30 min, with a half-time of approximately 15 min.

The effect of repeated challenges with insulin on the release of the factor from the HAE cells was then determined (Fig. 7Go). The HAE cells were treated with 10 nM insulin over a 30-min time course, and medium was collected and assayed by the release of LPL from the adipocytes (challenge 1). The cells were then washed, and insulin-free cell culture medium was replaced on the cells for 2.5 h. The cells were stimulated a second time with 10 nM insulin over a 30-min time course, and the medium was collected and again assayed by the release of LPL from the adipocytes (challenge 2). A separate set of HAE cells was treated with 100 nM insulin for 18 h, conditions that desensitize 3T3-L1 adipocytes to subsequent insulin stimulation. These desensitized HAE cells were washed extensively to remove the insulin and then restimulated with 10 nM insulin over a 30-min time course, and the medium was collected and assayed by release of LPL from the naive adipocytes (desensitized). The results from this experiment are shown in Fig. 7Go. After a rest period of 2.5 h, the HAE cells responded to a second challenge with insulin in a manner as robust as the initial challenge; the amplitude of the response and the time course of the response are as extensive in the second insulin challenge as in the first. However, if the HAE cells were chronically stimulated with insulin, the maximal level of LPL-releasing factor generated by the HAE cells in response to a subsequent acute insulin challenge was decreased by a factor of 4 when comparing the 15-min time point and correcting for zero time levels of LPL release. These data demonstrate that the release of LPL from the adipocytes is mediated through the response of the endothelial cells to insulin.



View larger version (26K):
[in this window]
[in a new window]
 
Figure 7. The effect of repeated insulin challenge on the ability of the endothelial cells to produce the LPL release factor. Basal, naive endothelial cells were incubated with 10 nM insulin for the indicated periods of time, and culture medium bathing the cells was collected and added to adipocytes for 60 min. Medium was then collected from the adipocytes and assayed for LPL activity (•). The same endothelial cells were washed to remove any residual insulin, and then incubated in basal medium for 2.5 h. The endothelial cells were rechallenged with insulin, the endothelial cell-conditioned medium was incubated with adipocytes, and the resultant medium was assayed for LPL activity ({circ}). A second set of endothelial cells was incubated with 100 nM insulin for 18 h. These desensitized endothelial cells were washed to remove insulin and were then incubated with 10 nM insulin for the indicated periods of time. The conditioned medium was removed from the desensitized endothelial cells and added to adipocytes for 60 min, and then the medium was removed from the adipocytes and assayed for LPL activity ({blacktriangleup}). A parallel set of endothelial cells was incubated in the absence of insulin for the indicated periods of time, and after incubation of this conditioned medium with the adipocytes for 60 min, the resultant medium was assayed for LPL activity ({triangleup}).

 
The adipocytes used in the experiment shown in Fig. 7Go were basal, nonstimulated cells. An identical experiment was performed in which the adipocytes were chronically pretreated with 100 nM insulin for 18 h, washed to remove the insulin, and then incubated with medium conditioned by the HAE cells, as described in Fig. 7Go. With the desensitized adipocytes, results identical to those shown in Fig. 7Go were obtained. Conditioned medium derived from acutely insulin-challenged HAE cells induced the release of LPL from the desensitized adipocytes, but conditioned medium obtained from desensitized HAE cells induced a blunted release of LPL from the desensitized adipocytes (data not shown). These data further substantiate the conclusion that the regulation of release of LPL from the 3T3-L1 adipocytes is in part mediated through the response of the endothelial cells to insulin.


    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
LPL activity can be released from 3T3-L1 adipocytes by both insulin and heparin in a concentration- and time-dependent manner. The mechanisms by which insulin and heparin release LPL activity from the adipocytes are not well defined. Some investigators have referred to heparin as a secretagogue (1), thereby implying that the released LPL is initially present in intracellular secretory vesicles, which fuse with the plasma membrane of the adipocyte upon stimulation with heparin. Other data indicate that there is a heparin-binding site on the LPL dimer, which binds to the HSP extracellular matrix of the adipocyte. Addition of heparin to the cells displaces the plasma membrane-bound LPL by competition with the HSP, resulting in the release of LPL into the cell culture medium (22, 23, 24). Whichever mechanism is operant, treatment of the adipocytes with heparin results in the rapid release of a large pool of LPL activity from the cells.

The mechanism by which insulin mediates the release of LPL may be through the induction of a phosphatidylinositol phospholipase C activity. It has been proposed that LPL is anchored to the plasma membrane of the cell by means of a glycosyl-phosphatidylinositol anchor and that insulin treatment of the cells induces a phosphatidylinositol phospholipase C activity that cleaves this anchor and releases LPL activity from the cell (25). However, it has also been demonstrated that insulin treatment induces the release of phosphatidylinositol-anchored HSP (25), and adipose cells have been found to express high levels of HSP (22, 23). Thus, insulin treatment of the adipocytes may result in the direct release LPL activity, or, in an indirect manner, insulin treatment may release the HSP to which LPL is bound. By either mechanism, the amount of LPL released by insulin is a small fraction (8.2%) of the amount of LPL released by heparin, and the time course for maximal release by insulin is approximately 4 times longer than the time required for heparin release.

Insulin treatment of 3T3-L1 adipocytes has been documented to increase the level of cellular and heparin-releasable LPL activity through posttranscriptional and posttranslational mechanisms (13). These early studies used extended (2-day) incubations to demonstrate these effects. Our data demonstrate that within 1 h of stimulation of the adipocytes with physiological concentrations of insulin, the pool of readily available, heparin-releasable LPL activity nearly doubles. This increase in LPL activity occurs without any significant decrease in the remaining cell-associated LPL activity. The source of this LPL may be newly synthesized LPL, as the biosynthetic half-time for LPL in 3T3-L1 adipocytes has been found to be 1 h (26). Alternately, as it has been shown that there is a large intracellular pool of inactive, probably monomeric, LPL (26), it is possible that this inactive pool of LPL is readily activated and recruited to the heparin-releasable pool. Studies to define the source of this LPL activity are currently in progress.

Insulin treatment of microvessel endothelial cells isolated from adipose tissue results in the production of a factor that greatly facilitates the release of LPL from the 3T3-L1 adipocytes. No comparable effect can be observed with endothelial cells derived from macrovessels. To our knowledge, this is the first demonstration of such cross-talk between adipocytes and endothelial cells. This endothelial cell-derived factor, or LPL release factor, releases nearly the entire pool of heparin-releasable LPL from the adipocytes. The time course for the release of LPL from the adipocytes with the LPL release factor is significantly slower (half-time, 15 min) than the release of LPL from adipocytes mediated by heparin (maximal release in 15 min). The slower LPL release time course for the factor makes it unlikely that the factor is itself heparin derived from the endothelial cells. We are currently pursuing the identity of this LPL release factor.

A peak of LPL release factor is demonstrated within 15 min of insulin stimulation of the HAE cells, and this maximal activity returns to near-basal levels within the ensuing 5–10 min. This rapid decline in LPL release factor activity does not appear to be due to the degradation or thermodynamic instability of the factor. The factor can be harvested from the HAE cells after 15 min of insulin stimulation, and it retains full activity after storage at 4 C for 24 h or when subjected to a round of freeze-thawing (data not shown). The loss of activity appears to be a function of the factor’s continued interaction with the HAE cells. Whether this is due to the release of an inactivating factor from the HAE cells or is due to the reassociation of the LPL release factor with the HAE cells is currently under investigation.

The expression of the LPL release factor from the HAE cells into the culture medium is highly insulin responsive. The maximal production of this factor in the cell culture medium bathing the HAE cells occurs within 15–20 min of insulin stimulation, with an EC50 of 500 pM. Significant levels of the factor are generated upon stimulation of the cells with 100 pM insulin. Therefore, its production occurs rapidly, and with physiological concentrations of insulin. The production of this release factor may be highly relevant to the release of LPL from the adipocyte in a physiological context.

Also relevant from a physiological context is the ability of the HAE cells to respond to multiple challenges with insulin. After a recovery period of 2 h, a second round of stimulation of the HAE cells with insulin resulted in the release of the LPL release factor from the HAE cells with a profile as robust as the initial insulin challenge. In a normal human feeding pattern, with many hours separating meals and the corresponding peaks (postprandial) and troughs (preprandial) in the blood levels of insulin, VLDL, and chylomicrons, it would be anticipated that the endothelial cells should be able to repeatedly respond to these waves of hormones and LPL substrates. This flexibility would optimize the availability of LPL, with maximal hydrolysis of the triglycerides associated with the lipoprotein particles.

Further extending the analysis of this in situ data to the physiological context, it appears that the site of regulation of bioavailable LPL is the endothelial cell. The effect of insulin on the adipocyte is to increase the pool of readily available LPL. However, this population of LPL for the most part remains attached to the adipocyte and is not available to be routed to the luminal domain of the endothelial cell. It is insulin’s effect on the endothelial cell, mobilizing the LPL-releasing factor, that releases the LPL from the adipocyte for ultimate transit to and across the endothelial cell monolayer.

The role of the endothelial cell in regulating LPL is further underscored in the hyperinsulinemic conditions that we have shown to mimic the insulin-resistant state (21). Chronic treatment of 3T3-L1 adipocytes with insulin results in a cellular distribution of LPL within the adipocyte that is very similar to what is seen in the adipocyte that has been stimulated with insulin for only 1 h. Upon chronic insulin stimulation, LPL found in the cell culture medium is elevated 5-fold above basal levels, and heparin-releasable LPL in the chronically stimulated cells is increased 1.3-fold above basal cells. So, although chronic insulin stimulation of 3T3-L1 adipocytes leads to a desensitized state with respect to insulin-induced lipogenesis and glycogen synthesis (21), in the desensitized adipocyte the readily available pool of LPL is elevated above the basal cell and is very similar to that in the acutely stimulated adipocyte. Chronic insulin stimulation of HAE cells, on the other hand, significantly blunts the release of LPL release factor from endothelial cells. Hence, under insulin-resistant conditions, despite the availability of LPL at or near the surface of the adipocyte, LPL cannot be extensively mobilized from the fat cell because the HAE cell is unable to respond to insulin. It appears, therefore, that the endothelial cell acts as the primary locus for the regulation of LPL mobilization from the adipocyte.

Previous investigators have demonstrated the important role played by the endothelial cell in the movement of LPL from parenchymal cells to its site of action, the luminal side of the endothelial cell monolayer. Goldberg’s laboratory has demonstrated that a heparanase-like activity is released from bovine aorta macrovessel endothelial cells after 16 h of incubation of the cells with lysophosphatidylcholine (a product of LPL hydrolysis). This heparanase-like activity causes the release of LPL from adipocytes (27). The relevance of these findings to a normal physiological setting is unknown. It is difficult to know whether, under the normal conditions of blood flow, sufficient lysophosphatidylcholine would be able to accumulate and regulate the endothelial cells. In addition, lysophosphatidylcholine treatment for 16 h was required to accumulate the indicated levels of heparanase activity. In contrast, insulin acts upon the endothelial cell by binding to its high affinity receptor, which we (28) and others (29, 30) have demonstrated to be present at high levels on endothelial cells. In addition, the rapid and robust response of the endothelial cells to low concentrations of insulin suggest that this process is physiologically significant. Nevertheless, these recent studies from the Goldberg laboratory indicate that endothelial cells play a role in regulating LPL release from adipocytes. Whether the LPL-releasing factor that we have identified here also maintains a heparanase-like activity is currently under investigation. Others have identified oligosaccharides derived from endothelial cell HSP with high affinity for LPL (31). The binding of these oligosaccharides to LPL stabilizes the activity of the enzyme and facilitates both its binding to the apical surface of the endothelial cell and its transcytosis across the endothelial cell monolayer (27). It is not known whether insulin induces binding and transcytosis of LPL to macrovessel (bovine aorta) endothelial cells, nor is it known whether these same processes are promoted by insulin in microvessel (adipose) endothelial cells. Studies to address these questions are currently underway.

These data indicate that at least three loci exist through which insulin regulates LPL. 1) Acting directly upon the adipocyte, insulin increases the release of LPL from the adipocyte. The magnitude of this response is small, and the insulin signaling pathway mediating this effect is unknown. 2) Acting directly on the adipocyte, insulin induces an increase in the population of LPL at the surface of the adipocyte (heparin-releasable LPL). The mechanism by which this large increase in LPL activity is acquired at the cell surface is unknown. 3) Insulin, acting on the microvessel endothelial cell, induces the release of a factor that, when incubated with the adipocyte, quantitatively releases the cell surface LPL activity from the adipocyte. The identity of this factor derived from the insulin-stimulated endothelial cells is unknown, and the mechanism by which insulin regulates its release is unknown.

The identity of the microvessel endothelial cell-derived LPL release factor and the mechanism by which it is regulated by insulin are under active investigation.

Received August 27, 1999.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Eckel RH 1989 Lipoprotein lipase: a multifunctional enzyme relevant to common metabolic diseases. N Engl J Med 320:1060–1068[Abstract]
  2. Osborne Jr JC, Bengtsson-Olivecrona G, Lee NS, Olivecrona T 1985 Studies on inactivation of lipoprotin lipase: role of the dimer to monomer dissociation. Biochemistry 24:5606–5611[CrossRef][Medline]
  3. Nielsen MS, Brejning J, Garcia R, Zhang H, Hayden MR, Vilaro S, Gliemann J 1997 Segments in the C-terminal folding domain of lipoprotein lipase important for binding to the low density lipoprotein receptor-related protein and to heparan sulfate proteoglycans. J Biol Chem 272:5821–5827[Abstract/Free Full Text]
  4. Bijvoet S, Gagne SE, Moorjani S, Gagne C, Henderson HE, Fruchart J-C, Dallongeville J, Alaupovic P, Prins M, Kastelein JJP, Hayden MR 1996 Alterations in plasma lipoproteins and apolipoproteins before the age of 40 in heterozygotes for lipoprotein lipase deficiency. J Lipid Res 37:640–650[Abstract]
  5. Brunzell JD 1995 Familial lipoprotein lipase deficiency and other causes of the chylomicronemia syndrome. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill, New York, pp 1913–1932
  6. Weinstock PH, Bisgaier CL, Aalto-Setala K, Radner H, Ramadrishnan R, Levak-Frank S, Essenburg AD, Zechner R, Breslow JL 1995 Severe hypertriglyceridemia, reduced high density lipoprotein, and neonatal death in lipoprotein lipase knockout mice. Mild hypertriglyceridemia with impaired very low density lipoprotein clearance in heterozygotes. J Clin Invest 96:2555–2568
  7. Excoffon KJ, Liu G, Miao L, Wilson JE, McManus BM, Semenkovich CF, Coleman T, Benoit P, Diverger N, Branellec D, Denefle P, Hayden MR, Lewis ME 1997 Correction of hypertriglyceridemia and impaired fat tolerance in lipoprotein lipase-deficient mice by adenovirus-mediated expression of human lipoprotein lipase. Arterioscler Thromb Vasc Biol 17:2532–2539[Abstract/Free Full Text]
  8. Jensen DR, Schlaepfer IR, Morin CL, Pennington DS, Marcell T 1997 Prevention of diet-induced obesity in transgenic mice overexpressing skeletal muscle lipoprotein lipase. Am J Physiol 273:R683–R689
  9. Blanchette-Mackie EJ, Masuno H, Dwyer NK, Olivecrona T, Scow RO 1989 Lipoprotein lipase in myocytes and capillary endothelium of heart: immunocytochemical study. Am J Physiol 256:E818–E828
  10. Camps L, Reina M, Llobera M, Vilaro S, Olivecrona T 1990 Lipoprotein lipase: cellular origin and functional distribution. Am J Physiol 258:C673–C681
  11. Pradines-Figueres A, Vannier C, Ailhaud G 1988 Short-term stimulation by insulin of lipoprotein lipase secretion in adipose cells. Biochem Biophys Res Commun 154:982–990[CrossRef][Medline]
  12. Spooner PM, Chernick SS, Garrison MM, Scow RO 1979 Insulin regulation of lipoprotein lipase activity and release in 3T3–L1 adipocytes. Separation and dependence of hormonal effects on hexose metabolism and synthesis of RNA and protein. J Biol Chem 254:10021–10029[Free Full Text]
  13. Semenkovich CF, Wims M, Noe L, Etienne J, Chan L 1989 Insulin regulation of lipoprotein lipase activity in 3T3–L1 adipocytes is mediated at posttranscriptional and posttranslationsal levels. J Biol Chem 264:9030–9038[Abstract/Free Full Text]
  14. Ronnett GV, Knutson VP, Lane MD 1982 Insulin-induced down-regulation of insulin receptors in 3T3–L1 adipocytes. Altered rate of receptor inactivation. J Biol Chem 257:4285–4291[Abstract/Free Full Text]
  15. Knutson VP, Donnelly PV, Balba Y, Lopez-Reyes M 1995 Insulin resistance mediated by a proteolytic fragment of the insulin receptor. J Biol Chem 270:24972–24981[Abstract/Free Full Text]
  16. Taylor L, Foxall T, Auger K, Heinsohn C, Polgar P 1987 Comparison of prostaglandin synthesis by endothelial cells from blood vessels originating in the rat, baboon, calf and human. Atherosclerosis 65:227–236[CrossRef][Medline]
  17. Kern PA, Knedler A, Eckel RH 1983 Isolation and culture of microvascular endothelium from human adipose tissue. J Clin Invest 71:1822–1829
  18. Milton SG, Knutson VP 1990 Comparison of the function of the tight junctions of endothelial cells and epithelial cells in regulating the movement of electrolytes and macromolecules across the cell monolayer. J Cell Physiol 144:498–504[CrossRef][Medline]
  19. Nilsson-Ehle P, Schotz MC 1976 A stable, radioactive substrate emulsion for assay of lipoprotein lipase. J Lipid Res 17:536–545[Abstract]
  20. Spooner PM, Chernick SS, Garrison MM, Scow RO 1979 Insulin regulation of lipoprotein lipase activity and release in 3T3–L1 adipocytes. Separation and dependence of hormonal effects on hexose metabolism and synthesis of RNA and protein. J Biol Chem 254:10021–10029
  21. Knutson VP, Balba Y 1997 3T3–L1 adipocytes as a cell culture model of insulin resistance. In Vitro Cell Dev Biol 33:77–81
  22. Cisar LA, Hoogewerf AJ, Cupp M, Rapport CA, Bensadoun A 1989 Secretion and degradation of lipoprotein lipase in cultured adipocytes. Binding of lipoprotein lipase to membrane heparan sulfate proteoglycans is necessary for degradation. J Biol Chem 264:1767–1774[Abstract/Free Full Text]
  23. Bengtsson G, Olivecrona T, Hook M, Riesenfeld J, Lindahl U 1980 Interaction of lipoprotein lipase with native and modified heparin-like polysaccharides. Biochem J 189:625–633[Medline]
  24. Lindahl U, Hook M 1978 Glycosaminoglycans and their binding to biological macromolecules. Annu Rev Biochem 47:385–417[CrossRef][Medline]
  25. Chan BL, Lisanti MP, Rodriguez-Boulan E, Saltiel AR 1988 Insulin-stimulated release of lipoprotein lipase by metabolism of its phosphatidylinositol anchor. Science 241:1670–1672[Abstract/Free Full Text]
  26. Olivecrona T, Chernick SS, Bengtsson-Olivecrona G, Garrison M, Scow RO 1987 Synthesis and secretion of lipoprotein lipase in 3T3–L1 adipocytes. Demonstration of inactive forms of lipase in cells. J Biol Chem 262:10748–10759[Abstract/Free Full Text]
  27. Pillarisetti S, Paka L, Sasaki A, Vanni-Reyes T, Yin B, Parthasarathy M, Wagner WD, Goldberg IJ 1997 Endothelial cell heparanase modulation of lipoprotein lipase activity. Evidence that heparan sulfate oligosaccharide is an extracellular chaperone. J Biol Chem 272:15753–15759[Abstract/Free Full Text]
  28. Milton SG, Knutson VP 1993 Insulin receptor characterization and function in bovine aorta endothelial cells: Insulin degradation by a plasma membrane, protease-resistant insulin receptor. J Cell Physiol 157:333–343[CrossRef][Medline]
  29. Bar RS, Dolash S, Dake BL, Boes M 1986 Cultured capillary endothelial cells from bovine adipose tissue: a model for insulin binding and action in microvascular endothelium. Metabolism 35:317–322[CrossRef][Medline]
  30. Peacock ML, Bar RS, Goldsmith E 1982 Interactions of insulin with bovine endothelium. Metabolism 31:52–56[Medline]
  31. Parthasarathy N, Goldberg IJ, Sivaram P, Mulloy B, Flory DM, Wagner WD 1994 Oligosaccharide sequences of endothelial cell sufrace heparan sulfate proteoglycan with affinity for lipoprotein lipase. J Biol Chem 269:22391–22396[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
J. Biol. Chem.Home page
N. L. Brooks, C. M. Trent, C. F. Raetzsch, K. Flurkey, G. Boysen, M. T. Perfetti, Y.-C. Jeong, S. Klebanov, K. B. Patel, V. R. Khodush, et al.
Low Utilization of Circulating Glucose after Food Withdrawal in Snell Dwarf Mice
J. Biol. Chem., November 30, 2007; 282(48): 35069 - 35077.
[Abstract] [Full Text] [PDF]


Home page
J. Lipid Res.Home page
M. Faraj, A. D. Sniderman, and K. Cianflone
ASP enhances in situ lipoprotein lipase activity by increasing fatty acid trapping in adipocytes
J. Lipid Res., April 1, 2004; 45(4): 657 - 666.
[Abstract] [Full Text] [PDF]


Home page
J. Biol. Chem.Home page
D. S. Ng, C. Xie, G. F. Maguire, X. Zhu, F. Ugwu, E. Lam, and P. W. Connelly
Hypertriglyceridemia in Lecithin-cholesterol Acyltransferase-deficient Mice Is Associated with Hepatic Overproduction of Triglycerides, Increased Lipogenesis, and Improved Glucose Tolerance
J. Biol. Chem., February 27, 2004; 279(9): 7636 - 7642.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Endocrinol. Metab.Home page
P. E. Bickel
Lipid rafts and insulin signaling
Am J Physiol Endocrinol Metab, January 1, 2002; 282(1): E1 - E10.
[Abstract] [Full Text] [PDF]


Home page
J. Clin. Endocrinol. Metab.Home page
I. J. Goldberg
Diabetic Dyslipidemia: Causes and Consequences
J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 965 - 971.
[Full Text]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Knutson, V. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Knutson, V. P.


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals