Metabolic Syndrome Insulin Resistance is Associated with Discordant Distrbution of GLUT4 and the Insulin Receptor in Fast‐Twitch and Slow‐Twitch Muscle Fiber Types

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Metabolic Syndrome Insulin Resistance Is Associated with Discordant Distribution of GLUT4 and the Insulin Receptor in Fast-Twitch and Slow-Twitch Muscle Fiber Types We have previously shown that We have previously shown that strength training alone improved insulin responsiveness in sedentary controls but not in metabolic syndrome subjects. Immunoblots of metabolic syndrome subjects[apos] muscle homogenates showed training-related increases in GLUT4 and mitochondrial enzymes was half that seen in the controls. To determine if this was due to changes primarily in fast-twitch fibers (strength fibers), we performed immunohistochemical (IHC) studies on muscle sections from these subjects to quantify fiber-specific changes in GLUT4, phospho-AMPK, phospho-mTOR, ATP synthase, and the insulin receptor. Signal intensity in confocal microscopic images was digitally quantified and the amount in each fiber type was adjusted by the fiber composition and the average size of each fiber type. Fiber type was classified using monoclonal antibodies against slow-twitch (type 1 fibers) and fast-twitch (type 2a and 2b fibers) myosin heavy chains. At baseline, both groups had slightly more insulin receptor in slow-twitch fibers, and most of the ATP synthase (mitochondrial marker) was in fast-twitch fibers. In controls, 55% of GLUT4 was in slow-twitch fibers, whereas metabolic syndrome subjects had only 33% of their GLUT4 in slow-twitch fibers. The IHC data showed modest increases in GLUT4 (9-25%), and substantial increases of ATP synthase (55-95%), and insulin receptors (44-104%) in both fiber types in both groups. Training-related increases were seen in phospho-AMPK (25% in slow-twitch, 15% in fast-twitch) only in the control subjects but no change in phospho-mTOR in either subject group. At baseline, metabolic syndrome subjects[apos] muscle had 56% of insulin receptors expressed in slow-twitch fibers, but only 33% of the GLUT4 was in these fibers. Thus, the untrained muscle composition of the metabolic syndrome subjects exhibited a mismatch between insulin receptors and GLUT4 in their fiber-specific distributions. This mismatch may contribute to the insulin resistance seen in the metabolic syndrome and may be involved in the diminished insulin sensitivity response to strength training in these subjects.


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