Introduction
Suboptimal nutrition during fetal and early postnatal life can have profound and lifelong detrimental effects on the health of an individual. Undernutrition in fetal life, which leads to intrauterine growth restriction (IUGR) and a low birthweight (LBW), is associated with an increased risk of developing multiorgan metabolic pathologies such as type 2 diabetes mellitus and the metabolic syndrome. The molecular mechanisms through which early nutrition permanently alters the phenotype of an organism and programmes its long-term metabolic health are slowly becoming defined.
Animal models have proven invaluable for studying the mechanisms linking early nutrition and type 2 diabetes risk [
1]. In this context, we and others have used a rat model of maternal protein restriction. The offspring of low protein fed dams (LP offspring) share phenotypic similarities with LBW humans, including the development of insulin resistance in both skeletal muscle and white adipose tissue (WAT) and age-dependent loss of glucose tolerance that lead to the development of type 2 diabetes [
2,
3]. Prior to the development of whole body insulin resistance, downregulation of key insulin signalling proteins such as insulin receptor substrate-1 (IRS1), glucose transporter type 4 (GLUT4), and the p110β catalytic subunit and p85α regulatory subunit of phosphatidylinositol 3-kinase (PI3K) have been observed in skeletal muscle and WAT of both LBW men and LP offspring rats [
2,
4‐
6]. These changes were detected in 15-month-old LP offspring rats, which had already developed impaired glucose tolerance.
Changes in the levels of key insulin signalling proteins were not accompanied by alterations in the levels of corresponding mRNAs, indicating that post-transcriptional regulatory mechanism(s) are involved. Recently, microRNAs (miRNAs) have emerged as important programming factors that can regulate gene expression by modulating mRNA translation without altering mRNA levels [
7,
8]. Other post-transcriptional regulatory mechanisms such as protein degradation have also been implicated in pathogenesis of type 2 diabetes [
9].
In recent years, our understanding of the importance of WAT in regulating whole body metabolic homeostasis has increased. WAT is the predominant type of fat in adult humans and rodents. It not only acts as the principal storage site for lipids but also secretes adipose-derived factors (i.e. adipokines) that can affect the metabolism of other organs and tissues [
10,
11]. WAT appears particularly vulnerable to suboptimal early nutrition: some of the earliest and most substantial effects of early nutritional manipulation have been observed in this tissue [
12,
13]. The aims of the current study were to: (1) investigate whether changes in insulin signalling molecules in the WAT of rats exposed to a low protein diet in utero and during the suckling period are present before the development of impaired glucose tolerance; (2) determine whether these changes are cell-autonomous; and (3) further investigate the potential mechanisms involved, focusing on post-transcriptional gene regulatory mechanisms.
Discussion
The present study investigated the mechanisms involved in mediating the effects of suboptimal early nutrition on the development of peripheral insulin resistance. Significant changes in body fat distribution, adipocyte size and the levels and phosphorylation status of key insulin signalling proteins were observed in WAT from adult male rats exposed to maternal protein restriction during gestation and lactation. Moreover, the molecular phenotype of impaired insulin signalling was retained in isolated pre-adipocytes from LP offspring after in vitro differentiation. Importantly, as LP offspring were normoglycaemic and normoinsulinaemic at the time of study, these changes are not a consequence of metabolic dysfunction but are likely to contribute to the later development of whole body insulin resistance and type 2 diabetes.
We observed that maternal protein restriction led to a reduction in total visceral WAT (intra-abdominal, retroperitoneal and epididymal fat depots combined) and altered the distribution of fat within the body in the offspring. In LP offspring, relative fat deposition within the epididymal depot was increased, while deposition into the retroperitoneal depot was reduced. Changes in body fat distribution have been observed in young, lean normoglycaemic LBW men, and may contribute to the development of impaired glucose tolerance and type 2 diabetes in developmentally programmed individuals [
23]. Altered fat deposition may lead to alterations in sympathetic drive and rates of lipolysis because these vary between different fat depots [
10]. Increased rates of lipolysis have been found in adipocytes isolated from 3-month-old LP offspring rats and LBW men [
24‐
26]. However, the full impact of altered fat distribution in LP offspring on metabolic phenotype remains to be determined.
We have previously shown that 3-month-old LP offspring have reduced adipocyte size. This was associated with increased miR-483 expression in both rodents and humans and led to a reduction in the expandability of adipose tissue [
7]. Here, we showed that reduced adipocyte size is retained in 14-month-old LP offspring rats and that a higher percentage of small adipocytes can be found in epididymal WAT of these animals compared with controls. An increased proportion of small adipocytes and a corresponding deficit in large adipocytes have been associated with insulin resistance [
27].
Impairments in insulin signalling including decreased IRS1 protein content, reduced Akt Ser473 phosphorylation, impaired insulin-stimulated PI3K activity and impaired glucose transport have been observed in adipocytes from individuals with a predisposition toward type 2 diabetes (i.e. with at least two first-degree relatives diagnosed with diabetes) [
28]. A similar pattern of abnormalities can be detected in adipocytes from diabetic patients and LBW young men [
5]. Here, we show reduced levels of IRS1, the p110β catalytic subunit of PI3K, Akt1 and PKCζ, and decreased Akt Ser473 phosphorylation in the epididymal fat of LP offspring. Importantly, we demonstrate that the reduction in key insulin signalling proteins (IRβ, IRS1, PI3K p85α and p110β subunits and Akt1) and decreased Akt Ser473 phosphorylation is retained in isolated primary pre-adipocytes from LP offspring after in vitro differentiation. This strongly suggests that cell-autonomous mechanism(s) retained throughout the life-course underlie the programmed phenotype. These are maintained following multiple rounds of cell division and differentiation in a controlled environment. As individuals with heritable predisposition to diabetes, LBW humans, LP offspring rats and mice exposed to maternal obesity during gestation and lactation had similar impairments in insulin signalling proteins in WAT (with IRS1 downregulation in mice also shown to be regulated in a cell-autonomous manner), common pathways may be initiated in response to a range of suboptimal early conditions that may drive the development of peripheral insulin resistance [
2,
5,
8,
28].
Although until recently research in the programming field has been primarily directed at understanding mechanisms mediating changes in gene expression at a transcriptional level, changes in the levels of multiple proteins are seen without alterations in the corresponding mRNA transcript levels [
7,
8,
12]. Our finding in LP offspring of impaired insulin signalling protein levels in both WAT and adipocytes in vitro differentiated without changes in the corresponding mRNA levels implies that the mechanisms underlying these programmed changes occur at the post-transcriptional level, and involve changes in protein synthesis and/or degradation.
To investigate the cell-autonomous mechanisms that may mediate the effects of maternal nutrition on susceptibility to developing peripheral insulin resistance in WAT in the offspring, we studied miRNAs implicated in regulating the synthesis of programmed insulin signalling proteins. MiRNAs repress mRNA translation by binding to specific sequences within the 3′UTRs of target mRNAs. Although numerous miRNAs have been implicated in the pathogenesis of insulin resistance and type 2 diabetes [
29], information on which miRNAs may be involved in developmental programming in WAT is scarce. Recently, a programmed increase in miR-126, was shown to repress translation of its
Irs1 target in WAT from mice exposed to maternal overnutrition in early life [
8]. Here, we used a candidate approach to identify miRNAs that could potentially influence the translation of
Irs1,
Pik3cb,
Pik3r1 and
Akt1 mRNAs. However, none of the candidate miRNAs (including miR-126) were upregulated in adipocytes that were differentiated in utero in response to maternal low protein diet. Therefore, none of the changes in the levels of insulin signalling molecules could be explained by upregulation of these miRNAs. This implies that: (1) altered levels of these proteins are not mediated by the candidate miRNAs studied; (2) other unidentified miRNAs play a role; or (3) other post-transcriptional mechanisms are involved.
In the current study, we observed increased serine phosphorylation and decreased tyrosine phosphorylation in IRS1 in in vitro differentiated adipocytes from LP offspring. Although tyrosine phosphorylation is required to generate the insulin signal, serine phosphorylation occurs before, during and after insulin stimulation [
30]. Increased IRS1 phosphorylation at serine 307 (rodents)/312 (humans) has been reported in insulin resistant states [
9,
31] and nutritionally programmed animals [
21]. One mechanism through which IRS1 can become phosphorylated at Ser307 involves activation of JNK1/2, a key component of the stress and inflammatory response pathway [
32]. However, we observed no differences in JNK1/2 Thr183/Tyr185 phosphorylation in differentiated adipocytes from LP offspring and controls, suggesting that other cell-autonomous mechanism(s) must be involved in upregulating IRS1 Ser307 phosphorylation. Prolonged IRS1 serine/threonine phosphorylation following chronic insulin stimulation leads to its targeted degradation by the proteasome [
33,
34]. Increased IRS1 ubiquitination and its subsequent degradation have been reported in a mouse model of type 2 diabetes (TALLYHO/Jng mice) and were associated with an increase in SOCS1 levels [
9]. SOCS proteins are important mediators of IRS1 degradation and target IRS1 via interaction with the SOCS box motif [
35]. Increased levels of SOCS1 in differentiated adipocytes from LP offspring animals suggests that lower IRS1 protein levels in these animals may be at least partly caused by SOCS1-mediated degradation of IRS1.
We investigated whether the other two MAPKs could play a role in the cell-autonomous programming of insulin signalling proteins. There was no difference in ERK Thr202/Tyr204 phosphorylation in differentiated adipocytes from LP offspring and controls. However, p38 MAPK Thr180/Tyr182 phosphorylation was significantly upregulated in differentiated adipocytes from LP offspring animals. Enhanced basal p38 MAPK activation has also been reported in adipocytes from type 2 diabetic patients [
36]. An in vitro study of isolated skeletal muscle strips showed that low levels of oxidative stress lead to increased p38 MAPK Thr180/Tyr182 phosphorylation which was associated with decreased IRS1 protein levels and inhibition of insulin-stimulated Akt Ser473 phosphorylation [
37].
In conclusion, we have demonstrated that a maternal low protein diet during gestation and lactation leads to altered adipose tissues distribution and insulin resistance in the WAT of male offspring. This is associated with reductions in protein levels and phosphorylation of key insulin signalling molecules in WAT. This phenotype was retained in primary in vitro differentiated adipocytes, suggesting that cell-autonomous mechanism(s) are responsible. These findings bring us a step closer to understanding the mechanisms that mediate the effects of suboptimal early nutrition on the risk of developing type 2 diabetes.