Cited by 274Nitric Oxide and Endothelin EffectsAdipokines, Inflammation, and Metabolic DiseasesAdipose Tissue and Metabolism

The DOI matches its Crossref record; 365 of the 368 references it cites were found in a registry or an index; 10 of the 155 sources its claims cite were checked for support.

Regulation of obesity and insulin resistance by nitric oxide

Open access
Sansbury, Brian E., Hill, Bradford G.·2014·Free Radical Biology and Medicine

Abstract

Obesity is a risk factor for developing type 2 diabetes and cardiovascular disease and has quickly become a worldwide pandemic with few tangible and safe treatment options. Although it is generally accepted that the primary cause of obesity is energy imbalance, i.e., the calories consumed are greater than are utilized, understanding how caloric balance is regulated has proven a challenge. Many "distal" causes of obesity, such as the structural environment, occupation, and social influences, are exceedingly difficult to change or manipulate. Hence, molecular processes and pathways more proximal to the origins of obesity-those that directly regulate energy metabolism or caloric intake-seem to be more feasible targets for therapy. In particular, nitric oxide (NO) is emerging as a central regulator of energy metabolism and body composition. NO bioavailability is decreased in animal models of diet-induced obesity and in obese and insulin-resistant patients, and increasing NO output has remarkable effects on obesity and insulin resistance. This review discusses the role of NO in regulating adiposity and insulin sensitivity and places its modes of action into context with the known causes and consequences of metabolic disease.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that nitric oxide (NO) is a central regulator of energy metabolism, body composition, and insulin sensitivity, with NO bioavailability reduced in obesity and diabetes. It proposes that NOS3-derived NO is largely anti-obesogenic and insulin-sensitizing, whereas NOS1 and NOS2-derived NO can promote hyperphagia and insulin resistance.

Key findings

  • NO bioavailability is decreased in animal models of obesity/diabetes and in obese and diabetic humans; diminished NO may arise from lower NOS expression, impaired NOS activity, NOS uncoupling, or NO quenching by reactive species such as superoxide.
  • NOS3-derived NO appears anti-obesogenic and insulin-sensitizing: NOS3 knockout causes insulin resistance, hyperlipidemia, and hypertension, while NOS3 overexpression prevents diet-induced obesity, raises metabolic rate, and lowers plasma free fatty acids and triglycerides.
  • NOS2 promotes insulin resistance: NOS2 ablation improves glucose tolerance and insulin sensitivity in high-fat-fed mice, and NOS2 expression is linked to S-nitrosation of insulin receptor, IRS-1, and Akt; NOS1 in the brain promotes hyperphagia.
  • Pharmacological studies show context-dependent effects: L-arginine increases food intake but reduces fat mass and improves insulin sensitivity in mice, rats, and pigs; chronic NOS inhibition reduces food intake/adiposity and improves insulin sensitivity in obese models, but acute NOS inhibition causes systemic insulin resistance.
  • The review cites obesity statistics: U.S. obesity prevalence rose from 13% to 36% (1962–2010); as of 2008, ~1.5 billion adults were overweight and 10% obese; >33% of U.S. adults and 17% of children were obese; estimated obesity-related health care costs were $147 billion per year.

Methods

  • Design: narrative review of the role of NO in regulating obesity, adiposity, and insulin sensitivity, integrating pharmacological, human, and genetic mouse studies.
  • Data/sample: no primary dataset or systematic sample; the paper synthesizes cited animal models, human studies, and genetic interventions, including NOS isoform knockout/overexpression models.
  • Main analysis: narrative synthesis and a proposed model (Figure 3) in which NOS3-derived NO is beneficial for metabolism while NOS1 and NOS2-derived NO contribute to deleterious metabolic changes.

Limitations

  • The paper does not state formal limitations.
  • It explicitly notes unresolved issues, including the identity of hepatic insulin-sensitizing substance (HISS), whether obesity itself decreases NO availability, the specific contribution of peroxynitrite and other reactive species to endothelial function, and the controversy over NO’s dual role in insulin secretion.
  • Evident from the text: as a narrative review, it lacks a systematic search strategy, formal quality assessment, meta-analysis, or new primary data, so conclusions depend on the cited literature and the proposed model.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.freeradbiomed.2014.05.016

Cites

365 of 365 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

71 Not checked yet · 15 Own interpretation · 2 Partly supported · 2 No basis given · 1 Supported so far · 1 Mixed support · accuracy not yet measured

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  • It may state two separate claims as one. 48
  • Probably not a substantial claim. 25
59 of 59
  • The paper relies on this without support.

    Findings from animal models of obesity and diabetes are informative about human obesity and diabetes.

    “NO bioavailability is decreased in animal models of obesity and diabetes [116, 117] and in obese and diabetic humans [118, 119].”
  • The paper relies on this without support.

    HISS is a liver-produced hormone that mediates a substantial portion of insulin's glucose disposal and peripheral vasodilation.

    “The answer has been suggested to lie in a hormone called ‘hepatic insulin-sensitizing substance (HISS)’. This substance, for which there are only suggestive candidates (e.g., bone morphogenetic protein-9 [296]), has been suggested to account for 55% of the glucose disposal effect of insulin.”
2 of 2

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Citations

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Metadata

Authors
Sansbury, B. E., & Hill, B. G.
Affiliations
University of Louisville (US)
Corresponding author
Hill, Bradford G.
Venue
Free Radical Biology and Medicine
Publisher
Elsevier BV
Published
2014-08
Volume
73
Pages
383-399
ISSN
0891-5849 (ISSN-L)
OpenAlex
W2004580431
Cited by
274
References
368
Citations by year
2026: 14 · 2025: 29 · 2024: 18 · 2023: 22 · 2022: 28 · 2021: 28 · 2020: 34 · 2019: 23 · 2018: 25 · 2017: 23 · 2016: 11 · 2015: 13 · 2014: 5
FWCI
2.04
Type
journal article
Language
en
Open access
Locations
  • Free Radical Biology and Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
NIH (GM103492, HL078825)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
Keywords
nitric oxide, obesity, insulin resistance, energy metabolism, energy balance, adiposity, insulin sensitivity, type 2 diabetes, cardiovascular disease, diet-induced obesity, NO bioavailability, body composition
MeSH terms
Body Composition, Energy Intake, Diet, Energy Metabolism, Humans, Hunger, Insulin Resistance, Nitric Oxide, Obesity, Satiety Response, Adiposity, Nitric Oxide Synthase Type III

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