Improvement of Cardiac Functions by Chronic Metformin Treatment Is Associated With Enhanced Cardiac Autophagy in Diabetic OVE26 Mice
Open accessAbstract
OBJECTIVE: Autophagy is a critical cellular system for removal of aggregated proteins and damaged organelles. Although dysregulated autophagy is implicated in the development of heart failure, the role of autophagy in the development of diabetic cardiomyopathy has not been studied. We investigated whether chronic activation of the AMP-activated protein kinase (AMPK) by metformin restores cardiac function and cardiomyocyte autophagy in OVE26 diabetic mice. RESEARCH DESIGN AND METHODS: OVE26 mice and cardiac-specific AMPK dominant negative transgenic (DN)-AMPK diabetic mice were treated with metformin or vehicle for 4 months, and cardiac autophagy, cardiac functions, and cardiomyocyte apoptosis were monitored. RESULTS: Compared with control mice, diabetic OVE26 mice exhibited a significant reduction of AMPK activity in parallel with reduced cardiomyocyte autophagy and cardiac dysfunction in vivo and in isolated hearts. Furthermore, diabetic OVE26 mouse hearts exhibited aggregation of chaotically distributed mitochondria between poorly organized myofibrils and increased polyubiquitinated protein and apoptosis. Inhibition of AMPK by overexpression of a cardiac-specific DN-AMPK gene reduced cardiomyocyte autophagy, exacerbated cardiac dysfunctions, and increased mortality in diabetic mice. Finally, chronic metformin therapy significantly enhanced autophagic activity and preserved cardiac functions in diabetic OVE26 mice but not in DN-AMPK diabetic mice. CONCLUSIONS: Decreased AMPK activity and subsequent reduction in cardiac autophagy are important events in the development of diabetic cardiomyopathy. Chronic AMPK activation by metformin prevents cardiomyopathy by upregulating autophagy activity in diabetic OVE26 mice. Thus, stimulation of AMPK may represent a novel approach to treat diabetic cardiomyopathy.
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In OVE26 diabetic mice, isolated hearts showed a substantial reduction in AMPK function and cardiomyocyte autophagy as well as mitochondria aggregations and increased apoptosis that was reversed following chronic treatment with metformin.
“Isolated hearts, from the diabetic mice showed a substantial reduction in AMPK function and cardiomyocyte autophagy as well as mitochondria aggregations dispersed between poorly organized myofibrils and increased apoptosis that was reversed following chronic treatment with metformin (231).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [231]
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- Authors
- Xie, Z., Lau, K., Eby, B., Lozano, P., He, C., Pennington, B., Li, H., Rathi, S., Dong, Y., Tian, R., Kem, D., & Zou, M.-H.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- Oklahoma City VA Medical Center (US)
- University of Washington (US)
- Corresponding author
- Xie, Zhonglin
- ORCID
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2011-05-21
- Volume
- 60
- Issue
- 6
- Pages
- 1770-1778
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- PMC
- PMC3114402
- OpenAlex
- W2096317893
- Cited by
- 490
- References
- 49
- Citations by year
- 2026: 9 · 2025: 23 · 2024: 22 · 2023: 30 · 2022: 30 · 2021: 38 · 2020: 59 · 2019: 35 · 2018: 34 · 2017: 44 · 2016: 35 · 2015: 36 · 2014: 42 · 2013: 21 · 2012: 23
- FWCI
- 22.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- American Heart Association
- Fraternal Order of Eagles
- University of Oklahoma
- Oklahoma Center for the Advancement of Science and Technology
- National Institutes of Health
- University of Oklahoma Health Sciences Center
- National Heart, Lung, and Blood Institute (R01HL105157, HL 079584, R01HL079584, HL-080499, HL096032, HL074399, R01HL074399, R01HL080499, HL-089920, R01HL110488, R01HL089920, R01HL096032)
- National Center for Research Resources (P20RR024215)
- Topics
- Health Sciences › Medicine › Epidemiology › Autophagy in Disease and Therapy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- metformin, cardiac autophagy, diabetic cardiomyopathy, AMPK, cardiomyocyte apoptosis, mitochondrial aggregation, polyubiquitinated proteins, cardiac dysfunction, heart failure
- MeSH terms
- Beclin-1, Animals, Autophagy, Echocardiography, Hypoglycemic Agents, Immunohistochemistry, Male, Metformin, Cardiomyopathies, Myocardium, Tuberous Sclerosis, Blotting, Western, Apoptosis, In Situ Nick-End Labeling, Myocytes, Cardiac, Microscopy, Electron, Transmission, Apoptosis Regulatory Proteins, Mice, AMP-Activated Protein Kinases
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