The antidiabetic drug metformin activates the AMP-activated protein kinase cascade via an adenine nucleotide-independent mechanism
Abstract
Metformin, a drug widely used to treat type 2 diabetes, was recently shown to activate the AMP-activated protein kinase (AMPK) in intact cells and in vivo. In this study we addressed the mechanism for this effect. In intact cells, metformin stimulated phosphorylation of the key regulatory site (Thr-172) on the catalytic (alpha) subunit of AMPK. It did not affect phosphorylation of this site by either of two upstream kinases in cell-free assays, although we were able to detect an increase in upstream kinase activity in extracts of metformin-treated cells. Metformin has been reported to be an inhibitor of complex 1 of the respiratory chain, but we present evidence that activation of AMPK in two different cell types is not a consequence of depletion of cellular energy charge via this mechanism. Whereas we have not established the definitive mechanism by which metformin activates AMPK, our results show that the mechanism is different from that of the existing AMPK-activating agent, 5-aminoimidazole-4-carboxamide (AICA) riboside. Metformin therefore represents a useful new tool to study the consequences of AMPK activation in intact cells and in vivo. Our results also show that AMPK can be activated by mechanisms other than changes in the cellular AMP-to-ATP ratio.
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Similar general outcome of metformin, AICAR, atheroprotective flow, and statins on endothelial cells can be found through AMPK activation.
“As discussed previously, a similar general outcome of metformin, AICAR, atheroprotective flow, and statins on ECs can be found through AMPK activation [245,250,251].”
From AMPK, Mitochondrial Function, and Cardiovascular Disease (2020) · cites this paper as [250]
AICAR plays anti-inflammatory roles in vascular cells both in vitro and in vivo.
“Additionally, AICAR, an AMPK activator, plays anti-inflammatory roles in vascular cells both in vitro and in vivo [248,249,250].”
From AMPK, Mitochondrial Function, and Cardiovascular Disease (2020) · cites this paper as [250]
AMPK is activated by the antidiabetic drugs metformin and rosiglitazone, and by the adipocyte-derived hormones leptin and adiponectin.
“It is also activated by the antidiabetic drugs metformin and rosiglitazone (21-23), and by the adipocyte-derived hormones leptin and adiponectin (24, 25).”
From CBS domains form energy-sensing modules whose binding of adenosine ligands is disrupted by disease mutations (2004) · cites this paper as [22]
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Ying, M., Maruschak, N., Mansur, R., Carvalho, A., Cha, D., & McIntyre, R. (2015) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/1871527313666141130205514 · Cited by 29 · see citing works
Bushi, G., Gaidhane, S., Ballal, S., Kumar, S., Bhat, M., Sharma, S., Kumar, M. R., Sinha, A., Khatib, M. N., Rai, N., et al. (2025) · Health Science Reports · doi:10.1002/hsr2.70490 · Cited by 13 · see citing works
- Authors
- Hawley, S. A., Gadalla, A. E., Olsen, G. S., & Hardie, D. G.
- Affiliations
- University of Dundee (GB)
- Novo Nordisk (Denmark) (DK)
- ORCID
- Hardie, D. Grahame
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2002-08-01
- Volume
- 51
- Issue
- 8
- Pages
- 2420-2425
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2147284001
- Cited by
- 696
- References
- 33
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 11 · 2023: 36 · 2022: 33 · 2021: 37 · 2020: 36 · 2019: 26 · 2018: 24 · 2017: 39 · 2016: 22 · 2015: 30 · 2014: 29 · 2013: 39 · 2012: 29
- FWCI
- 10.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Biotechnology and Biological Sciences Research Council
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Biochemical and Molecular Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › PI3K/AKT/mTOR signaling in cancer
- Keywords
- metformin, AMPK, type 2 diabetes, AICA riboside
- MeSH terms
- Adenosine Monophosphate, Animals, Cloning, Molecular, Escherichia coli, Cricetinae, Hypoglycemic Agents, Kinetics, Metformin, Multienzyme Complexes, Oligomycins, Phosphorylation, Recombinant Fusion Proteins, Recombinant Proteins, Transfection, CHO Cells, Protein Serine-Threonine Kinases, MAP Kinase Signaling System, Protein Subunits, AMP-Activated Protein Kinases
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