Adiponectin, an adipocyte-derived plasma protein, has been shown to play an important role in the regulation of fatty acid and glucose metabolism. Adiponectin enhances fatty acid oxidation both in skeletal and cardiac muscle as well as in the liver, thus reducing triglyceride content in these tissues. Moreover, it stimulates glucose uptake by skeletal and cardiac muscle, and inhibits glucose production by the liver; consequently decreasing blood glucose levels. This review focuses on the molecular mechanisms underlying adiponectin effects on carbohydrate and lipid metabolism in skeletal muscle, cardiac muscle and liver.
Cardiac hypertrophy in humans is associated with a decrease in myocardial fatty acid β-oxidation (FAO) and accompanying alterations in metabolic gene expression. Flux through the cardiac FAO pathway, which is the principal source of energy production in the adult mammalian heart, is tightly controlled in accordance with energy demands. In rodents, the FAO pathway is under control of a nuclear peroxisome proliferator-activated receptor α (PPARα). We sought to delineate the molecular regulatory events involved in the energy substrate preference switch from fatty acids to glucose during cardiac hypertrophic growth in humans. We analysed the amount of PPARα protein in human cardiac tissue. PPARα protein level was measured in homogenates prepared from left ventricular biopsies taken from five control donor hearts and compared to the amount of this transcription factor in biopsies from five patients with compensated end-stage heart failure (HF) at the time of transplantation. Using Western blot analysis with a monoclonal antibody against human PPARα, we observed a significant decrease (54%) in the mean amount of PPARα in the group of HF patients compared to that in the donor tissue. This study indicates that the decrease in cardiac PPARα transcription factor gene expression observed in the failing human heart could play an important role in a reduction in fatty acid utilisation by the adult heart during cardiac hypertrophy.