Hypercytolipidemia promotes diabetes (db/db) mutation-associated utero-ovarian involution: counter-regulatory influences of progesterone

Modelling gestational diabetes mellitus: large animals hold great promise

Gestational diabetes mellitus (GDM) characterized by hyperglycemia during pregnancy is a risk factor for various maternal and fetal complications. The key pathophysiological mechanisms underlying its development have not been elucidated, largely due to the lack of a model that accurately simulates the major clinical and pathological features of human GDM. In this review, we discuss the refined criteria for an ideal animal model of GDM, focusing on the key clinical and pathophysiological characteristics of human GDM. We provide a comprehensive overview of different models and currently used species for GDM research. In general, insulin insufficiency consequent to pancreatic β-cell death represents the current leading strategy to mimic human GDM-like hyperglycemia in animals. Nonetheless, these models have a limited capacity to mimic the natural history of GDM, the marked alteration in circulating estrogen/ progestogen, obesity and its related metabolic complications. We discuss emerging evidence of the increased susceptibility to GDM in rodents and large animals with genetic modifications in pregnancy-related hormones. An appraisal of current GDM models suggests that a combination strategy involving dietary stress, pregnancy-related hormones, insulin resistance and metabolic disorders might enable the development of better GDM models and expedite the translation of basic research findings to GDM treatment.

Hypercytolipidemia-induced nuclear lipoapoptosis: cytochemical analysis and integrated review of hypogonadal, diabetes-obesity syndrome-induced female reproductive axis disruption

Expression of the diabetes (db/db) mutation (i.e., leptin receptor defect) in C57BL/KsJ mice results in the functional suppression of the female pituitary-gonadal axis accompanied by premature utero-ovarian lipocytoatrophy. The current studies define the cytostructural, metabolic and endocrine disturbances associated with hypercytolipidemia and coincident nuclear lipoapoptosis following expression of the db/db-mutation. Adult, female C57BL/KsJ control (+/+ and +/? genotypes) and db/db mutant littermates were monitored for systemic alterations in blood glucose, insulin, luteinizing hormone (LH) and 17-B-estradiol (E2) concentrations associated with db/db-enhanced cytolipid depositions and TUNEL-labeled 3'-DNA fragmentation indexed nuclear lipoapoptosis. Obesity, hyperglycemia and hyperinsulinemia, in addition to depressed LH and E2 concentrations, characterized all db/db-mutants relative to control indices. Structural and cytochemical analysis of basophilic gonadotroph cells, ovarian follicular granulosa cells and uterine endometrial epithelial layers indicated that db/db mutants demonstrated prominent hypercytolipidemia relative to control cytoarchitecture profiles. Vasolipidemia and interstitial cytoadiposity were prominent in all db/db tissue compartments. In each affected cell type within the db/db pituitary-reproductive tract axis, hypercytolipidemia was localized with pronounced nuclear lipo-infiltration and 3'-DNA TUNEL-labeled fragmentation. These data indicate that coincident cytostructural, endocrine and metabolic disturbances associated with hypogonadal pituitary-reproductive tract hypercytolipidemia are functional manifestations of the expressed diabetes-obesity syndrome in db/db-mutants. The progressive vaso-, interstitial-, and cyto-lipidemic alterations in cytoarchitecture correlated with the coincident nuclear lipoapoptotic dissolution and pronounced organo-involution, alterations which contributed to the functional disruption of the pituitary-hypogonadal axis in C57BL/KsJ-db/db mice.

Influences of diabetes (db/db), obese (ob/ob) and dystrophic (dy/dy) genotype mutations on hind limb bone maturation: a morphometric, radiological and cytochemical indices analysis

The influences of single-gene missense mutations expressing diabetes (db/db), obese (ob/ob) or dystrophia (dy/dy) dysregulated metabolic syndromes on hind limb bone maturation and cytodevelopment in C57BL/KsJ mice were evaluated by radiological, macro- and cytomorphometric analysis of the resulting variances in os coxae, femur and tibia osteodevelopment indices relative to control parameters between 8 and 16 weeks of age. Associated with obesity and hyperglycaemic/hyperinsulinaemic states, both db/db and ob/ob mutants demonstrated significant suppression of hind limb maturation (length) and cytodensity indices relative to control growth parameters. By contrast, skeletal growth suppression induced by dy/dy mutation expression was associated with lean body mass and normoglycaemic/hypoinsulinaemic systemic endometabolic indices. In both db/db and ob/ob mutation syndromes, osteovascular, -interstitial and -cytolipidaemia were prominent cytochemical aberrations of the osteopaenic states relative to the dyslipidaemia/fibrodysplasia characteristic of dy/dy osteomaturation. Between 8 and 16 weeks of age, both ob/ob and db/db groups demonstrated extensive cortical interstitial (laminal) osteolipidaemia and suppressed cytodensities compared to control indices. These data demonstrate that the abnormal hyperglycaemic/hyperinsulinaemic endometabolic states associated with the expression of db/db and ob/ob genomutations promote extensive lipidaemia-induced osteopaenia, compromising hind limb osteomaturation and cytodensity indices, as compared to the hyperfibritic osteopaenia characteristic of dy/dy mutation syndromes. Recognized therapeutic modulation of the hypercytolipidaemic component of diabetes-obesity syndromes may prove to be effective towards amelioration of the deleterious influences of these expressed hyperglycaemic, dysregulated lipometabolic conditions on osteomaturation and cytodevelopment.

Hypercytolipidemia-induced cellular lipoapoptosis: Cytostructural and endometabolic basis of progressive organo-involution following expression of diabetes (db/db) and obese (ob/ob) mutation syndromes

Onset expression of Type 2 (NIDDM) diabetes and obesity metabolic syndromes (DOS) are characterized by premature, progressive cytoatrophy and organo-involution induced by dysregulated cellular gluco- and lipo-metabolic cascades. The consequential systemic, interstitial and intracellular hyperlipidemia disrupts normal cytointegrity and metabolic responsivity to the established hypercaloric pericellular environments. The sequential cytostructural, metabolic and endocrine disturbances associated with the development of progressive DOS-associated hypercytolipidemia compromises cellular metabolic response cascades and promotes cytochemical disturbances which culminate with nuclear lipoapoptosis and cytoatrophy. The dramatic alterations in interstitial glucose and lipid (free fatty acids/triglycerides) concentrations are recognized to influence interstitial and cytoplasmic microchemical environments, which markedly alter cellular nutrient diffusion and active trans-membrane flux rates. The progressive exacerbation of interstitial and cytoplasmic lipid imbibition has been demonstrated to be associated with DNA fragmentation by lipo-infiltration into the chromatin matrix, inducing structural disruption and physical dissolution, indexed as nuclear lipoapoptosis. Therapeutic reduction of the severity of hypercytolipidemia-induced structural and cytochemical compromise promotes the restoration of homeostatic metabolic support for normalized cytostructural indices and supportive cellular gluco- and lipo-metabolic cascades. The re-establishment of a homeostatic interstitial microenvironment moderates the severity of cytolipidemic compromise within affected cell types, reduces nuclear lipo-infiltration and DNA lipo-dissolution, resulting in the preservation of cytostructural integrity. Through the therapeutic restoration of extra- and intra-cellular microchemical environments in genetically dysregulated metabolic syndrome models, the coincident cytochemical, endocrine and metabolic disturbances associated with progressive hypercytolipidemia, resulting from the expressed systemic hypercaloric environmental and hepato-pancreatic endometabolic disturbances which characterize Type 2 (NIDDM) diabetes-obesity and metabolic (X) syndromes, may be ameliorated.

Influences of obese (ob/ob) and diabetes (db/db) genotype mutations on lumber vertebral radiological and morphometric indices: skeletal deformation associated with dysregulated systemic glucometabolism

Background

Both diabetes and obesity syndromes are recognized to promote lumbar vertebral instability, premature osteodegeneration, exacerbate progressive osteoporosis and increase the propensity towards vertebral degeneration, instability and deformation in humans.

Methods

The influences of single-gene missense mutations, expressing either diabetes (db/db) or obese (ob/ob) metabolic syndromes on vertebral maturation and development in C57BL/KsJ mice were evaluated by radiological and macro-morphometric analysis of the resulting variances in osteodevelopment indices relative to control parameters between 8 and 16 weeks of age (syndrome onset @ 4 weeks), and the influences of low-dose 17-B-estradiol therapy on vertebral growth expression evaluated.

Results

Associated with the indicative genotypic obesity and hyper-glycemic/-insulinemic states, both db/db and ob/ob mutants demonstrated a significant (P ≤ 0.05) elongation of total lumbar vertebrae column (VC) regional length, and individual lumbar vertebrae (LV1-5) lengths, relative to control VC and LV parameters. In contrast, LV1-5 width indices were suppressed in db/db and ob/ob mutants relative to control LV growth rates. Between 8 and 16 weeks of age, the suppressed LV1-5 width indices were sustained in both genotype mutant groups relative to control osteomaturation rates. The severity of LV1-5 width osteosuppression correlated with the severe systemic hyperglycemic and hypertriglyceridemic conditions sustained in ob/ob and db/db mutants. Low-dose 17-B-estradiol therapy (E2-HRx: 1.0 ug/ 0.1 ml oil s.c/3.5 days), initiated at 4 weeks of age (i.e., initial onset phase of db/db and ob/ob expressions) re-established control LV 1–5 width indices without influencing VC or LV lengths in db/db groups.

Conclusion

These data demonstrate that the abnormal systemic endometabolic states associated with the expression of db/db and ob/ob genomutation syndromes suppress LV 1–5 width osteomaturation rates, but enhanced development related VC and LV length expression, relative to control indices in a progressive manner similar to recognized human metabolic syndrome conditions. Therapeutic E2 modulation of the hyperglycemic component of diabetes-obesity syndrome protected the regional LV from the mutation-induced osteopenic width-growth suppression. These data suggest that these genotype mutation models may prove valuable for the evaluation of therapeutic methodologies suitable for the treatment of human diabetes- or obesity-influenced, LV degeneration-linked human conditions, which demonstrate amelioration from conventional replacement therapies following diagnosis of systemic syndrome-induced LV osteomaturation-associated deformations.

Gonadal steroid modulation of the diabetes (db/db) mutation-induced hyperlipometabolic, hypogonadal syndrome: Restoration of female reproductive tract cytochemical and structural indices

The gonadal steroids, 17-B-estradiol (E2) and progesterone (P), are recognized to stimulate cellular gluco- and lipo-metabolic compensatory cascades which counteract the deleterious influences of the diabetes (db/db) mutation (i.e., leptin membrane receptor defect) which promotes a progressive, hypercytolipidemia-induced premature involution of the female reproductive tract (FRT). The current studies define the therapeutic efficacy of E2 (1 microg/3.5 days) and P (1 mg/3.5 days) treatments (HRx) on utero-ovarian structural and cytochemical (gluco-/lipo-metabolic) maintenance, and the prevention of premature nuclear apoptosis and cytostructural disruption, following the expression of progressive db/db-induced hypercytolipidemia. Control (normal: +/+ and +/?) and diabetes (db/db) genotype groups of 8-week-old (i.e., overt phase of the db/db-hypogonadal syndrome) C57BL/KsJ mice were prepared for high resolution (HRLM) cytochemical and transmission electron (TEM) microscopic analysis of cytolipidemia and nuclear apoptosis (TUNEL-labeled 3'-DNA fragmentation) indices from uterine and ovarian secondary (early antral) follicular tissue samples. Compared to HRx controls, the db/db mutation induced a dramatic increase in cytolipid vacuole volume and density within all ovarian follicular granulosa cells (GC) and uterine endometrial epithelial (UEE) layers. The co-localization of nuclear apoptotic 3'-DNA fragments within identified hyperlipidemic granulosa cells was coincident with the cytochemical and ultrastructural identification of lipid penetration through the nuclear envelope in db/db mutants. P-HRx moderated the severity of db/db-induced GC and UEE hypercytolipidemia, reducing the cytodensity of lipid vacuole accumulations and maintaining cytoplasmic organelle structure, organization, and nuclear membrane integrity. In contrast, E2-HRx resulted in a dramatic reduction in db/db cytolipidemia in both ovarian GC and UEE tissue compartments. Following E2-HRx, UEE cells demonstrated non-pycnotic nuclear profiles, reduced nuclear apoptosis TUNEL-labeling, increased cytoplasmic organelle density profiles and a pronounced cytoplasmic cisternal expansion indicative of active cellular nutrient/metabolite trafficking. Ovarian follicular GC populations demonstrated minimal cytolipidemia, a restored cytoarchitecture with prominent organelle compartments and reduced TUNEL-indexed nuclear lipoapoptosis. These results are the first cytochemical and ultrastructural indications that P- and E2-HRx compensate for the genetic db/db mutation-induced metabolic disturbances, which promote utero-ovarian hypercytolipidemia and the coincident nuclear lipoapoptosis culminating in the expressed diabetes hypogonadal syndrome. The capability of P-HRx to moderate the severity of utero-ovarian involution in db/db mutants, and of E2-HRx to restore and maintain viable GC and UEE cyto-chemical and -structural indices under normoglycemic conditions, suggests that chronic, low-dose cyclic P- and E2-HRx stimulate cellular gluco- and lipo-metabolic cascades which compensate for the lack of leptin signaling in these single-gene, obese-Type II diabetic mutants. The compensatory endometabolic maintenance of utero-ovarian cellular and nuclear architecture suggests that the gluco- and lipo-metabolic disregulation may be therapeutically prevented or reversed, restoring reproductive tract cytointegrity and function, reducing the manifestation of hypogonadal reproductive sterility and db/db compromise of the female reproductive tract.

Cytochemical analysis of pancreatic islet lipoapoptosis: hyperlipidemia-induced cytoinvolution following expression of the diabetes (db/db) mutation

The diabetes (db/db) genotype mutation induces a hyperglycemic-hyperinsulinemic endometabolic state in C57BL/KsJ mice, manifesting a type II NIDDM diabetes-obesity syndrome (DOS) associated with intrinsic leptin receptor expression defects. The severity of the DOS-induced premature pancreatic dysfunction and cytoatrophic involution has been linked to the severity of hypercytolipidemia which develops in pancreatic islets following systemic lipoidosis. The current studies define the cytochemical changes associated with pancreatic islet and acinar vesicular degranulation (deproteinization), cytoinvolution and B-cell dysfunction relative to the onset of cellular (nuclear DNA fragmentation) apoptosis in 20- to 26-week-old chronic db/db mutants relative to control (+/?) indices. The db/db mutation induced dramatic increases in body weights, blood glucose as well as serum and tissue triglyceride concentrations relative to +/? parameters. In contrast, pancreatic tissue weights and insulin concentrations were significantly decreased in db/db groups in association with premature islet cytoatrophy relative to +/? indices. Concurrent elevations in db/db tissue triglyceride concentrations and islet cytolipid depositions accompanied the progressive pancreatic cytoatrophic alterations. Diminished B-cell vesicular (insulin) granulation was pronounced in atrophic pancreatic islets, which were also characterized by hyperplasic acinar cellular intrusion and subsequent proteolytic B-cell dissolution coincident with 3'-DNA fragmentation-indexed (TUNEL-labeled) nuclear apoptosis. The chronic expression of the db/db mutation exacerbated these pancreatic islet B-cell atrophy indices, characterized by insulin vesicular degranulation, suppressed systemic insulin concentrations, invasive hypercytolipidemia, progressive cellular atrophy and hyperplasic acinar proteolytic dissolution, culminating in islet volume/mass reduction and chronic db/db-related pancreatic involution. The results of these studies indicate that pancreatic islet B-cell apoptosis is coincident with the progressive hypercytolipidemia component of the type II DOS promoted by the db/db genotypic mutation. These data suggest that the severity of progressive pancreatic lipoapoptosis disrupts regulatory cellular metabolic cascades, resulting in nuclear fragmentation, organelle dissolution and the subsequent promotion of a nonhomeostatic cytochemical milieu which ultimately renders islet B-cell populations susceptible to acinar proteolytic dissolution and progressive pancreatic involution.

Ovarian follicular lipoapoptosis: structural, cytochemical and metabolic basis of reproductive tract atrophy following expression of the hypogonadal diabetes (db/db) syndrome

The diabetes (db/db) mutation (i.e., leptin membrane receptor defect) promotes a progressive, hypercytolipidemia within ovarian follicular granulosa, thecal and interstitial layers of C57BL/KsJ mice which manifests an infertile, acyclic hypogonadal syndrome. The current studies focus on the structural, cytochemical and gluco-/lipo-metabolic changes which induce cellular lipoapoptosis and the resulting cytostructural disruption of db/db follicular populations, relative to littermate control indices, following the expression of progressive ovarian hypercytolipidemia. Control (normal: +/+ and +/?) and diabetes (db/db) genotype groups were prepared for high resolution light microscopic (HRLM) analysis of cytolipidemia and nuclear apoptosis (TUNEL-labeled 3'-DNA fragmentation) indices and compared to the transmission electron (TEM) microscopic analysis of ovarian follicular samples collected from 8-16-week-old groups. Compared to controls, the db/db mutation induced a dramatic increase in cytolipid vacuole volume and density within all ovarian follicular layers. TEM analysis revealed that the lipid vacuoles initially aggregated along the inner membrane compartments of affected thecal and granulosa cells in response to the interstitial and vaso-lipidemic-hyperglycemic conditions which characterized the ovarian microenvironment of db/db follicles. Progressive cytoplasmic movement of lipid pools into the perinuclear compartment of affected granulosa cells induced nuclear isolation from cytoplasmic organelles that were displaced towards peripheral intracellular compartments. Cytochemical analysis of lipid vacuole accumulations indicated attraction towards, and incorporation within, the nuclear envelope of hyperlipidemic cells. Co-localization of nuclear apoptotic 3'-DNA fragments within identified hyperlipidemic granulosa cells was coincident with the cytochemical and ultrastructural identification of lipid penetration through the nuclear envelope in db/db mutants. These results are the first cytochemical evidence that the lipometabolic disturbances in db/db mutants, which promote hypercytolipidemia-induced premature ovarian involution, are coincident with lipoapoptosis-induced nuclear dissolution within follicular granulosa layers. The lipidemia-induced alterations in cellular and nuclear architecture suggests that the disturbances in glucose and lipid metabolic cascade activities in diabetes (db/db) mutants disrupts follicular cytointegrity, culminating in nuclear disregulation (as indicated by lipoapoptosis) which results in premature reproductive tract organo-involution and manifest reproductive sterility.

Diabetes (db/db) mutation-induced endometrial epithelial lipoapoptosis: ultrastructural and cytochemical analysis of reproductive tract atrophy

BACKGROUND

The diabetes (db/db) mutation in C57BL/KsJ mice promotes a progressive cytolipidemia within the endometrial epithelial (EE) layer of the female reproductive tract which results in premature cellular and organ atrophy. The current studies focus on the ultrastructural and cytochemical changes which promote nuclear apoptosis and cytostructural disruption following the expression of endometrial hypercytolipidemia which promotes diabetes-associated organoinvolution and manifest infertility.

METHODS

Control (normal:+/+) and diabetes (db/db) genotype groups were prepared for high resolution light microscopic analysis of cytolipidemia and nuclear apoptosis (TUNEL-labeled 3'-DNA fragmentation) indices and compared to the transmission electron (TEM) microscopic analysis of endometrial tissue samples collected from 8-16 week-old groups.

RESULTS

Compared to controls, db/db mutation expression induced a dramatic increase in EE cytolipid vacuole volume and density within the epithelial endometrial layer. TEM analysis revealed that cytolipid vacuole accumulations initially aggregated at the baso-polar regions of UEE cells in response to the systemic hyperglycemic/hypertriglyceridemic conditions which characterized the (db/db) groups. Progressive cytoplasmic movement of the lipid pools into perinuclear compartments of affected EE cells induced nuclear isolation from organelles that were displaced towards peripheral cytoplasmic compartments. Cytochemical analysis of lipid vacuole accumulations indicated attraction towards, and incorporation within, the nuclear envelope of hyperlipidemic cells. Co-localization of nuclear apoptotic 3'-DNA fragments within identified hyperlipidemic EE cells was coincident with the cytochemical and ultrastructural identification of lipid penetration through the nuclear envelope in db/db mutants.

CONCLUSION

These results are the first cytochemical indication that the metabolic disturbances in db/db mutants which promote hypercytolipidemia are coincident with lipoapoptosis-induced nuclear dissolution, as denoted by DNA fragmentation analysis. The lipidemia-induced alterations in intracellular organelle and nuclear architectures suggests that the metabolic disturbances in glucose and lipid metabolic cascades in diabetes (db/db) mutants disrupts cytointegrity, culminating in nuclear disregulation (as indicated by lipoapoptosis) and eventual premature reproductive tract organoinvolution and resultant, manifest, reproductive sterility.

Estrogenic restoration of functional pancreatic islet cytoarchitecture in diabetes (db/db) mutant C57BL/KsJ mice: relationship to estradiol localization, systemic glycemia, and persistent hyperinsulinemia

The diabetes (db/db) genotype mutation induces a hyperglycemic-hyperinsulinemic endometabolic state in C57BL/KsJ mice, manifesting a type 2 NIDDM diabetes-obesity syndrome (DOS) in this hyperphagic, leptin receptor (lf) defective model. The severity of the DOS induced by the single gene, homozygous-recessive mutation may be therapeutically moderated by gonadal steroids and pre-steroidal metabolites. The current studies define the estradiol (E2)-modulated phenotypic, systemic, cytochemical, and cellular metabolic responses to db/db mutation expression as compared to littermate control (+/?) indices. The db/db mutation induced dramatic age- and DOS severity-related increases in body weights, blood glucose, and serum insulin concentrations relative to +/? indices between 4-week-old (i.e., initial onset stage of DOS phenotype) and 16-week-old (i.e., chronic stage of DOS) groups. Chronic, low-dose (0.1 microg/3.5 days) E2 treatment (E2-HRx) significantly reduced the obesity mass and blood glucose levels of db/db mutants relative to oil-HRx groups. Similarly, E2-HRx maintained pancreatic glucose utilization rates and pancreatic tissue weights in db/db mutants to near +/? indices. Concurrent amelioration of db/db-enhanced pancreatic lipogenesis and islet hypercytolipidemia occurred following E2-HRx. Pancreatic islet lipo-deposition was markedly reduced in db/db mutants following E2-HRx, and the restoration of islet size and cellular insulin concentrations correlated with beta-cell cytoplasmic regranulation of insulin secretory vesicles. In chronic E2-HRx db/db groups, autoradiographic localization of (3)H-E2 was demonstrated in the nuclear compartments of regranulated, nonhypertrophic islet cell populations, including insulin-containing beta-cells. In chronic E2-HRx db/db mutants, beta-cell insulin granulation was prominent in mildly hypertrophic pancreatic islets, with cytodistribution patterns and concentrations comparable to normal +/? indices. In contrast, E2-HRx maintained the systemic hyperinsulinemia characteristic of oil-HRx db/db mutants. The results of these studies indicate that the severity of the type 2 NIDDM endometabolic syndrome induced by the db/db genotypic mutation may be influenced by E2-HRx, including reduction of the islet hypercytolipidemia and hypertrophic atrophy which are indicators of impending pancreatic involution in this mutant model. The hypercytolipidemia-induced demise of beta-cell cytoarchitecture was reduced by E2-HRx, including the reestablishment of islet beta-cell cytogranulation. These data suggest that the severity of genomic db/db-mutation expression may be modified by E2-HRx, with the gonadal steroid probably acting as a nuclear-specific stimulatory transcriptional modulator of cellular glucometabolic cascades in the absence of leptin-directed homeostatic influences.