Myocardial loss of IRS1 and IRS2 causes heart failure and is controlled by p38 MAPK during insulin resistance. Academic Article uri icon


  • Cardiac failure is a major cause of death in patients with type 2 diabetes, but the molecular mechanism that links diabetes to heart failure remains unclear. Insulin resistance is a hallmark of type 2 diabetes, and insulin receptor substrates 1 and 2 (IRS1 and IRS2) are the major insulin-signaling components regulating cellular metabolism and survival. To determine the role of IRS1 and IRS2 in the heart and examine whether hyperinsulinemia causes myocardial insulin resistance and cellular dysfunction via IRS1 and IRS2, we generated heart-specific IRS1 and IRS2 gene double-knockout (H-DKO) mice and liver-specific IRS1 and IRS2 double-knockout (L-DKO) mice. H-DKO mice had reduced ventricular mass; developed cardiac apoptosis, fibrosis, and failure; and showed diminished Aktforkhead box class O-1 signaling that was accompanied by impaired cardiac metabolic gene expression and reduced ATP content. L-DKO mice had decreased cardiac IRS1 and IRS2 proteins and exhibited features of heart failure, with impaired cardiac energy metabolism gene expression and activation of p38 mitogen-activated protein kinase (p38). Using neonatal rat ventricular cardiomyocytes, we further found that chronic insulin exposure reduced IRS1 and IRS2 proteins and prevented insulin action through activation of p38, revealing a fundamental mechanism of cardiac dysfunction during insulin resistance and type 2 diabetes.

published proceedings

  • Diabetes

altmetric score

  • 4

author list (cited authors)

  • Qi, Y., Xu, Z., Zhu, Q., Thomas, C., Kumar, R., Feng, H., ... Guo, S.

citation count

  • 109

complete list of authors

  • Qi, Yajuan||Xu, Zihui||Zhu, Qinglei||Thomas, Candice||Kumar, Rajesh||Feng, Hao||Dostal, David E||White, Morris F||Baker, Kenneth M||Guo, Shaodong

publication date

  • November 2013