Abel et al generated mice with adipose-selective interruption of the Slc2a4 gene in order to determine the role of adipose GLUT4 in glucose homeostasis and in the pathogenesis of insulin resistance and diabetes. Despite markedly impaired insulin-stimulated glucose uptake in adipocytes, these mice exhibit normal growth and adipose mass. Although expression of GLUT4 is preserved in muscle, fat tissue-specitific GLUT4 mice develop secondarily induced insulin resistance in muscle and liver, resulting in the devel opment of glucose intolerance and hyperinsulinemia. Thus, an adipose-specific disruption of GLUT4 increases the risk of developing diabetes." In contrast to the specific effects on glucose homeostasis observed in the tissue-specific GLUT4 null mutants, conventional GLU24 mice were growth-retarded and exhibited decreased longevity associated with cardiac hypertrophy and severely reduced adipose tissue. Although these GLUT4 null mice were less sensitive to insulin action, they showed only mild disturbance in glucose homeostasis and exhibited nearly normal blood glucose levels. Thus, it was concluded that GLUT4 is not required for main- taining glucose homeostasis but is absolutely essential for sustained growth. However, the effects of GLUT4 disruption on growth and development may have obscured specific effects on glucose homeostasis in tis- sues. Concluding Remarks and Future Perspectives Glucose transporters of the SGLT and the GLUT family are critical regulators of glucose use, glucose and also- as part of glucosensing systems- the hormonal control of metabolism. Their heterogene ity allows a complex and specific fine tuning of glucose transport activity that is based on variable expression or subcellular distribution of individual isotypes. In spite of considerable progress in recent years, there is still much to be learned about the substrate specificity, the kinetics, and the physiologic function of some isotypes. Furthermore, future research will expand our knowledge as to the association of single nucleotide polymorphisms in transporter genes or in genes regu lating their function, with diseases of carbohydrate metabolism(eg, insulin resistance and diabetes melli tus).
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