Abstract: OBJECTIVE: To observe the therapeutic effect of Shenzhu Tiaopi granule(参术调脾颗粒, STG) on insulin resistance(IR) in the liver of diabetic Goto-Kakizaki(GK) rat and investigate underlying mechanisms.METHODS: Ten 12-week-old male Wistar rats were assigned as normal control(NC) group, while 4012-week-old male specific-pathogen-free GK rats were randomly divided into four experimental groups, 10 diabetic rats each. Animals were fed with a normal diet. Fasting blood glucose(FBG), water intake, and body weight were recorded during6 weeks of daily single-dose treatment: STG low-dose group, 4.5 g/kg(STG-L); STG high-dose group,9 g/kg(STG-H); metformin group, 0.1 g/kg(MET); model control(MC) and NC groups, equal volume of 0.9% Na Cl solution. The serum fasting insulin(FINS), C-Peptide and IR index(HOMA-IR) were detected every 2 weeks during treatment and glucose tolerance was measured in the 3 rd day before the material was taken. After the 6-week STG treatment, Liver tissues were processed for hematoxylin-eosin staining to perform light microscopy analysis and for assessing expression and distribution of insulin receptor substrates(IRS-1) and glucose transporter(GLUT-4) by immunohistochemistry analysis. Expression levels of liver kinase B1(LKB1)/adenosine 5'-monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) pathway proteins, including LKB1, phospho-AMPK(p-AMPK)/AMPK, phospho-mTOR(p-mTOR)/mTOR, and ribosomal protein S6 kinase polypeptide 1(S6 K1),were detected by Western blotting.RESULTS: STG significantly reduced the FBG level and liver fat deposition in diabetic GK rats. After STG treatment completion, FINS, HOMA-IR, C-Peptide and area under blood glucose curve(AUC)were lower in STG groups than in the MC group, indicating that IR was reduced and liver fat lesions were resolved. In liver tissues, STG groups displayed significantly higher IRS-1 and GLUT-4 expression than the MC group, along with increased LKB1 and p-AMPK/AMPK expression and decreased p-mTOR/mTOR and phospho-S6 K1 expression, suggesting that STG stimulated LKB1 activation of AMPK and suppressed themTOR/S6 K1 downstream pathway.CONCLUSION: Growing GK rats developed hepatic IR, but STG treatment significantly improved hyperglycemia and IR and resolved hepatic fatty lesions.Interestingly, STG treatment stimulated the expression of IRS-1 and GLUT-4 in the liver of diabetic GK rats, indicating a potential involvement in the regulation of the LKB1/AMPK/mTOR signaling pathway.

Key words: Diabetes mellitus, insulin resistance, insulin receptor substrate proteins, TOR serine-threonine kinases, Shenzhu Tiaopi granule