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Sandra Pereira Department of Physiology, University of Toronto, Toronto, Ontario, Canada

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Jessy Moore Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada

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Jia-Xu Li Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada

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Wen Qin Yu Department of Physiology, University of Toronto, Toronto, Ontario, Canada

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Husam Ghanim Division of Endocrinology, Diabetes, and Metabolism, State University of New York at Buffalo, Kaleida Health, Buffalo, New York, USA

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Filip Vlavcheski Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada

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Yemisi Deborah Joseph Department of Physiology, University of Toronto, Toronto, Ontario, Canada

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Paresh Dandona Division of Endocrinology, Diabetes, and Metabolism, State University of New York at Buffalo, Kaleida Health, Buffalo, New York, USA

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Allen Volchuk Department of Physiology, University of Toronto, Toronto, Ontario, Canada
Division of Cellular and Molecular Biology, Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada

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Carolyn L Cummins Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada

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Evangelia Tsiani Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada

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Adria Giacca Department of Physiology, University of Toronto, Toronto, Ontario, Canada
Department of Medicine, University of Toronto, Toronto, Ontario, Canada
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada

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Plasma free fatty acids (FFAs) are elevated in obesity and can induce insulin resistance via endoplasmic reticulum (ER) stress. However, it is unknown whether hepatic insulin resistance caused by the elevation of plasma FFAs is alleviated by chemical chaperones. Rats received one of the following i.v. treatments for 48 h: saline, intralipid plus heparin (IH), IH plus the chemical chaperone 4-phenylbutyric acid (PBA), or PBA alone and a hyperinsulinemic-euglycemic clamp was performed during the last 2 h. PBA co-infusion normalized IH-induced peripheral insulin resistance, similar to our previous findings with an antioxidant and an IκBα kinase β (IKKβ) inhibitor. Different from our previous results with the antioxidant and IKKβ inhibitor, PBA also improved IH-induced hepatic insulin resistance in parallel with activation of Akt. Unexpectedly, IH did not induce markers of ER stress in the liver, but PBA prevented IH-induced elevation of phosphorylated eukaryotic initiation factor-2α protein in adipose tissue. PBA tended to decrease circulating fetuin-A and significantly increased circulating fibroblast growth factor 21 (FGF21) without affecting markers of activation of hepatic protein kinase C-δ or p38 mitogen-activated protein kinase that we have previously involved in hepatic insulin resistance in this model. In conclusion: (i) PBA prevented hepatic insulin resistance caused by prolonged plasma FFA elevation without affecting hepatic ER stress markers; (ii) the PBA effect is likely due to increased FGF21 and/or decreased fetuin-A, which directly signal to upregulate Akt activation.

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