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Mol Metab. 2017 Jun 6;6(8):854-862. doi: 10.1016/j.molmet.2017.05.017. eCollection 2017 Aug.

Beta-adrenergic receptors are critical for weight loss but not for other metabolic adaptations to the consumption of a ketogenic diet in male mice.

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Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Department of Biology and Center for Obesity Reversal, Georgia State University, Atlanta, GA 30302-4010, USA.
Department of Pharmacology, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, USA.



We have previously shown that the consumption of a low-carbohydrate ketogenic diet (KD) by mice leads to a distinct physiologic state associated with weight loss, increased metabolic rate, and improved insulin sensitivity [1]. Furthermore, we identified fibroblast growth factor 21 (FGF21) as a necessary mediator of the changes, as mice lacking FGF21 fed KD gain rather than lose weight [2]. FGF21 activates the sympathetic nervous system (SNS) [3], which is a key regulator of metabolic rate. Thus, we considered that the SNS may play a role in mediating the metabolic adaption to ketosis.


To test this hypothesis, we measured the response of mice lacking all three β-adrenergic receptors (β-less mice) to KD feeding.


In contrast to wild-type (WT) controls, β-less mice gained weight, increased adipose tissue depots mass, and did not increase energy expenditure when consuming KD. Remarkably, despite weight-gain, β-less mice were insulin sensitive. KD-induced changes in hepatic gene expression of β-less mice were similar to those seen in WT controls eating KD. Expression of FGF21 mRNA rose over 60-fold in both WT and β-less mice fed KD, and corresponding circulating FGF21 levels were 12.5 ng/ml in KD-fed wild type controls and 35.5 ng/ml in KD-fed β-less mice.


The response of β-less mice distinguishes at least two distinct categories of physiologic effects in mice consuming KD. In the liver, KD regulates peroxisome proliferator-activated receptor alpha (PPARα)-dependent pathways through an action of FGF21 independent of the SNS and beta-adrenergic receptors. In sharp contrast, induction of interscapular brown adipose tissue (BAT) and increased energy expenditure absolutely require SNS signals involving action on one or more β-adrenergic receptors. In this way, the key metabolic actions of FGF21 in response to KD have diverse effector mechanisms.


BAT, brown adipose tissue; EE, energy expenditure; FGF21, fibroblast growth factor 21; IP, intraperitoneal; ITT, insulin tolerance test; IWAT, inguinal white adipose tissue; KD, ketogenic diet; Ketogenic diet; PPARα, peroxisome proliferator-activated receptor alpha; SEM, standard error of the mean; SNA, sympathetic nerve activity; SNS, sympathetic nervous system; Sympathetic nervous system; UCP1, uncoupling protein 1; Weight loss; β-Adrenergic receptors; β-less, lacking β1, β2, β3 adrenergic receptors

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