Lithium reduces blood glucose levels, but aggravates albuminuria in BTBR-ob/ob mice

PLoS One. 2017 Dec 15;12(12):e0189485. doi: 10.1371/journal.pone.0189485. eCollection 2017.

Abstract

Glycogen synthase kinase 3 (GSK3) plays an important role in the development of diabetes mellitus and renal injury. GSK3 inhibition increases glucose uptake in insulin-insensitive muscle and adipose tissue, while it reduces albuminuria and glomerulosclerosis in acute kidney injury. The effect of chronic GSK3 inhibition in diabetic nephropathy is not known. We tested the effect of lithium, the only clinical GSK3 inhibitor, on the development of diabetes mellitus and kidney injury in a mouse model of diabetic nephropathy. Twelve-week old female BTBR-ob/ob mice were treated for 12 weeks with 0, 10 and 40 mmol LiCl/kg after which the development of diabetes and diabetic nephropathy were analysed. In comparison to BTBR-WT mice, ob/ob mice demonstrated elevated bodyweight, increased blood glucose/insulin levels, urinary albumin and immunoglobulin G levels, glomerulosclerosis, reduced nephrin abundance and a damaged proximal tubule brush border. The lithium-10 and -40 diets did not affect body weight and resulted in blood lithium levels of respectively <0.25 mM and 0.48 mM. The Li-40 diet fully rescued the elevated non-fasting blood glucose levels. Importantly, glomerular filtration rate was not affected by lithium, while urine albumin and immunoglobulin G content were further elevated. While lithium did not worsen the glomerulosclerosis, proximal tubule function seemed affected by lithium, as urinary NGAL levels were significantly increased. These results demonstrate that lithium attenuates non-fasting blood glucose levels in diabetic mice, but aggravates urinary albumin and immunoglobulin G content, possibly resulting from proximal tubule dysfunction.

MeSH terms

  • Albuminuria / drug therapy*
  • Albuminuria / etiology
  • Animals
  • Blood Glucose
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / prevention & control*
  • Drug Evaluation, Preclinical
  • Female
  • Glycogen Synthase Kinase 3 / metabolism
  • Hypoglycemic Agents / pharmacology*
  • Hypoglycemic Agents / therapeutic use
  • Kidney / drug effects
  • Kidney / enzymology
  • Kidney / pathology
  • Lithium Chloride / pharmacology*
  • Lithium Chloride / therapeutic use
  • Mice, Obese

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Glycogen Synthase Kinase 3
  • Lithium Chloride

Grants and funding

This project received support from a grant from the Society of Experimental Laboratory Medicine to PMTD and a Niels Stensen Fellowship (nielsstensenfellowship.nl/nl) and Marie Curie Fellowship PIOF-GA-2012-332395 (ec.europa.eu/research/mariecurieactions/about_en) to TG. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.