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Insulin resistance, a key etiological factor in metabolic syndrome, is closely linked to ectopic lipid accumulation and increased intracellular Ca 2+ concentrations in muscle and liver. However, the mechanism by which dysregulated intracellular Ca 2+ homeostasis causes insulin resistance remains elusive. Here, we show that increased intracellular Ca 2+ acts as a negative regulator of insulin signaling. Chronic intracellular Ca 2+ overload in hepatocytes during obesity and hyperlipidemia attenuates the phosphorylation of protein kinase B (Akt) and its key downstream signaling molecules by inhibiting membrane localization of pleckstrin homology (PH) domains. Pharmacological approaches showed that elevated intracellular Ca 2+ inhibits insulin-stimulated Akt phosphorylation and abrogates membrane localization of various PH domain proteins such as phospholipase Cδ and insulin receptor substrate 1, suggesting a common mechanism inhibiting the membrane targeting of PH domains. PH domain-lipid overlay assays confirmed that Ca 2+ abolishes the binding of various PH domains to phosphoinositides (PIPs) with two adjacent phosphate groups, such as PI(3,4)P 2 , PI(4,5)P 2 , and PI(3,4,5)P 3 Finally, thermodynamic analysis of the binding interaction showed that Ca 2+ -mediated inhibition of targeting PH domains to the membrane resulted from the tight binding of Ca 2+ rather than PH domains to PIPs forming Ca 2+ -PIPs. Thus, Ca 2+ -PIPs prevent the recognition of PIPs by PH domains, potentially due to electrostatic repulsion between positively charged side chains in PH domains and the Ca 2+ -PIPs. Our findings provide a mechanistic link between intracellular Ca 2+ dysregulation and Akt inactivation in insulin resistance.

proceedings of the national academy of sciences of the united states of america

Increased intracellular Ca <sup>2+</sup> concentrations prevent membrane localization of PH domains through the formation of Ca <sup>2+</sup> -phosphoinositides

Increased intracellular Ca 2+ concentrations prevent membrane localization of PH domains through the formation of Ca 2+ -phosphoinositides

Increased intracellular Ca ²⁺ concentrations prevent membrane localization of PH domains through the formation of Ca ²⁺ -phosphoinositides