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Hypophagia and metabolic adaptations in mice with defective ATGL-mediated lipolysis cause resistance to HFD-induced obesity

Significance The mass of white adipose tissue (WAT) in an organism is tightly controlled by the balance of triglyceride (TG) synthesis and catabolism. Here, we show that these opposing pathways communicate. TG catabolism by adipose triglyceride lipase (ATGL) activates peroxisome proliferator-activated receptor gamma (PPAR-γ), a crucial transcription factor for TG synthesis and storage in WAT. Consequently, ATGL deficiency in WAT not only impairs TG breakdown, but also PPAR-γ–driven TG formation. This decrease in TG synthesis leads to a paradoxical resistance to high fat diet-induced obesity in mice lacking ATGL. Interdependence of lipid catabolism and synthesis provides a rational explanation for the lack of obesity in ATGL-deficient mice and humans and identifies ATGL inhibition as potential treatment target to prevent diet-induced obesity and insulin resistance. Adipose triglyceride lipase (ATGL) initiates intracellular triglyceride (TG) catabolism. In humans, ATGL deficiency causes neutral lipid storage disease with myopathy (NLSDM) characterized by a systemic TG accumulation. Mice with a genetic deletion of ATGL (AKO) also accumulate TG in many tissues. However, neither NLSDM patients nor AKO mice are exceedingly obese. This phenotype is unexpected considering the importance of the enzyme for TG catabolism in white adipose tissue (WAT). In this study, we identified the counteracting mechanisms that prevent excessive obesity in the absence of ATGL. We used “healthy” AKO mice expressing ATGL exclusively in cardiomyocytes (AKO/cTg) to circumvent the cardiomyopathy and premature lethality observed in AKO mice. AKO/cTg mice were protected from high-fat diet (HFD)-induced obesity despite complete ATGL deficiency in WAT and normal adipocyte differentiation. AKO/cTg mice were highly insulin sensitive under hyperinsulinemic-euglycemic clamp conditions, eliminating insulin insensitivity as a possible protective mechanism. Instead, reduced food intake and altered signaling by peroxisome proliferator-activated receptor-gamma (PPAR-γ) and sterol regulatory element binding protein-1c in WAT accounted for the phenotype. These adaptations led to reduced lipid synthesis and storage in WAT of HFD-fed AKO/cTg mice. Treatment with the PPAR-γ agonist rosiglitazone reversed the phenotype. These results argue for the existence of an adaptive interdependence between lipolysis and lipid synthesis. Pharmacological inhibition of ATGL may prove useful to prevent HFD-induced obesity and insulin resistance.