摘要Background:Diabetic cardiomyopathy(DCM)causes the myocardium to rely on fatty acid β-oxidation for energy.The accumulation of intracellular lipids and fatty acids in the myocardium usually results in lipotoxicity,which impairs myocardial function.Adipsin may play an important protective role in the pathogenesis of DCM.The aim of this study is to investigate the regulatory effect of Adipsin on DCM lipotoxicity and its molecular mechanism.Methods:A high-fat diet(HFD)-induced type 2 diabetes mellitus model was constructed in mice with adipose tissue-specific overexpression of Adipsin(Adipsin-Tg).Liquid chromatography-tandem mass spectrometry(LC-MS/MS),glutathione-S-transferase(GST)pull-down technique,Co-immunoprecipitation(Co-IP)and immunofluorescence colocalization analyses were used to investigate the molecules which can directly interact with Adipsin.The immunocolloidal gold method was also used to detect the interaction between Adipsin and its downstream modulator.Results:The expression of Adipsin was significantly downregulated in the HFD-induced DCM model(P＜0.05).Adipose tissue-specific overexpression of Adipsin significantly improved cardiac function and alleviated cardiac remodeling in DCM(P＜0.05).Adipsin overexpression also alleviated mitochondrial oxidative phosphorylation function in diabetic stress(P＜0.05).LC-MS/MS analysis,GST pull-down technique and Co-IP studies revealed that interleukin-1 receptor-associated kinase-like 2(Irak2)was a downstream regulator of Adipsin.Immunofluorescence analysis also revealed that Adipsin was co-localized with Irak2 in cardiomyocytes.Immunocolloidal gold electron microscopy and Western blotting analysis indicated that Adipsin inhibited the mitochondrial translocation of Irak2 in DCM,thus dampening the interaction between Irak2 and prohibitin(Phb)-optic atrophy protein 1(Opa1)on mitochondria and improving the structural integrity and function of mitochondria(P＜0.05).Interestingly,in the presence of Irak2 knockdown,Adipsin overexpression did not further alleviate myocardial mitochondrial destruction and cardiac dysfunction,suggesting a downstream role of Irak2 in Adipsin-induced responses(P＜0.05).Consistent with these findings,overexpression of Adipsin after Irak2 knockdown did not further reduce the accumulation of lipids and their metabolites in the cardiac myocardium,nor did it enhance the oxidation capacity of cardiomyocytes expose to palmitate(PA)(P＜0.05).These results indicated that Irak2 may be a downstream regulator of Adipsin.Conclusions:Adipsin improves fatty acid β-oxidation and alleviates mitochondrial injury in DCM.The mechanism is related to Irak2 interaction and inhibition of Irak2 mitochondrial translocation.