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Selina Mäkinen Minerva Foundation Institute for Medical Research, Tukholmankatu, Helsinki, Finland
Department of Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu, Helsinki, Finland

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Neeta Datta Minerva Foundation Institute for Medical Research, Tukholmankatu, Helsinki, Finland
Department of Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu, Helsinki, Finland

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Savithri Rangarajan Pam Gene International B.V., Wolvenhoek, BJ ´s-Hertogenbosch, The Netherlands

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Yen H Nguyen Minerva Foundation Institute for Medical Research, Tukholmankatu, Helsinki, Finland
Department of Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu, Helsinki, Finland

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Vesa M Olkkonen Minerva Foundation Institute for Medical Research, Tukholmankatu, Helsinki, Finland
Department of Anatomy, Faculty of Medicine, Haartmaninkatu, University of Helsinki, Helsinki, Finland

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Aino Latva-Rasku Turku PET Centre, University of Turku, Kiinamyllynkatu, Turku, Finland
Turku PET Centre, Turku University Hospital, Kiinamyllynkatu, Turku, Finland

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Pirjo Nuutila Turku PET Centre, University of Turku, Kiinamyllynkatu, Turku, Finland
Turku PET Centre, Turku University Hospital, Kiinamyllynkatu, Turku, Finland

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Markku Laakso Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Puijonlaaksontie, Kuopio, Finland

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Heikki A Koistinen Minerva Foundation Institute for Medical Research, Tukholmankatu, Helsinki, Finland
Department of Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu, Helsinki, Finland

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Finnish-specific gene variant p.P50T/AKT2 (minor allele frequency (MAF) = 1.1%) is associated with insulin resistance and increased predisposition to type 2 diabetes. Here, we have investigated in vitro the impact of the gene variant on glucose metabolism and intracellular signalling in human primary skeletal muscle cells, which were established from 14 male p.P50T/AKT2 variant carriers and 14 controls. Insulin-stimulated glucose uptake and glucose incorporation into glycogen were detected with 2-[1,2-3H]-deoxy-D-glucose and D-[14C]-glucose, respectively, and the rate of glycolysis was measured with a Seahorse XFe96 analyzer. Insulin signalling was investigated with Western blotting. The binding of variant and control AKT2-PH domains to phosphatidylinositol (3,4,5)-trisphosphate (PI(3,4,5)P3) was assayed using PIP StripsTM Membranes. Protein tyrosine kinase and serine-threonine kinase assays were performed using the PamGene® kinome profiling system. Insulin-stimulated glucose uptake and glycogen synthesis in myotubes in vitro were not significantly affected by the genotype. However, the insulin-stimulated glycolytic rate was impaired in variant myotubes. Western blot analysis showed that insulin-stimulated phosphorylation of AKT-Thr308, AS160-Thr642 and GSK3β-Ser9 was reduced in variant myotubes compared to controls. The binding of variant AKT2-PH domain to PI(3,4,5)P3 was reduced as compared to the control protein. PamGene® kinome profiling revealed multiple differentially phosphorylated kinase substrates, e.g. calmodulin, between the genotypes. Further in silico upstream kinase analysis predicted a large-scale impairment in activities of kinases participating, for example, in intracellular signal transduction, protein translation and cell cycle events. In conclusion, myotubes from p.P50T/AKT2 variant carriers show multiple signalling alterations which may contribute to predisposition to insulin resistance and T2D in the carriers of this signalling variant.

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