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Basic Science| Volume 123, 154846, October 2021

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Ovarian insufficiency impairs glucose-stimulated insulin secretion through activation of hypothalamic de novo ceramide synthesis

  • Author Footnotes
    1 Contributed equally to this work.
    ,
    Author Footnotes
    2 Present address: Institut de Recherche Biomédicale des Armées (IRBA), Département Microbiologie et Maladies Infectieuses (2MI), Unité Biothérapies anti-Infectieuses et Immunité (B2I), Brétigny-sur-Orge, France.
    Kelly Meneyrol
    Footnotes
    1 Contributed equally to this work.
    2 Present address: Institut de Recherche Biomédicale des Armées (IRBA), Département Microbiologie et Maladies Infectieuses (2MI), Unité Biothérapies anti-Infectieuses et Immunité (B2I), Brétigny-sur-Orge, France.
    Affiliations
    Unité de Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université de Paris, Paris, France
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  • Author Footnotes
    1 Contributed equally to this work.
    Ánxela Estévez-Salguero
    Footnotes
    1 Contributed equally to this work.
    Affiliations
    NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain

    CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706, Spain
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  • Ismael González-García
    Affiliations
    NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain

    CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706, Spain
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  • Jeanne Guitton
    Affiliations
    Institut des Neurosciences Paris-Saclay, CNRS UMR 9197, Université Paris Saclay, Orsay, France
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  • Mohammed Taouis
    Affiliations
    Institut des Neurosciences Paris-Saclay, CNRS UMR 9197, Université Paris Saclay, Orsay, France
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  • Yacir Benomar
    Affiliations
    Institut des Neurosciences Paris-Saclay, CNRS UMR 9197, Université Paris Saclay, Orsay, France
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  • Christophe Magnan
    Affiliations
    Unité de Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université de Paris, Paris, France
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  • Miguel López
    Correspondence
    Correspondence to: M. López, NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain.
    Affiliations
    NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain

    CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706, Spain
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  • Hervé Le Stunff
    Correspondence
    Correspondence to: H. Le Stunff, Institut des Neurosciences Paris-Saclay, CNRS UMR 9197, Université Paris Saclay, Orsay, France.
    Affiliations
    Unité de Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université de Paris, Paris, France

    Institut des Neurosciences Paris-Saclay, CNRS UMR 9197, Université Paris Saclay, Orsay, France
    Search for articles by this author
  • Author Footnotes
    1 Contributed equally to this work.
    2 Present address: Institut de Recherche Biomédicale des Armées (IRBA), Département Microbiologie et Maladies Infectieuses (2MI), Unité Biothérapies anti-Infectieuses et Immunité (B2I), Brétigny-sur-Orge, France.

      Highlights

      • Ovarian insufficiency (OVX) increases body weight and SPTLC1/SPTLC2 expression in hypothalamus
      • Down-regulation of hypothalamic SPTLC1 decreases neuronal inflammation
      • Down-regulation of hypothalamic SPTLC1 partially reverses glucose intolerance induced by OVX
      • Down-regulation of hypothalamic SPTLC1 represses the second phase of insulin secretion induced by OVX
      • Down-regulation of hypothalamic SPTLC1 reverses the defect of glucose-induced insulin secretion induced by OVX

      Abstract

      Oestrogens regulate body weight through their action on hypothalamus to modulate food intake and energy expenditure. Hypothalamic de novo ceramide synthesis plays a central role on obesity induced by oestrogen deficiency. Depletion in oestrogens is also known to be associated with glucose intolerance, which favours type 2 diabetes (T2D). However, the implication of hypothalamic ceramide in the regulation of glucose homeostasis by oestrogen is unknown. Here, we studied glucose homeostasis and insulin secretion in ovariectomized (OVX) female rats. OVX induces body weight gain associated with a hypothalamic inflammation and impaired glucose homeostasis. Genetic blockade of ceramide synthesis in the ventromedial nucleus of the hypothalamus (VMH) reverses hypothalamic inflammation and partly restored glucose tolerance induced by OVX. Furthermore, glucose-stimulated insulin secretion (GSIS) is increased in OVX rats due to a raise of insulin secretion second phase, a characteristic of early stage of T2D. In contrast, GSIS from isolated islets of OVX rats is totally blunted. Inhibition of ceramide synthesis in the VMH restores GSIS from isolated OVX islets and represses the second phase of insulin secretion. Stimulation of oestrogen receptor α (ERα) by oestradiol (E2) down-regulates ceramide synthesis in hypothalamic neuronal GT1–7 cells but no in microglial SIM-A9 cells. In contrast, genetic inactivation of ERα in VMH upregulates ceramide synthesis. These results indicate that hypothalamic neuronal de novo ceramide synthesis triggers the OVX-dependent impairment of glucose homeostasis which is partly mediated by a dysregulation of GSIS.

      Keywords

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      References

        • Carr M.C.
        The emergence of the metabolic syndrome with menopause.
        J Clin Endocrinol Metab. 2003; 88: 2404-2411
        • Rogers N.H.
        • Perfield 2nd, J.W.
        • Strissel K.J.
        • Obin M.S.
        • Greenberg A.S.
        Reduced energy expenditure and increased inflammation are early events in the development of ovariectomy-induced obesity.
        Endocrinology. 2009; 150: 2161-2168
        • Mauvais-Jarvis F.
        • Clegg D.J.
        • Hevener A.L.
        The role of estrogens in control of energy balance and glucose homeostasis.
        Endocr Rev. 2013; 34: 309-338
        • Wren B.G.
        The benefits of oestrogen following menopause: why hormone replacement therapy should be offered to postmenopausal women.
        Med J Aust. 2009; 190: 321-325
        • Nadal A.
        • Díaz M.
        • Valverde M.A.
        The estrogen trinity: membrane, cytosolic, and nuclear effects.
        News Physiol Sci. 2001; 16: 251-255
        • Paterni I.
        • Granchi C.
        • Katzenellenbogen J.A.
        • Minutolo F.
        Estrogen receptors alpha (ERalpha) and beta (ERbeta): subtype-selective ligands and clinical potential.
        Steroids. 2014; 90: 13-29
        • Jakacka M.
        • Ito M.
        • Martinson F.
        • Ishikawa T.
        • Lee E.J.
        • Jameson J.L.
        An estrogen receptor (ER)alpha deoxyribonucleic acid-binding domain knock-in mutation provides evidence for nonclassical ER pathway signaling in vivo.
        Mol Endocrinol. 2002; 16: 2188-2201
        • Prossnitz E.R.
        • Barton M.
        Estrogen biology: new insights into GPER function and clinical opportunities.
        Mol Cell Endocrinol. 2014; 389: 71-83
        • Sharma G.
        • Hu C.
        • Brigman J.L.
        • Zhu G.
        • Hathaway H.J.
        • Prossnitz E.R.
        GPER deficiency in male mice results in insulin resistance, dyslipidemia, and a proinflammatory state.
        Endocrinology. 2013; 154: 4136-4145
        • Srivastava D.P.
        • Evans P.D.
        G-protein oestrogen receptor 1: trials and tribulations of a membrane oestrogen receptor.
        J Neuroendocrinol. 2013; 25: 1219-1230
        • Mauvais-Jarvis F.
        • Manson J.E.
        • Stevenson J.C.
        • Fonseca V.A.
        Menopausal hormone therapy and type 2 diabetes prevention: evidence, mechanisms, and clinical implications.
        Endocr Rev. 2017; 38: 173-188
        • Xu Y.
        • López M.
        Central regulation of energy metabolism by estrogens.
        Mol Metab. 2018; 15: 104-115
        • Riant E.
        • Waget A.
        • Cogo H.
        • Arnal J.F.
        • Burcelin R.
        • Gourdy P.
        Estrogens protect against high-fat diet-induced insulin resistance and glucose intolerance in mice.
        Endocrinology. 2009; 150: 2109-2117
        • Zhu L.
        • Brown W.C.
        • Cai Q.
        • et al.
        Estrogen treatment after ovariectomy protects against fatty liver and may improve pathway-selective insulin resistance.
        Diabetes. 2013; 62: 424-434
        • Le May C.
        • Chu K.
        • Hu M.
        • et al.
        Estrogens protect pancreatic beta-cells from apoptosis and prevent insulin-deficient diabetes mellitus in mice.
        Proc Natl Acad Sci U S A. 2006; 103: 9232-9237
        • Tiano J.P.
        • Delghingaro-Augusto V.
        • Le May C.
        • et al.
        Estrogen receptor activation reduces lipid synthesis in pancreatic islets and prevents b cell failure in rodent models of type 2 diabetes.
        J Clin Invest. 2011; 121: 3331-3342
        • Lopez M.
        • Tena-Sempere M.
        Estrogens and the control of energy homeostasis: a brain perspective.
        Trends Endocrinol Metab. 2015; 26: 411-421
        • Xu Y.
        • Nedungadi T.P.
        • Zhu L.
        • Sobhani N.
        • Irani B.G.
        • Davis K.E.
        • et al.
        Distinct hypothalamic neurons mediate estrogenic effects on energy homeostasis and reproduction.
        Cell Metab. 2011; 14: 453-465
        • Martínez de Morentin P.B.
        • González-García I.
        • Martins L.
        • Lage R.
        • Fernández-Mallo D.
        • Martínez-Sánchez N.
        • et al.
        Estradiol regulates brown adipose tissue thermogenesis via hypothalamic AMPK.
        Cell Metab. 2014; 20: 41-53
        • Contreras C.
        • Gonzalez-Garcıa I.
        • Martınez-Sanchez N.
        • Seoane-Collazo P.
        • Jacas J.
        • Morgan D.A.
        • et al.
        Central ceramide-induced hypothalamic lipotoxicity and ER stressregulate energy balance.
        Cell Rep. 2014; 9: 366-377
        • Cruciani-Guglielmacci C.
        • López M.
        • Campana M.
        • le Stunff H.
        Brain ceramide metabolism in the control of energy balance.
        Front Physiol. 2017; 8: 787
        • Martınez de Morentin P.B.
        • Lopez M.
        “Mens sana in corpore sano”: exercise and hypothalamic ER stress.
        PLoS Biol. 2010; 8 (e1000464)
        • Milanski M.
        • Arruda A.P.
        • Coope A.
        • Ignacio-Souza L.M.
        • Nunez C.E.
        • Roman E.A.
        • et al.
        Inhibition of hypothalamic inflammation reverses diet-induced insulin resistance in the liver.
        Diabetes. 2012; 61: 1455-1462
        • Bellini L.
        • Campana M.
        • Mahfouz R.
        • Carlier A.
        • Véret J.
        • Magnan C.
        • et al.
        Targeting sphingolipid metabolism in the treatment of obesity/type 2 diabetes.
        Expert Opin Ther Targets. 2015; 19: 1037-1050
        • Chaurasia B.
        • Summers S.A.
        Ceramides - lipotoxic inducers of metabolic disorders.
        Trends Endocrinol Metab. 2015; 26: 538-550
        • Martínez-Sánchez N.
        • Seoane-Collazo P.
        • Contreras C.
        • Varela L.
        • Villarroya J.
        • Rial-Pensado E.
        • et al.
        Hypothalamic AMPK-ER stress-JNK1 axis mediates the central actions of thyroid hormones on energy balance.
        Cell Metab. 2017; 26: 212-229
        • Campana M.
        • Bellini L.
        • Rouch C.
        • Rachdi L.
        • Coant N.
        • Butin N.
        • et al.
        Inhibition of central de novo ceramide synthesis restores insulin signaling in hypothalamus and enhances β-cell function of obese Zucker rats.
        Mol Metab. 2018; 8: 23-36
        • Magnan C.
        • Le Stunff H.
        Role of hypothalamic de novo ceramides synthesis in obesity and associated metabolic disorders.
        Mol Metab. 2021; 14: 101298https://doi.org/10.1016/j.molmet.2021.101298
        • González-García I.
        • Contreras C.
        • Estévez-Salguero Á.
        • Ruíz-Pino F.
        • Colsh B.
        • Pensado I.
        • et al.
        Oestradiol regulates energy balance by ameliorating hypothalamic ceramide-induced ER stress.
        Cell Rep. 2018; 25: 413-423.e5
        • Heras V.
        • Castellano J.M.
        • Fernandois D.
        • Velasco I.
        • Rodríguez-Vazquez E.
        • Roa J.
        • et al.
        Central ceramide signaling mediates obesity-induced precocious puberty.
        Cell Metab. 2020; 32: 951-966.e8
        • Martínez de Morentin P.B.
        • Lage R.
        • González-García I.
        • Ruíz-Pino F.
        • Martins L.
        • Fernández-Mallo D.
        • et al.
        Pregnancy induces resistance to the anorectic effect of hypothalamic malonyl-CoA and the thermogenic effect of hypothalamic AMPK inhibition in female rats.
        Endocrinology. 2015; 156: 947-960
        • Lopez M.
        • Lage R.
        • Saha A.K.
        • Perez-Tilve D.
        • Vazquez M.J.
        • Varela L.
        • et al.
        Hypothalamic fatty acid metabolism mediates the orexigenic action of ghrelin.
        Cell Metab. 2008; 7: 389-399
        • Lopez M.
        • Tena-Sempere M.
        • Dieguez C.
        Cross-talk between orexins (hypocretins) and the neuroendocrine axes (hypothalamic-pituitary axes).
        Front Neuroendocrinol. 2010; 31: 113-127
        • Martinez de Morentin P.B.
        • Whittle A.J.
        • Ferno J.
        • Nogueiras R.
        • Dieguez C.
        • Vidal-Puig A.
        • et al.
        Nicotine induces negative energy balance through hypothalamic AMP-activated protein kinase.
        Diabetes. 2012; 61: 807-817
        • Contreras C.
        • Gonzalez-Garcia I.
        • Seoane-Collazo P.
        • Martinez-Sanchez N.
        • Linares-Pose L.
        • Rial-Pensado E.
        • et al.
        Reduction of hypothalamic endoplasmic reticulum stress activates browning of white fat and ameliorates obesity.
        Diabetes. 2017; 66: 87-99
        • Martins L.
        • Seoane-Collazo P.
        • Contreras C.
        • Gonzalez-Garcia I.
        • Martinez-Sanchez N.
        • Gonzalez F.
        • et al.
        A functional link between AMPK and orexin mediates the effect of BMP8B on energy balance.
        Cell Rep. 2016; 16: 2231-2242
        • Martinez-Sanchez N.
        • Moreno-Navarrete J.M.
        • Contreras C.
        • Rial-Pensado E.
        • Ferno J.
        • Nogueiras R.
        • et al.
        Thyroid hormones induce browning of white fat.
        J Endocrinol. 2017; 232: 351-362
        • Martinez-Sanchez N.
        • Seoane-Collazo P.
        • Contreras C.
        • Varela L.
        • Villarroya J.
        • Rial-Pensado E.
        • et al.
        Hypothalamic AMPK-ER stress-JNK1 axis mediates the central actions of thyroid hormones on energy balance.
        Cell Metab. 2017; 26 ([e212]): 212-229
        • Seoane-Collazo P.
        • Roa J.
        • Rial-Pensado E.
        • Linares-Pose L.
        • Beiroa D.
        • Ruiz-Pino F.
        • et al.
        SF1-specific AMPKalpha1 deletion protects against diet-induced obesity.
        Diabetes. 2018; 67: 2213-2226
        • Bellini L.
        • Campana M.
        • Rouch C.
        • Chacinska M.
        • Bugliani M.
        • Meneyrol K.
        • et al.
        Protective role of the ELOVL2/docosahexaenoic acid axis in glucolipotoxicity-induced apoptosis in rodent beta cells and human islets.
        Diabetologia. 2018; 61: 1780-1793
        • Thaler J.P.
        • Choi S.J.
        • Schwartz M.W.
        • Wisse B.E.
        Hypothalamic inflammation and energy homeostasis: resolving the paradox.
        Front Neuroendocrinol. 2010; 31: 79-84
        • Zhang Xiaoqing
        • Zhang Guo
        • Zhang Hai
        • Karin Michael
        • Bai Hua
        • Cai Dongsheng
        Hypothalamic IKKbeta/NF-kappaB and ER stress link overnutrition to energy imbalance and obesity.
        Cell. 2008; 135: 61-73
        • Douglass J.D.
        • Dorfman M.D.
        • Fasnacht R.
        • Shaffer L.D.
        • Thaler J.P.
        Astrocyte IKKβ/NF-κB signaling is required for diet-induced obesity and hypothalamic inflammation.
        Mol Metab. 2017; 6: 366-373
        • Iwasa T.
        • Matsuzaki T.
        • Matsui S.
        • Tungalagsuvd A.
        • Munkhzaya M.
        • Kawami T.
        • et al.
        The effects of ovariectomy and LPS-induced endotoxemia on resistin levels in female rats.
        Cytokine. 2015; 76: 558-560
        • Dey S.
        • Cui Z.
        • Gavrilova O.
        • Zhang X.
        • Gassmann M.
        • Noguchi C.T.
        Sex-specific brain erythropoietin regulation of mouse metabolism and hypothalamic inflammation.
        JCI Insight. 2020; 5e134061
        • Hayden M.S.
        • Ghosh S.
        Shared principles in NF-kappaB signaling.
        Cell. 2008; 132: 344-362
        • Valdearcos M.
        • Douglass J.D.
        • Robblee M.M.
        • Dorfman M.D.
        • Stifler D.R.
        • Bennett M.L.
        • et al.
        Microglial inflammatory signaling orchestrates the hypothalamic immune response to dietary excess and mediates obesity susceptibility.
        Cell Metab. 2018; 27: 1356
        • Musatov S.
        • Chen W.
        • Pfaff D.W.
        • Mobbs C.V.
        • Yang X.J.
        • Clegg D.J.
        • et al.
        Silencing of estrogen receptor alpha in the ventromedial nucleus of hypothalamus leads to metabolic syndrome.
        Proc Natl Acad Sci U S A. 2007; 13: 2501-2506
        • Turpin-Nolan S.M.
        • Hammerschmidt P.
        • Chen W.
        • Jais A.
        • Timper K.
        • Awazawa M.
        • et al.
        CerS1-derived C(18:0) ceramide in skeletal muscle promotes obesity-induced insulin resistance.
        Cell Rep. 2019; 26: 1-10.e7
        • Vogel H.
        • Mirhashemi F.
        • Liehl B.
        • Taugner F.
        • Kluth O.
        • Kluge R.
        • et al.
        Estrogen deficiency aggravates insulin resistance and induces β-cell loss and diabetes in female New Zealand obese mice.
        Horm Metab Res. 2013; 45: 430-435
        • Santos R.S.
        • Batista T.M.
        • Camargo R.L.
        • Morato P.N.
        • Borck P.C.
        • Leite N.C.
        • et al.
        Lacking of oestradiol reduces insulin exocytosis from pancreatic β-cells and increases hepatic insulin degradation.
        Steroids. 2016; 114: 16-24
        • Jacobson Lauren
        • Ansari Tasneem
        • McGuinness Owen P.
        Counterregulatory deficits occur within 24 h of a single hypoglycemic episode in conscious, unrestrained, chronically cannulated mice.
        Am J Physiol Endocrinol Metab. 2006; 290: E678-E684
        • Chan Owen
        • Sherwin Robert
        Influence of VMH fuel sensing on hypoglycemic responses.
        Trends Endocrinol Metab. 2013; 24: 616-624
        • Pozo M.
        • Claret M.
        Hypothalamic control of systemic glucose homeostasis: the pancreas connection.
        Trends Endocrinol Metab. 2018; 29: 581-594
        • Arruda A.P.
        • Milanski M.
        • Coope A.
        • Torsoni A.S.
        • Ropelle E.
        • Carvalho D.P.
        • et al.
        Low-grade hypothalamic inflammation leads to defective thermogenesis, insulin resistance, and impaired insulin secretion.
        Endocrinology. 2011; 152: 1314-1326
        • Ward W.K.
        • Bolgiano D.C.
        • McKnight B.
        • Halter J.B.
        • Porte Jr., D.
        Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus.
        J Clin Invest. 1984; 74: 1318-1328
        • Allard C.
        • Morford J.J.
        • Xu B.
        • Salwen B.
        • Xu W.
        • Desmoulins L.
        • et al.
        Loss of nuclear and membrane estrogen receptor-α differentially impairs insulin secretion and action in male and female mice.
        Diabetes. 2019; 68: 490-501
        • Liang T.
        • Qin T.
        • Xie L.
        • Dolai S.
        • Zhu D.
        • Prentice K.J.
        • et al.
        New roles of syntaxin-1A in insulin granule exocytosis and replenishment.
        J Biol Chem. 2017; 292: 2203-2216
        • Ahrén B.
        Autonomic regulation of islet hormone secretion--implications for health and disease.
        Diabetologia. 2000; 43: 393-410
        • Handgraaf S.
        • Dusaulcy R.
        • Visentin F.
        • Philippe J.
        • Gosmain Y.
        17-β estradiol regulates proglucagon-derived peptide secretion in mouse and human α- and L cells.
        JCI Insight. 2018; 3e98569
        • Drareni K.
        • Ballaire R.
        • Alzaid F.
        • Goncalves A.
        • Chollet C.
        • Barilla S.
        • et al.
        Adipocyte reprogramming by the transcriptional coregulator GPS2 impacts Beta cell insulin secretion.
        Cell Rep. 2020; 32: 108141
        • Wang F.
        • So K.F.
        • Xiao J.
        • Wang H.
        Organ-organ communication: the liver’s perspective.
        Theranostics. 2021; 11: 3317-3330
        • Quarta C.
        • Claret M.
        • Zeltser L.M.
        • Williams K.W.
        • Yeo G.S.H.
        • Tschöp M.H.
        • et al.
        POMC neuronal heterogeneity in energy balance and beyond: an integrated view.
        Nat Metab. 2021; 3: 299-308
        • Fosch A.
        • Zagmutt S.
        • Casals N.
        • Rodríguez-Rodríguez R.
        New insights of SF1 neurons in hypothalamic regulation of obesity and diabetes.
        Int J Mol Sci. 2021; 22: 6186
        • Myers Jr, M.G.
        • Affinati A.H.
        • Richardson N.
        • Schwartz M.W.
        Central nervous system regulation of organismal energy and glucose homeostasis.
        Nat Metab. 2021; 3: 737-750
        • Ramírez S.
        • Gómez-Valadés A.G.
        • Schneeberger M.
        • Varela L.
        • Haddad-Tóvolli R.
        • Altirriba J.
        • et al.
        Mitochondrial dynamics mediated by mitofusin 1 is required for pomc neuron glucose-sensing and insulin release control.
        Cell Metab. 2017; 25: 1390-1399.e6
        • Sternson S.M.
        • Shepherd G.M.
        • Friedman J.M.
        Topographic mapping of VMH --> arcuate nucleus microcircuits and their reorganization by fasting.
        Nat Neurosci. 2005; 8: 1356-1363
        • Fabelo C.
        • Hernandez J.
        • Chang R.
        • Seng S.
        • Alicea N.
        • Tian S.
        • et al.
        Endocannabinoid signaling at hypothalamic steroidogenic factor-1/proopiomelanocortin synapses is sex- and diet-sensitive.
        Front Mol Neurosci. 2018; 11: 214
        • Vozella V.
        • Basit A.
        • Piras F.
        • Realini N.
        • Armirotti A.
        • Bossù P.
        • et al.
        Elevated plasma ceramide levels in post-menopausal women: a cross-sectional study.
        Aging (Albany NY). 2019; 11: 73-88