Research Article| Volume 139, 155371, February 2023

Impaired hepatic glucose metabolism and liver-α-cell axis in mice with liver-specific ablation of the Hepatocyte Nuclear Factor 4α (Hnf4a) gene

  • Efstathia Thymiakou
    Laboratory of Biochemistry, University of Crete Medical School, Heraklion 71003, Greece

    Gene Regulation and Epigenetics group, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology of Hellas, Heraklion 71003, Greece
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  • Maria Tzardi
    Department of Pathology, University of Crete Medical School, Heraklion, Crete, Greece
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  • Dimitris Kardassis
    Corresponding author at: Laboratory of Biochemistry, University of Crete Medical School, Heraklion 71003, Greece.
    Laboratory of Biochemistry, University of Crete Medical School, Heraklion 71003, Greece

    Gene Regulation and Epigenetics group, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology of Hellas, Heraklion 71003, Greece
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Published:November 30, 2022DOI:


      • Insulin and glucagon signaling are perturbed in H4LivKO mice.
      • Liver-α-cell axis is impaired in H4LivKO mice.
      • Oral administration of glucose significantly improves survival of H4LivKO mice.
      • H4LivKO mice show increased hepatic gene expression of fibrotic markers.



      Hnf4a gene ablation in mouse liver causes hepatic steatosis, perturbs HDL structure and function and affects many pathways and genes related to glucose metabolism. Our aim here was to investigate the role of liver HNF4A in glucose homeostasis.


      Serum and tissue samples were obtained from Alb-Cre;Hnf4afl/fl (H4LivKO) mice and their littermate Hnf4afl/fl controls. Fasting glucose and insulin, glucose tolerance, insulin tolerance and glucagon challenge tests were performed by standard procedures. Binding of HNF4A to DNA was assessed by chromatin immunoprecipitation assays. Gene expression analysis was performed by quantitative reverse transcription PCR.


      H4LivKO mice presented lower blood levels of fasting glucose, improved glucose tolerance, increased serum lactate levels and reduced response to glucagon challenge compared to their control littermates. Insulin signaling in the liver was reduced despite the increase in serum insulin levels. H4LivKO mice showed altered expression of genes involved in glycolysis, gluconeogenesis and glycogen metabolism in the liver. The expression of the gene encoding the glucagon receptor (Gcgr) was markedly reduced in H4LivKO liver and chromatin immunoprecipitation assays revealed specific and strong binding of HNF4A to the Gcgr promoter. H4LivKO mice presented increased amino acid concentration in the serum, α-cell hyperplasia and a dramatic increase in glucagon levels suggesting an impairment of the liver-α-cell axis. Glucose administration in the drinking water of H4LivKO mice resulted in an impressive extension of survival. The expression of several genes related to non-alcoholic fatty liver disease progression to more severe liver pathologies, including Mcp1, Gdf15, Igfbp-1 and Hmox1, was increased in H4LivKO mice as early as 6 weeks of age and this increased expression was sustained until the endpoint of the study.


      Our results reveal a novel role of liver HNF4A in controlling blood glucose levels via regulation of glucagon signaling. In combination with the steatotic phenotype, our results suggest that H4LivKO mice could serve as a valuable model for studying glucose homeostasis in the context of non-alcoholic fatty liver disease.

      Graphical abstract

      Unlabelled Image
      Graphical AbstractSchematic representation of the effect of hepatic Hnf4a gene ablation on glucose and amino acid metabolism in the liver and the impairment of the liver-α-cell axis.


      AUC (area under the curve), CTR (control), GCT (glucagon challenge test), GCGR (glucagon receptor), GLUT (glucose transporter), H4LivKO (HNF4A liver-specific knock out), H&E (hematoxylin and eosin), HCC (hepatocellular carcinoma), HNF4 (hepatocyte nuclear factor 4), HOMA-IR (homeostatic model assessment of insulin resistance), IPGTT (intraperitoneal glucose tolerance test), IR (Insulin resistance), ITT (insulin tolerance test), MODY1 (maturity-onset diabetes of the young type 1), NAFLD (non-alcoholic Fatty Liver Disease), NASH (non-alcoholic steatohepatitis), RT-qPCR (quantitative reverse transcription PCR), SGOT (aspartate transaminase), SGPT (alanine transaminase), T2D (type 2 diabetes), ZT (Zeitgeber time)


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