Hepatic PHD3 Stimulates Gluconeogenesis and Aggravates Hyperglycemia and Type 2 Diabetes by Hydroxylating CRTC2 at Pro129 and Pro615

Hepatic gluconeogenesis is critical for metabolic adaption in response to fasting, and its abnormal elevation contributes to the pathogenesis of hyperglycemia and type 2 diabetes. However, whether and how protein hydroxylation regulates hepatic gluconeogenesis and glucose metabolism remains largely unknown. Here we report that PHD3 is identified as a fasting-induced factor and regulates hepatic gluconeogenesis through interaction and hydroxylation of CRTC2. Pro129 and Pro615 hydroxylation of CRTC2 following PHD3 activation is necessary for its nuclear translocation and association with CREB, and enhanced binding to promoters of gluconeogenic target genes in response to fasting or the cAMP activator forskolin. CRTC2 hydroxylation-stimulated gluconeogenic gene expression is independent of SIK-mediated phosphorylation of CRTC2. Liver-specific knockout of PHD3 (PHD3 LKO) mice or prolyl hydroxylase-deficient knockin mice with alanine mutation in PHD3 at Pro196 (PHD3 KI) show significant attenuated gluconeogenic genes, glycaemia and hepatic capacity to produce glucose during fasting or fed with high-fat, high-sucrose diet. The efficacies of glucagon or adenylyl cyclase activator forskolin on stimulating the expression of gluconeogenic enzymes, such as PEPCK and G6Pase, and on glucose output are abolished in PHD3-/- mouse primary hepatocytes. Importantly, Pro615 hydroxylation of CRTC2 by PHD3 is increased in livers of fasted mice, diet-induced insulin resistance or genetically obese ob/ob mice and humans with diabetes. Together, these findings increase our understanding of the molecular mechanisms linking protein hydroxylation to gluconeogenesis under physiological and insulin resistant conditions, and may offer therapeutic potential for treating sustained gluconeogenesis, hyperglycemia and type 2 diabetes. Disclosure Y.Xue: None. W.Su: None. J.Zhao: None. C.Gao: None. J.Wen: None. Y.Xu: None. W.Fu: None. J.C.Fang: None. Y.Li: None. A.Cui: None. S.Wei: None. F.Ma: None. Z.Liu: None. X.Fang: None. W.Li: None. Y.Liu: None. G.Cai: None. Funding National Key R&D Program of China (2019YFA0802502); National Natural Science Foundation of China (81925008, 82073061, 82170587, 32100943); Ministry of Science and Technology of China (2020YFA0803301); Open Project Program of Metabolic Vascular Diseases Key Laboratory of Sichuan Province (2022MVDKL-K2); Shandong Natural Science Foundation (ZR2020MH206); China Postdoctoral Science Foundation (2021M693273)