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Chronic and heavy alcohol consumption is one of the causes of heart diseases. However, the effects of ethanol on insulin sensitivity in myocardium has been unclear. To investigate the effects of ethanol on the expression of AMP-activated protein kinase (AMPK), myocyte enhancer factor 2 (MEF2) and glucose transporter 4 (GLUT4), all of which are involved in the regulation of insulin sensitivity, in the myocardium, we performed three parts of experiments in vivo and in vitro. I: Rats were injected with 5-amino-4-imidazolecarboxamide ribonucleotide (AICAR, 0.8 mg.kg-1) for 2 h. II:Rats received different dose (0.5, 2.5 or 5 g.kg-1.d-1) of ethanol for 22-week. III: Primary neonatal rat cardiomyocytes were isolated and treated with or without 100 mM ethanol or 1 mM AICAR for 4 h. The cardiac protein and mRNA expression of AMPKα subunits, MEF2and GLUT4 were observed by western-blotting and RT-PCR, respectively. Serum TNFα levels were assessed by ELISA. The results showed chronic ethanol exposure induced insulin resistance. Ethanol decreased the mRNA levels of AMPKα1 and α2, the protein levels of total- and phospho-AMPKα in cardiomyocytes. Similarly, ethanol showed inhibitory effects on both the mRNA and protein levels of MEF2A and 2D,and GLUT4 in a dose-response-like fashion. Correlation analysis implied an association between phospho-AMPKα and MEF2A or MEF2D, and between the levels of MEF2 protein and GLUT4 transcription. In addition,ethanol elevated serum TNFα level. Taken together,chronic ethanol exposure decreases the expression of AMPKα and MEF2, and is associated with GLUT4 decline in rat myocardium.

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