Journal of Molecular Endocrinology

Role of ER–mitochondria miscommunication in metabolic diseases. At top: optimal ER–mitochondria interactions are required for metabolic flexibility (left) and insulin signaling (right). Top left: increased organelle interactions at fasting state promote mitochondria fusion and maximal oxidative capacities to predominantly oxidize lipids. Top right: antidiabetic drugs improve both insulin sensitivity and organelle interactions in diabetic mice. At the bottom: ER–mitochondria miscommunication is involved in metabolic inflexibility during nutritional transition (left) and in insulin resistance (right). Bottom left: high glucose levels reduce ER–mitochondria interactions at post-prandial state, presumably leading to the storage of excess of glucose into lipids. Bottom right: palmitate treatment, high-fat and high-sucrose diet (HFHSD) feeding or loss of cyclophilin D (CypD) reduces both organelle interactions and insulin sensitivity.