Loss of TFB1M results in mitochondrial dysfunction that leads to impaired insulin secretion and diabetes

We have previously identified transcription factor B1 mitochondrial (TFB1M) as a type 2 diabetes (T2D) risk gene, using human and mouse genetics. To further understand the function of TFB1M and how it is associated with T2D, we created a b-cell-specific knockout of Tfb1m, which gradually developed diabetes. Prior to the onset of diabetes, b-Tfb1m2/2 mice exhibited retarded glucose clearance owing to impaired insulin secretion. b-Tfb1m2/2 islets released less insulin in response to fuels, contained less insulin and secretory granules and displayed reduced b-cell mass. Moreover, mitochondria in Tfb1m-deficient b-cells were more abundant with disrupted architecture. TFB1M is known to control mitochondrial protein translation by adenine dimethyla-tion of 12S ribosomal RNA (rRNA). Here, we found that the levels of TFB1M and mitochondrial-encoded proteins, mitochondrial 12S rRNA methylation, ATP production and oxygen consumption were reduced in b-Tfb1m2/2 islets. Furthermore, the levels of reactive oxygen species (ROS) in response to cellular stress were increased whereas induction of defense mechanisms was attenuated. We also show increased apoptosis and necrosis as well as infiltration of macrophages and CD41 cells in the islets. Taken together, our findings demonstrate that Tfb1m-deficiency in b-cells caused mitochondrial dysfunction and subsequently diabetes owing to com-bined loss of b-cell function and mass. These observations reflect pathogenetic processes in human islets: using RNA sequencing, we found that the TFB1M risk variant exhibited a negative gene-dosage effect on isle