Wang Peipei, Chatham John C
Division of Cardiovascular Disease, Department of Medicine, The Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Al 35294-0005, USA.
Am J Physiol Endocrinol Metab. 2004 May;286(5):E725-36. doi: 10.1152/ajpendo.00295.2003. Epub 2004 Jan 13.
The aim of this study was to determine whether the transition from insulin resistance to hyperglycemia in a model of type 2 diabetes leads to intrinsic changes in the myocardium that increase the sensitivity to ischemic injury. Hearts from 6-, 12-, and 24-wk-old lean (Control) and obese Zucker diabetic fatty (ZDF) rats were isolated, perfused, and subjected to 30 min of low-flow ischemia (LFI) and 60 min of reperfusion. At 6 wk, ZDF animals were insulin resistant but not hyperglycemic. By 12 wk, the ZDF group was hyperglycemic and became progressively worse by 24 wk. In spontaneously beating hearts rate-pressure product (RPP) was depressed in the ZDF groups compared with age-matched Controls, primarily due to lower heart rate. Pacing significantly increased RPP in all ZDF groups; however, this was accompanied by a significant decrease in left ventricular developed pressure. There was also greater contracture during LFI in the ZDF groups compared with the Control group; surprisingly, however, functional recovery upon reperfusion was significantly higher in the diabetic 12- and 24-wk ZDF groups compared with age-matched Control groups and the 6-wk ZDF group. This improvement in recovery in the ZDF diabetic groups was independent of substrate availability, severity of ischemia, and duration of diabetes. These data demonstrate that, although the development of type 2 diabetes leads to progressive contractile and metabolic abnormalities during normoxia and LFI, it was not associated with increased susceptibility to ischemic injury.
本研究的目的是确定在2型糖尿病模型中从胰岛素抵抗转变为高血糖是否会导致心肌发生内在变化,从而增加对缺血性损伤的敏感性。分离6周龄、12周龄和24周龄的瘦型(对照)和肥胖型Zucker糖尿病脂肪大鼠(ZDF)的心脏,进行灌注,并使其经历30分钟的低流量缺血(LFI)和60分钟的再灌注。在6周时,ZDF动物存在胰岛素抵抗但未出现高血糖。到12周时,ZDF组出现高血糖,且到24周时病情逐渐加重。在自主跳动的心脏中,与年龄匹配的对照组相比,ZDF组的心率-压力乘积(RPP)降低,主要是由于心率较低。起搏显著增加了所有ZDF组的RPP;然而,这伴随着左心室舒张末压的显著降低。与对照组相比,ZDF组在LFI期间的挛缩也更严重;然而,令人惊讶的是,与年龄匹配的对照组和6周龄ZDF组相比,糖尿病12周龄和24周龄ZDF组再灌注后的功能恢复明显更高。ZDF糖尿病组恢复情况的改善与底物可用性、缺血严重程度和糖尿病持续时间无关。这些数据表明,尽管2型糖尿病的发展会导致常氧和LFI期间逐渐出现收缩和代谢异常,但这与对缺血性损伤的易感性增加无关。