Department of Endocrinology, University of Ioannina, Ioannina, Greece.
Curr Med Chem. 2012;19(32):5451-8. doi: 10.2174/092986712803833182.
Adiponectin represents one of the most abundant and well-studied adipokines that has been implicated as a major protective factor against the adverse metabolic and cardiovascular consequences of obesity. The main insulin-sensitizing action of adiponectin results from decrease in hepatic gluconeogenesis and increase in muscle glucose transport and, secondly from enhancement of energy consumption and fatty acid oxidation in peripheral tissues with the aim of increasing ATP production. Besides these effects, the potential role of adiponectin on insulin secretion, as well as on energy expenditure, through central action, has also been investigated. Accumulating evidence from clinical, experimental animal and genetic studies support a close association between hypoadiponectinemia and insulin resistance/ type 2 diabetes. The question that arises is whether hypoadiponectinemia is the result of insulin resistance/type 2 diabetes or the cause of this disorder. Based on the observation that various drug classes exert beneficial effects on insulin resistance partly by increasing plasma adiponectin levels, it could hypothesized that substances that enhance or mimic adiponectin to activate its receptors and/or postreceptor signaling pathway may be a promising therapeutic strategy in the prevention and treatment of diabetes. However, many questions need to be addressed before adiponectin can be used as a potent therapeutic target.
脂联素是含量最丰富、研究最多的脂肪因子之一，被认为是肥胖导致代谢和心血管不良后果的主要保护因子。脂联素的主要胰岛素增敏作用源于降低肝糖异生和增加肌肉葡萄糖转运，其次源于增强外周组织的能量消耗和脂肪酸氧化，以增加 ATP 产生。除了这些作用外，还研究了脂联素通过中枢作用对胰岛素分泌以及能量消耗的潜在作用。来自临床、实验动物和遗传研究的越来越多的证据支持低脂联素血症与胰岛素抵抗/2 型糖尿病之间的密切关联。问题是低脂联素血症是胰岛素抵抗/2 型糖尿病的结果还是这种疾病的原因。基于各种药物类别通过增加血浆脂联素水平对胰岛素抵抗产生有益影响的观察，人们可以假设，增强或模拟脂联素以激活其受体和/或受体后信号通路的物质可能是预防和治疗糖尿病的一种有前途的治疗策略。然而，在将脂联素用作有效的治疗靶点之前，还需要解决许多问题。
