Division of Molecular Cardiology, Department of Medicine, College of Medicine, Texas A&M University Health Science Center, Scott & White, Central Texas Veterans Health Care System, 1901 South 1st Street, Bldg. 205, Temple, Texas 76504, USA.
J Endocrinol. 2014 Jan 8;220(2):T1-T23. doi: 10.1530/JOE-13-0327. Print 2014 Feb.
Insulin resistance is a major underlying mechanism responsible for the 'metabolic syndrome', which is also known as insulin resistance syndrome. The incidence of the metabolic syndrome is increasing at an alarming rate, becoming a major public and clinical problem worldwide. The metabolic syndrome is represented by a group of interrelated disorders, including obesity, hyperglycemia, hyperlipidemia, and hypertension. It is also a significant risk factor for cardiovascular disease and increased morbidity and mortality. Animal studies have demonstrated that insulin and its signaling cascade normally control cell growth, metabolism, and survival through the activation of MAPKs and activation of phosphatidylinositide-3-kinase (PI3K), in which the activation of PI3K associated with insulin receptor substrate 1 (IRS1) and IRS2 and subsequent Akt→Foxo1 phosphorylation cascade has a central role in the control of nutrient homeostasis and organ survival. The inactivation of Akt and activation of Foxo1, through the suppression IRS1 and IRS2 in different organs following hyperinsulinemia, metabolic inflammation, and overnutrition, may act as the underlying mechanisms for the metabolic syndrome in humans. Targeting the IRS→Akt→Foxo1 signaling cascade will probably provide a strategy for therapeutic intervention in the treatment of type 2 diabetes and its complications. This review discusses the basis of insulin signaling, insulin resistance in different mouse models, and how a deficiency of insulin signaling components in different organs contributes to the features of the metabolic syndrome. Emphasis is placed on the role of IRS1, IRS2, and associated signaling pathways that are coupled to Akt and the forkhead/winged helix transcription factor Foxo1.
胰岛素抵抗是导致“代谢综合征”的主要潜在机制,也称为胰岛素抵抗综合征。代谢综合征的发病率正在以惊人的速度增长,成为全球主要的公共和临床问题。代谢综合征表现为一组相互关联的疾病,包括肥胖、高血糖、高血脂和高血压。它也是心血管疾病发病率和死亡率增加的重要危险因素。动物研究表明,胰岛素及其信号级联通过激活 MAPK 和磷脂酰肌醇 3-激酶 (PI3K) 来正常控制细胞生长、代谢和存活,其中与胰岛素受体底物 1 (IRS1) 和 IRS2 相关的 PI3K 的激活以及随后 Akt→Foxo1 磷酸化级联在控制营养稳态和器官存活方面发挥核心作用。在高胰岛素血症、代谢炎症和营养过剩的情况下,Akt 的失活和 Foxo1 的激活会抑制不同器官中的 IRS1 和 IRS2,这可能是人类代谢综合征的潜在机制。针对 IRS→Akt→Foxo1 信号级联可能为治疗 2 型糖尿病及其并发症提供治疗干预策略。本文讨论了胰岛素信号的基础、不同小鼠模型中的胰岛素抵抗以及不同器官中胰岛素信号成分的缺乏如何导致代谢综合征的特征。重点介绍了 IRS1、IRS2 以及与 Akt 和叉头/翼状螺旋转录因子 Foxo1 偶联的相关信号通路的作用。