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脂肪酸代谢的“宜居带”;确保与心脏功能的关系恰到好处。

The 'Goldilocks zone' of fatty acid metabolism; to ensure that the relationship with cardiac function is just right.

作者信息

Kerr Matthew, Dodd Michael S, Heather Lisa C

机构信息

Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K.

出版信息

Clin Sci (Lond). 2017 Jul 24;131(16):2079-2094. doi: 10.1042/CS20160671. Print 2017 Aug 15.

Abstract

Fatty acids (FA) are the main fuel used by the healthy heart to power contraction, supplying 60-70% of the ATP required. FA generate more ATP per carbon molecule than glucose, but require more oxygen to produce the ATP, making them a more energy dense but less oxygen efficient fuel compared with glucose. The pathways involved in myocardial FA metabolism are regulated at various subcellular levels, and can be divided into sarcolemmal FA uptake, cytosolic activation and storage, mitochondrial uptake and β-oxidation. An understanding of the critical involvement of each of these steps has been amassed from genetic mouse models, where forcing the heart to metabolize too much or too little fat was accompanied by cardiac contractile dysfunction and hypertrophy. In cardiac pathologies, such as heart disease and diabetes, aberrations in FA metabolism occur concomitantly with changes in cardiac function. In heart failure, FA oxidation is decreased, correlating with systolic dysfunction and hypertrophy. In contrast, in type 2 diabetes, FA oxidation and triglyceride storage are increased, and correlate with diastolic dysfunction and insulin resistance. Therefore, too much FA metabolism is as detrimental as too little FA metabolism in these settings. Therapeutic compounds that rebalance FA metabolism may provide a mechanism to improve cardiac function in disease. Just like Goldilocks and her porridge, the heart needs to maintain FA metabolism in a zone that is 'just right' to support contractile function.

摘要

脂肪酸(FA)是健康心脏用于驱动收缩的主要燃料,提供所需ATP的60 - 70%。与葡萄糖相比,每个碳原子的脂肪酸产生的ATP更多,但产生ATP需要更多氧气,这使得它们与葡萄糖相比是一种能量密度更高但氧利用效率更低的燃料。心肌脂肪酸代谢所涉及的途径在各个亚细胞水平受到调控,可分为肌膜脂肪酸摄取、胞质激活与储存、线粒体摄取及β -氧化。从基因小鼠模型中已积累了对这些步骤中每一步关键作用的认识,在这些模型中,迫使心脏过多或过少地代谢脂肪会伴随着心脏收缩功能障碍和肥大。在诸如心脏病和糖尿病等心脏疾病中,脂肪酸代谢异常与心脏功能变化同时出现。在心力衰竭中,脂肪酸氧化减少,这与收缩功能障碍和肥大相关。相反,在2型糖尿病中,脂肪酸氧化和甘油三酯储存增加,且与舒张功能障碍和胰岛素抵抗相关。因此,在这些情况下,过多的脂肪酸代谢与过少的脂肪酸代谢一样有害。重新平衡脂肪酸代谢的治疗性化合物可能提供一种改善疾病中心脏功能的机制。就像金发姑娘和她的粥一样,心脏需要将脂肪酸代谢维持在一个“恰到好处”的水平以支持收缩功能。

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