Titov V N, Rozhkova Т А, Kaminnaya V А
National Medical Research Center of Cardiology of the Ministry of Health of Russia, Moscow, 121552.
Klin Lab Diagn. 2018;63(3):132-141. doi: 10.18821/0869-2084-2018-63-3-132-141.
Phylogenetic theory of general pathology draws researchers' attention to the following aspects of the biological effects of insulin. 1. Phylogenetically, in vivo insulin is primarily involved in the metabolism of fatty acids (FA) and only in the second turn in glucose metabolism; regulation of FA metabolism in cells started millions of years earlier than that of glucose metabolism. Phylogenetically late insulin blocks lipolysis only in phylogenetically late insulin-dependent subcutaneous adipocytes but not in phylogenetically early visceral fat cells of the omentum. 2. Biological role of insulin consists in the formation of the biological function of locomotion, i.e., movement arising from contraction of striated myocytes provided with substrates (FA and glucose) for energy production as macroergic ATP. 3. Biological destiny of phylogenetically late insulin is transformation of carnivorous (fish-eating) animals living in the ocean into herbivores living on the dry land. 4. Insulin has formed in vivo highly efficient oleic variant of FA metabolism instead of phylogenetically early less efficient palmitic variant. 5. Biologically, insulin is destined for providing cells with energy and perfection of physical activity and kinetic parameters of the organism. According to phylogenetic theory of general pathology and basic principles of endocrinology, clinical cases should be regarded as: 1. rare structurally-related insulindeficient type I diabetes mellitus, 2. rare structurally-related (receptor pathology) hyperinsulinemic type II diabetes mellitus, and 3. a great number of patients with functional disorders in the hormone activity, insulin resistance syndrome, metabolic syndrome and obesity. We believe that the food of herbivores should contain palmitic acid in the amounts that hepatocytes can esterify into oleic very low density lipoproteins and cells can internalize as ligand oleic by apoЕ/В-100 endocytosis without formation of low density lipoproteins.
普通病理学的系统发育理论促使研究人员关注胰岛素生物效应的以下几个方面。1. 从系统发育角度来看，体内胰岛素主要参与脂肪酸（FA）代谢，而在葡萄糖代谢中仅处于次要地位；细胞内FA代谢的调节比葡萄糖代谢早数百万年开始。从系统发育角度来看，较晚出现的胰岛素仅在系统发育较晚的依赖胰岛素的皮下脂肪细胞中阻止脂肪分解，而在系统发育较早的网膜内脏脂肪细胞中则不然。2. 胰岛素的生物学作用在于形成运动的生物学功能，即由横纹肌细胞收缩产生的运动，这些细胞提供底物（FA和葡萄糖）用于产生作为高能ATP的能量。3. 系统发育较晚出现的胰岛素的生物学命运是将生活在海洋中的肉食性（食鱼）动物转变为生活在陆地上的草食性动物。4. 胰岛素在体内形成了高效的FA代谢油酸变体，而不是系统发育较早的效率较低的棕榈酸变体。5. 从生物学角度来看，胰岛素的作用是为细胞提供能量，并完善机体的体力活动和动力学参数。根据普通病理学的系统发育理论和内分泌学的基本原理，临床病例应被视为：1. 罕见的与结构相关的胰岛素缺乏型I型糖尿病，2. 罕见的与结构相关的（受体病理）高胰岛素血症型II型糖尿病，以及3. 大量激素活性功能障碍、胰岛素抵抗综合征、代谢综合征和肥胖患者。我们认为，食草动物的食物中应含有一定量的棕榈酸，肝细胞可以将其酯化为油酸极低密度脂蛋白，细胞可以通过载脂蛋白E/B-100内吞作用将油酸作为配体内化，而不会形成低密度脂蛋白。
