Alberto González-Regueiro José, Moreno-Castañeda Lidia, Uribe Misael, Carlos Chávez-Tapia Norberto
Department of Internal Medicine. Medica Sur Clinic & Foundation. Mexico City, Mexico.
Department of Endocrinology. Medica Sur Clinic & Foundation. Mexico City, Mexico.
Ann Hepatol. 2017 Nov;16 Suppl 1:S15-S20. doi: 10.5604/01.3001.0010.5494.
Bile acids (BAs), the end products of cholesterol catabolism, are essential for the absorption of lipids and fat-soluble vitamins; but they have also emerged as novel signaling molecules that act as metabolic regulators. It has been well described that the enterohe-patic circulation, a nuclear (FXR) and a cytoplasmic (TGR5/M-BAR) receptor aid in controlling hepatic bile acid synthesis. Modulating bile acid synthesis greatly impacts in metabolism, because these receptors also are implicated in glucose, lipid, and energy expenditure. Recent studies had revealed the way these receptors participate in regulating gluconeogenesis, peripheral insulin sensitivity, glycogen synthesis, glucagon like peptide 1 (GLP-1) and insulin secretion. Nowadays, it is demonstrated that enhancing bile acid signaling in the intestine contributes to the metabolic benefits of bile acid sequestrants and bariatric surgery on glucose homeos-tasis. This paper discusses the role of bile acid as regulators of glucose metabolism and their potential as therapeutic targets for diabetes.
胆汁酸(BAs)是胆固醇分解代谢的终产物,对脂质和脂溶性维生素的吸收至关重要;但它们也已成为作为代谢调节因子的新型信号分子。肠肝循环、一种核受体(FXR)和一种细胞质受体(TGR5/M-BAR)有助于控制肝脏胆汁酸合成,这一点已得到充分描述。调节胆汁酸合成对代谢有很大影响,因为这些受体也与葡萄糖、脂质和能量消耗有关。最近的研究揭示了这些受体参与调节糖异生、外周胰岛素敏感性、糖原合成、胰高血糖素样肽1(GLP-1)和胰岛素分泌的方式。如今,已证明增强肠道中的胆汁酸信号传导有助于胆汁酸螯合剂和减肥手术对葡萄糖稳态产生代谢益处。本文讨论了胆汁酸作为葡萄糖代谢调节因子的作用及其作为糖尿病治疗靶点的潜力。