Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Functional Food Research Center for Well-Being, Chiang Mai University, Chiang Mai, Thailand.
Am J Med Sci. 2020 Feb;359(2):84-99. doi: 10.1016/j.amjms.2019.11.004. Epub 2019 Nov 25.
The pathogenesis of diabetic kidney disease is a complex process caused by both glucotoxicity and lipotoxicity due to lipid accumulation. In cases of diabetic animals, lipid deposition is found in both tubular and glomerular portions of the kidneys, which are the major sites of diabetic nephropathy lesions. The aim of this review was to provide insights into the mechanisms that lead to the development of renal lipid accumulation and the effects of renal lipotoxicity in the diabetic condition. An increased number of lipogenic genes and a decreased number of lipid oxidation genes are also detected in diabetic kidneys, both of which lead to lipid accumulation. The induction of oxidative stress, inflammation, fibrosis and apoptosis caused by lipid accumulation and lipid metabolites is called lipotoxicity. Renal lipotoxicity due to derangement in lipid metabolism may be a pathogenic mechanism leading to diabetic nephropathy and renal dysfunction.
糖尿病肾病的发病机制是一个复杂的过程,由葡萄糖毒性和脂质毒性引起,脂质堆积是导致其发病的原因。在糖尿病动物模型中,脂质在肾脏的管状和肾小球部分均有沉积,这是糖尿病肾病病变的主要部位。本综述旨在深入了解导致肾脏脂质堆积的机制,以及在糖尿病状态下肾脏脂毒性的作用。在糖尿病肾脏中,还检测到了更多的生脂基因和更少的脂质氧化基因,这两者均导致了脂质堆积。脂质堆积和脂质代谢物引起的氧化应激、炎症、纤维化和细胞凋亡被称为脂毒性。由于脂质代谢紊乱导致的肾脏脂毒性可能是导致糖尿病肾病和肾功能障碍的发病机制之一。