Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Am J Physiol Endocrinol Metab. 2020 Jul 1;319(1):E43-E47. doi: 10.1152/ajpendo.00219.2020. Epub 2020 May 29.
The COVID-19 pandemic, caused by the novel coronavirus, SARS-CoV-2, is threating our health systems and daily lives and is responsible for causing substantial morbidity and mortality. In particular, aged individuals and individuals with comorbidities, including obesity, diabetes mellitus, and hypertension, have significantly higher risks of hospitalization and death than normal individuals. The renin-angiotensin system (RAS) plays a pivotal role in the pathogenesis of diabetes mellitus, obesity, and hypertension. Angiotensin-converting enzyme 2 (ACE2), belonging to the RAS family, has received much attention during this COVID-19 pandemic, owing to the fact that SARS-CoV-2 uses ACE2 as a receptor for cellular entry. Additionally, the RAS greatly affects energy metabolism in certain pathological conditions, including cardiac failure, diabetes mellitus, and viral infections. This article discusses the potential mechanisms by which SARS-CoV-2 modulates the RAS and energy metabolism in individuals with obesity and diabetes mellitus. The article aims to highlight the appropriate strategies for combating the COVID-19 pandemic in the clinical setting and emphasize on the areas that require further investigation in relation to COVID-19 infections in patients with obesity and diabetes mellitus from the viewpoint of endocrinology and metabolism.
新型冠状病毒引起的 COVID-19 大流行正在威胁我们的医疗体系和日常生活，并导致大量发病和死亡。特别是老年人和合并症患者（包括肥胖、糖尿病和高血压）的住院和死亡风险明显高于一般人群。肾素-血管紧张素系统（RAS）在糖尿病、肥胖和高血压的发病机制中起关键作用。血管紧张素转换酶 2（ACE2）属于 RAS 家族，在 COVID-19 大流行期间受到了广泛关注，因为 SARS-CoV-2 利用 ACE2 作为细胞进入的受体。此外，RAS 在某些病理情况下（包括心力衰竭、糖尿病和病毒感染）对能量代谢有很大影响。本文讨论了 SARS-CoV-2 在肥胖和糖尿病患者中调节 RAS 和能量代谢的潜在机制。本文旨在强调在临床环境中对抗 COVID-19 大流行的适当策略，并从内分泌和代谢的角度强调肥胖和糖尿病患者 COVID-19 感染相关需要进一步研究的领域。
