Abushamat Layla A, McClatchey P Mason, Scalzo Rebecca L, Schauer Irene, Huebschmann Amy G, Nadeau Kristen J, Liu Zhenqi, Regensteiner Judith G, Reusch Jane E B
Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
Sigilon Therapeutics, Cambridge, Massachusetts.
J Endocr Soc. 2020 Jun 7;4(7):bvaa063. doi: 10.1210/jendso/bvaa063. eCollection 2020 Jul 1.
Type 2 diabetes (T2D) has been rising in prevalence in the United States and worldwide over the past few decades and contributes to significant morbidity and premature mortality, primarily due to cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable cardiovascular (CV) risk factor in the general population and in people with T2D. Young people and adults with T2D have reduced CRF when compared with their peers without T2D who are similarly active and of similar body mass index. Furthermore, the impairment in CRF conferred by T2D is greater in women than in men. Various factors may contribute to this abnormality in people with T2D, including insulin resistance and mitochondrial, vascular, and cardiac dysfunction. As proof of concept that understanding the mediators of impaired CRF in T2D can inform intervention, we previously demonstrated that an insulin sensitizer improved CRF in adults with T2D. This review focuses on how contributing factors influence CRF and why they may be compromised in T2D. Functional exercise capacity is a measure of interrelated systems biology; as such, the contribution of derangement in each of these factors to T2D-mediated impairment in CRF is complex and varied. Therefore, successful approaches to improve CRF in T2D should be multifaceted and individually designed. The current status of this research and future directions are outlined.
在过去几十年里，2型糖尿病（T2D）在美国及全球范围内的患病率一直在上升，并且主要由于心血管疾病（CVD）导致了显著的发病率和过早死亡。心肺适能（CRF）是一般人群以及T2D患者中一个可改变的心血管（CV）风险因素。与同样活跃且体重指数相似但无T2D的同龄人相比，患有T2D的年轻人和成年人的CRF较低。此外，T2D导致的CRF损害在女性中比在男性中更严重。T2D患者出现这种异常可能有多种因素，包括胰岛素抵抗以及线粒体、血管和心脏功能障碍。作为理解T2D中CRF受损的介导因素可为干预提供依据的概念验证，我们之前证明了一种胰岛素增敏剂可改善成年T2D患者的CRF。本综述重点关注促成因素如何影响CRF以及它们在T2D中可能受损的原因。功能性运动能力是相互关联的系统生物学的一种度量；因此，这些因素中的每一个紊乱对T2D介导的CRF损害的贡献都是复杂且多样的。所以，改善T2D患者CRF的成功方法应该是多方面的且需个体化设计。本文概述了该研究的现状及未来方向。
