Ye Hui, He Yanan, Zheng Chuan, Wang Fang, Yang Ming, Lin Junzhi, Xu Runchun, Zhang Dingkun
State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2022 Mar 3;13:816588. doi: 10.3389/fphar.2022.816588. eCollection 2022.
Type 2 diabetes mellitus (T2DM) and heart failure (HF) are diseases characterized by high morbidity and mortality. They often occur simultaneously and increase the risk of each other. T2DM complicated with HF, as one of the most dangerous disease combinations in modern medicine, is more common in middle-aged and elderly people, making the treatment more difficult. At present, the combination of blood glucose control and anti-heart failure is a common therapy for patients with T2DM complicated with HF, but their effect is not ideal, and many hypoglycemic drugs have the risk of heart failure. Abnormal insulin signaling pathway, as a common pathogenic mechanism in T2DM and HF, could lead to pathological features such as insulin resistance (IR), myocardial energy metabolism disorders, and vascular endothelial disorders. The therapy based on the insulin signaling pathway may become a specific therapeutic target for T2DM patients with HF. Here, we reviewed the mechanisms and potential drugs of insulin signaling pathway in the treatment of T2DM complicated with HF, with a view to opening up a new perspective for the treatment of T2DM patients with HF and the research and development of new drugs.
2型糖尿病(T2DM)和心力衰竭(HF)是发病率和死亡率都很高的疾病。它们常常同时发生,且会增加彼此的发病风险。T2DM合并HF是现代医学中最危险的疾病组合之一,在中老年人中更为常见,这使得治疗更加困难。目前,控制血糖与抗心力衰竭相结合是T2DM合并HF患者的常用治疗方法,但效果并不理想,而且许多降糖药物都有导致心力衰竭的风险。胰岛素信号通路异常作为T2DM和HF的共同致病机制,可导致胰岛素抵抗(IR)、心肌能量代谢紊乱和血管内皮紊乱等病理特征。基于胰岛素信号通路的治疗可能成为T2DM合并HF患者的特异性治疗靶点。在此,我们综述了胰岛素信号通路在治疗T2DM合并HF中的机制及潜在药物,以期为T2DM合并HF患者的治疗及新药研发开辟新的视角。