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胰岛素抵抗治疗靶点的分子和代谢途径的最新进展:一场注定失败的战斗?

Recent Advances in the Treatment of Insulin Resistance Targeting Molecular and Metabolic Pathways: Fighting a Losing Battle?

机构信息

Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland.

Faculty of Health Sciences, Lomza State University of Applied Sciences, 18-400 Lomza, Poland.

出版信息

Medicina (Kaunas). 2022 Mar 25;58(4):472. doi: 10.3390/medicina58040472.

Abstract

Diabetes Mellitus (DM) is amongst the most notable causes of years of life lost worldwide and its prevalence increases perpetually. The disease is characterized as multisystemic dysfunctions attributed to hyperglycemia resulting directly from insulin resistance (IR), inadequate insulin secretion, or enormous glucagon secretion. Insulin is a highly anabolic peptide hormone that regulates blood glucose levels by hastening cellular glucose uptake as well as controlling carbohydrate, protein, and lipid metabolism. In the course of Type 2 Diabetes Mellitus (T2DM), which accounts for nearly 90% of all cases of diabetes, the insulin response is inadequate, and this condition is defined as Insulin Resistance. IR sequela include, but are not limited to, hyperglycemia, cardiovascular system impairment, chronic inflammation, disbalance in oxidative stress status, and metabolic syndrome occurrence. Despite the substantial progress in understanding the molecular and metabolic pathways accounting for injurious effects of IR towards multiple body organs, IR still is recognized as a ferocious enigma. The number of widely available therapeutic approaches is growing, however, the demand for precise, safe, and effective therapy is also increasing. A literature search was carried out using the MEDLINE/PubMed, Google Scholar, SCOPUS and Clinical Trials Registry databases with a combination of keywords and MeSH terms, and papers published from February 2021 to March 2022 were selected as recently published papers. This review paper aims to provide critical, concise, but comprehensive insights into the advances in the treatment of IR that were achieved in the last months.

摘要

糖尿病(DM)是全球导致寿命损失的最显著原因之一,其患病率不断增加。该疾病的特征为多系统功能障碍,归因于高血糖,这直接源于胰岛素抵抗(IR)、胰岛素分泌不足或巨大的胰高血糖素分泌。胰岛素是一种高度合成代谢的肽类激素,通过加速细胞葡萄糖摄取以及控制碳水化合物、蛋白质和脂质代谢来调节血糖水平。在占所有糖尿病病例近 90%的 2 型糖尿病(T2DM)中,胰岛素反应不足,这种情况被定义为胰岛素抵抗。IR 的后果包括但不限于高血糖、心血管系统损伤、慢性炎症、氧化应激状态失衡和代谢综合征的发生。尽管在理解导致 IR 对多个身体器官有害影响的分子和代谢途径方面取得了重大进展,但 IR 仍然被认为是一个凶猛的谜。虽然有大量的治疗方法可供选择,但对精确、安全和有效的治疗的需求也在增加。本文使用 MEDLINE/PubMed、Google Scholar、SCOPUS 和临床试验注册数据库进行了文献检索,结合了关键词和 MeSH 术语,并选择了 2021 年 2 月至 2022 年 3 月发表的论文作为最近发表的论文。本文旨在提供关于过去几个月中 IR 治疗进展的关键、简明但全面的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1145/9029454/951bd89d4300/medicina-58-00472-g001.jpg

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