Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China.
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China.
Brain Res Bull. 2023 Jul;199:110672. doi: 10.1016/j.brainresbull.2023.110672. Epub 2023 May 18.
Impairments in systematic and regional glucose metabolism exist in patients with Parkinson's disease (PD) at every stage of the disease course, and such impairments are associated with the incidence, progression, and special phenotypes of PD, which affect each physiological process of glucose metabolism including glucose uptake, glycolysis, tricarboxylic acid cycle, oxidative phosphorylation, and pentose phosphate shunt pathway. These impairments may be attributed to various mechanisms, such as insulin resistance, oxidative stress, abnormal glycated modification, blood-brain-barrier dysfunction, and hyperglycemia-induced damages. These mechanisms could subsequently cause excessive methylglyoxal and reactive oxygen species production, neuroinflammation, abnormal aggregation of protein, mitochondrial dysfunction, and decreased dopamine, and finally result in energy supply insufficiency, neurotransmitter dysregulation, aggregation and phosphorylation of α-synuclein, and dopaminergic neuron loss. This review discusses the glucose metabolism impairment in PD and its pathophysiological mechanisms, and briefly summarized the currently-available therapies targeting glucose metabolism impairment in PD, including glucagon-likepeptide-1 (GLP-1) receptor agonists and dual GLP-1/gastric inhibitory peptide receptor agonists, metformin, and thiazoledinediones.
帕金森病(PD)患者在疾病的各个阶段都存在系统性和区域性葡萄糖代谢障碍,这些障碍与 PD 的发病率、进展和特殊表型有关,影响葡萄糖代谢的每一个生理过程,包括葡萄糖摄取、糖酵解、三羧酸循环、氧化磷酸化和磷酸戊糖旁路途径。这些损伤可能归因于多种机制,如胰岛素抵抗、氧化应激、异常糖化修饰、血脑屏障功能障碍和高血糖引起的损伤。这些机制可能会导致甲基乙二醛和活性氧的产生过多、神经炎症、蛋白质异常聚集、线粒体功能障碍以及多巴胺的减少,最终导致能量供应不足、神经递质失调、α-突触核蛋白的聚集和磷酸化以及多巴胺能神经元的丧失。本综述讨论了 PD 中的葡萄糖代谢障碍及其病理生理机制,并简要总结了目前针对 PD 中葡萄糖代谢障碍的治疗方法,包括胰高血糖素样肽-1(GLP-1)受体激动剂和双重 GLP-1/胃抑制肽受体激动剂、二甲双胍和噻唑烷二酮类药物。
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