Department of Pharmacology, Health Science Center, Yangtze University, Jingzhou, Hubei, China.
Qianjiang Central Hospital Affiliated to Yangtze University, Qianjiang, Hubei, China.
Phytother Res. 2024 Jul;38(7):3564-3582. doi: 10.1002/ptr.8229. Epub 2024 May 7.
Type 2 diabetes mellitus (T2DM), a metabolic disease with persistent hyperglycemia primarily caused by insulin resistance (IR), has become one of the most serious health challenges of the 21st century, with considerable economic and societal implications worldwide. Considering the inevitable side effects of conventional antidiabetic drugs, natural ingredients exhibit promising therapeutic efficacy and can serve as safer and more cost-effective alternatives for the management of T2DM. Saponins are a structurally diverse class of amphiphilic compounds widely distributed in many popular herbal medicinal plants, some animals, and marine organisms. There are many saponin monomers, such as ginsenoside compound K, ginsenoside Rb1, ginsenoside Rg1, astragaloside IV, glycyrrhizin, and diosgenin, showing great efficacy in the treatment of T2DM and its complications in vivo and in vitro. However, although the mechanisms of action of saponin monomers at the animal and cell levels have been gradually elucidated, there is a lack of clinical data, which hinders the development of saponin-based antidiabetic drugs. Herein, the main factors/pathways associated with T2DM and the comprehensive underlying mechanisms and potential applications of these saponin monomers in the management of T2DM and its complications are reviewed and discussed, aiming to provide fundamental data for future high-quality clinical studies and trials.
2 型糖尿病（T2DM）是一种代谢性疾病，以持续性高血糖为主要特征，主要由胰岛素抵抗（IR）引起，已成为 21 世纪最严重的健康挑战之一，在全球范围内带来了巨大的经济和社会影响。鉴于传统抗糖尿病药物不可避免的副作用，天然成分表现出有希望的治疗效果，可以作为管理 T2DM 的更安全、更具成本效益的替代方法。皂苷是一类结构多样的两亲性化合物，广泛分布于许多流行的草药植物、一些动物和海洋生物中。有许多皂苷单体，如人参皂苷化合物 K、人参皂苷 Rb1、人参皂苷 Rg1、黄芪甲苷 IV、甘草酸和薯蓣皂苷元，在治疗 T2DM 及其体内和体外并发症方面显示出巨大的疗效。然而，尽管皂苷单体在动物和细胞水平的作用机制已逐渐阐明，但缺乏临床数据，这阻碍了基于皂苷的抗糖尿病药物的发展。本文综述了与 T2DM 相关的主要因素/途径，以及这些皂苷单体在管理 T2DM 及其并发症方面的综合潜在机制和应用，并讨论了这些内容，旨在为未来高质量的临床研究和试验提供基础数据。
