College of Physical Education, Taiyuan University of Technology, Taiyuan, Shanxi 030024, China.
Biomed Pharmacother. 2024 Aug;177:117122. doi: 10.1016/j.biopha.2024.117122. Epub 2024 Jul 10.
Type 2 diabetes mellitus (T2DM) is a metabolic disease primarily characterized by insulin resistance (IR) and insufficient insulin secretion. The unfolded protein response (UPR) overactivation induced by endoplasmic reticulum stress (ERS) appears to play a key role in this process, although the exact pathogenesis of T2DM is not fully understood. Studies have demonstrated that appropriate exercise can regulate ERS in the heart, liver, pancreas, skeletal muscle, and other body tissues leading to an improvement in diabetes and its complications. However, the exact mechanism remains unclear. By analyzing the relationship between ERS, T2DM pathology, and exercise intervention, this review concludes that exercise can increase insulin sensitivity, inhibit IR, promote insulin secretion and alleviate T2DM by regulating ERS. This paper specifically reviews the signaling pathways by which ERS induces diabetes, the mechanisms of exercise regulation of ERS in diabetes, and the varying effects of different types of exercise on diabetes improvement through ERS mechanisms. Physical exercise is an effective non-pharmacological intervention for T2DM. Thus, further exploration of how exercise regulates ERS in diabetes could refine "precision exercise medicine" for diabetes and identify new drug targets.
2 型糖尿病（T2DM）是一种代谢疾病，主要表现为胰岛素抵抗（IR）和胰岛素分泌不足。内质网应激（ERS）引起的未折叠蛋白反应（UPR）过度激活似乎在这一过程中起关键作用，尽管 T2DM 的确切发病机制尚不完全清楚。研究表明，适当的运动可以调节心脏、肝脏、胰腺、骨骼肌等身体组织中的 ERS，从而改善糖尿病及其并发症。然而，确切的机制仍不清楚。通过分析 ERS、T2DM 病理学和运动干预之间的关系，本综述得出结论，运动可以通过调节 ERS 增加胰岛素敏感性、抑制 IR、促进胰岛素分泌并缓解 T2DM。本文专门综述了 ERS 诱导糖尿病的信号通路、运动调节糖尿病 ERS 的机制，以及不同类型的运动通过 ERS 机制对糖尿病改善的不同影响。体育锻炼是 T2DM 的一种有效非药物干预措施。因此，进一步探索运动如何调节糖尿病中的 ERS，可能会完善糖尿病的“精准运动医学”，并确定新的药物靶点。
