Zhang Tingran, Liu Yongsen, Yang Yi, Luo Jiong, Hao Chen
College of Physical Education, Southwest University, Chongqing 400715, China.
College of Physical Education, Chongqing University, Chongqing 401331, China.
Int J Mol Sci. 2025 Apr 28;26(9):4199. doi: 10.3390/ijms26094199.
Insulin resistance is more common in the elderly, and with the improvement in people's living standards and changes in lifestyle habits, the incidence of insulin resistance in other age groups is also increasing year by year. Overweight and obesity caused by abnormal fat metabolism or accumulation can significantly reduce glucose intake, which is the direct cause of insulin resistance and the trigger for the occurrence and development of type II diabetes. This article reviews and analyzes relevant literature on empirical research on the effect of regular exercise on improving insulin resistance. It was found that the most important step in carbohydrate metabolism is the translocation of glucose transporter 4 (GLUT4) to the cell membrane, carrying water-soluble glucose through the lipid soluble cell membrane to complete carbohydrate transport. The process of glucose transporter protein translocation to the cell membrane can be driven by two different signaling pathways: one is the insulin information transfer pathway (ITP), the second is to induce the ITP of monophosphate-activated protein kinase (AMPK) through hypoxia or muscle contraction. For type II diabetes patients, the insulin signal transmission pathway through insulin receptors (IRS, IRS) and phosphatidylinositol 3-kinase (PI3K) (PI3K) is damaged, which results in the decrease in glucose absorption stimulated by insulin in skeletal muscle, while the noninsulin signal transmission pathway of AMPK in these patients is normal. It can be seen that regular exercise can regulate glucose intake and the metabolism of skeletal muscle, improve insulin resistance, reduce fasting blood glucose and glycosylated hemoglobin in diabetes patients, and thus, effectively regulate blood glucose. However, many steps in the molecular mechanism of how exercise training improves systemic insulin resistance are still not fully understood, and further discussion is needed in the future.
胰岛素抵抗在老年人中更为常见，并且随着人们生活水平的提高和生活方式习惯的改变，其他年龄组中胰岛素抵抗的发生率也在逐年上升。由脂肪代谢异常或脂肪堆积引起的超重和肥胖会显著降低葡萄糖摄取，这是胰岛素抵抗的直接原因以及II型糖尿病发生和发展的触发因素。本文回顾并分析了关于规律运动对改善胰岛素抵抗作用的实证研究的相关文献。研究发现，碳水化合物代谢中最重要的步骤是葡萄糖转运蛋白4（GLUT4）向细胞膜的转位，通过脂溶性细胞膜携带水溶性葡萄糖以完成碳水化合物转运。葡萄糖转运蛋白向细胞膜的转位过程可由两种不同的信号通路驱动：一种是胰岛素信息传递通路（ITP），另一种是通过缺氧或肌肉收缩诱导单磷酸激活蛋白激酶（AMPK）的ITP。对于II型糖尿病患者，通过胰岛素受体（IRS，IRS）和磷脂酰肌醇3激酶（PI3K）（PI3K）的胰岛素信号传递通路受损，这导致骨骼肌中胰岛素刺激的葡萄糖吸收减少，而这些患者中AMPK的非胰岛素信号传递通路正常。由此可见，规律运动可调节葡萄糖摄取和骨骼肌代谢，改善胰岛素抵抗，降低糖尿病患者的空腹血糖和糖化血红蛋白，从而有效调节血糖。然而，运动训练改善全身胰岛素抵抗的分子机制中的许多步骤仍未完全明了，未来还需要进一步探讨。
