Wu XiaoPei, Yang Ji, He JunDong
Medical School, Kunming University of Science and Technology, Kunming, People's Republic of China.
Department of Endocrinology and Metabolism, The First People's Hospital of Yunnan Province, Kunming, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Sep 2;18:3167-3180. doi: 10.2147/DMSO.S541768. eCollection 2025.
Diabetes has emerged as a critical global health issue, with its associated complications posing a severe threat to patients' quality of life. Current research demonstrates that imbalance in mitochondrial dynamics and autophagic dysregulation play pivotal roles in the pathogenesis of diabetic complications, particularly in diabetic cardiomyopathy, nephropathy, peripheral neuropathy and retinopathy. Strategic modulation of mitochondrial function and autophagic activity represents a promising therapeutic approach for managing diabetic complications. Furthermore, integrating mitochondrial dynamics and autophagy, we have outlined the application prospects of strategies related to diabetic complications, including mitochondrial fission inhibitors, autophagy inducers, and certain compounds extracted from traditional Chinese medicines, and incorporated new breakthroughs in mitochondrial imaging, omics, and artificial intelligence-based therapeutic prediction. This review systematically examines the intricate relationship between diabetic complications and dysregulations in mitochondrial dynamics and autophagic dysfunction, while elucidating the underlying molecular mechanisms, and highlights the significance of mitochondrial dynamics and autophagy in diabetic complications. Imbalances in mitochondrial dynamics-whether abnormal fission or fusion-and autophagic dysregulation do not exist in isolation. A comprehensive understanding of the interplay between diabetic pathophysiology and the mitochondrial-autophagy axis may provide novel research perspectives for therapeutic development. This paper provides a comprehensive review of the literature to clarify the above content, using a narrative review approach. Future investigations should prioritize translational exploration to harness the clinical potential of these mechanistic insights, thereby advancing precision medicine strategies for the management of diabetic complications.
糖尿病已成为一个关键的全球健康问题,其相关并发症对患者的生活质量构成严重威胁。当前研究表明,线粒体动力学失衡和自噬失调在糖尿病并发症的发病机制中起关键作用,尤其是在糖尿病心肌病、肾病、周围神经病变和视网膜病变中。对线粒体功能和自噬活性进行策略性调节是治疗糖尿病并发症的一种有前景的方法。此外,综合线粒体动力学和自噬,我们概述了与糖尿病并发症相关策略的应用前景,包括线粒体分裂抑制剂、自噬诱导剂以及某些从中药中提取的化合物,并纳入了线粒体成像、组学和基于人工智能的治疗预测方面的新突破。本综述系统地研究了糖尿病并发症与线粒体动力学失调和自噬功能障碍之间的复杂关系,同时阐明了潜在的分子机制,并强调了线粒体动力学和自噬在糖尿病并发症中的重要性。线粒体动力学的失衡——无论是异常分裂还是融合——以及自噬失调并非孤立存在。全面了解糖尿病病理生理学与线粒体-自噬轴之间的相互作用可能为治疗开发提供新的研究视角。本文采用叙述性综述方法,对文献进行全面回顾以阐明上述内容。未来的研究应优先进行转化探索,以利用这些机制性见解的临床潜力,从而推进糖尿病并发症管理的精准医学策略。