Preview

Сахарный диабет

Расширенный поиск

Инсулинорезистентность в патогенезе сахарного диабета 2 типа

https://doi.org/10.14341/2072-0351-6105

Аннотация

Инсулинорезистентность - снижение биологического ответа к одному или нескольким эффектам действия инсулина. Чаще инсулинорезистентность определяют как состояние, которое сопровождается сниженным поглощением глюкозы тканями организма под влиянием инсулина, т.е. резистентностью клеток различных органов и тканей к сахароснижающему действию инсулина. Инсулинорезистентность ответственна как за манифестацию СД 2 типа, так и за поддержание хронической гипергликемии, которая является пусковым механизмом патогенеза поздних сосудистых осложнений диабета, способствуя их быстрому прогрессированию и приводя к инвалидизации и высокой летальности. В настоящем обзоре подробно рассматриваются молекулярные механизмы формирования феномена инсулинорезистентности и возможные подходы (в том числе, медикаментозные) к ее устранению.

Об авторах

Михаил Иванович Балаболкин
Эндокринологический научный центр РАМН, Москва


Елена Михайловна Клебанова
Эндокринологический научный центр РАМН, Москва


Список литературы

1. Banerji М A, Chaiken R L, Gordon D et al., Does intra-abdominal adipose tissue in black men determine whether NIDDM is insulin-resistant or insulin-sensitive, Diabetes, 1995, 44, 141-146

2. Boden G, Chen X, Iqbal N., Acute lowering of plasma fatty acids lower insulin secretion in diabetic and non-diabetic subjects, Diabetes, 1998, 47,1609-1612

3. Boden G, Chen X, Rosner J, Barton M, Effects of a 48-h fat infusion on insulin secretion and glucose utilisation, Diabetes, 1995, 44, 1239-1242

4. Brockley М., and Schneider R.L. The onset of blood glucose response in patients with type 2 diabetes treated with pioglitazone. //Diabetes.— 2000,Vol. 49, Suppl 1.A99, P.400

5. Caro F, Insulin resistance in obese and nonobese man, J Clin Endocrinol Meta,ol, 1991, 73, 691-695

6. Diraison F, Large V, Brunengraber H, Beylot М., Non-invasive tracing of liver intermediary metabolism in normal subjects and in moderately hyperglycaemic NIDDM subjects. Evidence against increased gluconeogenesis and hepatic fatty acid oxidation in NIDDM, Diabetologia,1998, 41, 212-220

7. Dobbins R L, Chester M W, Daniels M В et al., Circulating fatty acids are essential for efficient glucose-stimulated insulin secretion after prolonged fasting in humans, Diabetes, 1998, 47, 1613-1618

8. Duncan M N, Singh В M, Wise P H et al.,A simple measure of insulin resistance, Lancet, 1995, 346, 120-121

9. Edwards G. and Eckland D. Pharmacokinetics of pioglitazone in patients with renal impairment. //Diabetologia.— 1999.— Vol. 42, Suppl 1A230, P. 863

10. Egan J. W. and Mathisen A.J. The effect of pioglitazone on glucose control and lipid profile in patients with type 2 diabetes. //Diabetes.— 2000,Vol. 49, Suppl 1.Al 05, P.423

11. Gora B. Pioglitazone is superior to acarbose in improving glycemic control and dyslipidemia in patients with type 2 diabetes — an interim analysis. //Diabetologia.— 2000.— Vol. 43, Suppl 1.— Al 93, P.740

12. Geerlof J. et Glazer B. Effect of food on the pharmacokinetics of pioglitazone. //Diabetologia.— 2000.— Vol. 43, Suppl 1.— Al 92, P.739

13. Groop L, Ekstrand A, Forsblom С et al., Insulin resistance, hypertension and microalbuminuria in patients with type 2 (noninsulin-dependent) diabetes mellitus, Diabetologia, 1993, 36, 642-647

14. Ferranninu E, Camastra S, Coppack S W et al., Insulin action and nonesterified fatty acids, Proc Nutr Soc, 1997, 56, 753-761

15. Ferrannini E, Insulin resistance versus insulin deficiency in non-insulindependent diabetes mellitus: problems and prospects, Endocrine Rev., 1998, 19, 477-490

16. Frayn К N, Williams С M, Amer P, Are increased plasma nonesterified fatty acid concentration a risk marker for coronary heart disease and other chronic diseases?, Clin Sci, 1996, 90, 243-253

17. Jenkins A B, Storlien L N, Insulin resistance and hyperinsulinemia in insulin receptor substrate-1 knockout mice, Diabetologia, 1997, 40, 1113-1114

18. Haffner S. M, Howard G, Mayer E et al. Insulin sensitivity and acute insulin response in African-American, non-Hispanic whites, and Hispanics with NIDDM, The insulin resistance Atherosclerosis Study, Diabetes, 1997, 46, 63-69

19. Haffner S M, Stern M P,Mitchell В D et al., Incidence of type 2 diabetes in Mexican Americans predicted by fasting insulin and glucose levels, obesiry, and body-fat distribution, Diabetes, 1990, 39, 283-290

20. Hallakou S., Foufelle F., Doare L. et al. Pioglitazone-induced increase of insulin sensitivity in the muscles of the obese Zucker fa/fa rat cannot be explained by local adipocytes differentiation. //Diabetologia.— 1998, -Vol. 41,P. 963-968

21. Harris P.K.W. and Kletzien R.F. Localization of a pioglitazone response element in the adipocyte fatty acid-binding protein gene.//Mol. Pharmacol.1994,Vol. 45.P.439-445

22. Kelly L.J.,Vicario P.P., Thompson G.M. et al. Peroxisome proliferatoractivated receptors g and a mediate in vivo regulation of uncoupling Kortboyer J.M. and Eckland D. Pioglitazone has low potential for drug interactipns. //Diabetologia.— 1999.—Vol.42, Suppl 1.— A228, P.855

23. Kruszynska Y.T., Mukherjee R., Jow L. et al. Skeletal muscle peroxisome proliferator-activated receptor g expression in obesity and non-insulin-dependent diabetes mellitus. //J.Oin. Invest.— 1998. — Vol. 101.— P.543-548

24. Lee Y, Hirose H, Ohneda M et al., b-cell lipotoxicity in the pathogenesis of non-insulin-dependent diabetes mellitus of obese rats: impairment in adipocyte-b-cell relationships, Proc Natl Acad Sci, 1994, 91, 10878-1088

25. Lillioja S, Mott D M, Spraul M et al., Insulin resistance and secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: prospective studies of Pima Indians, N Engl. J Med, 1993, 329, 19881922

26. McGarry J D, Dobbins R L., Fatty acids, lipotoxicity and insulin secretion, Diabetologia, 1999, 42, 128-138

27. Paolisso G, Tagliamonte M R, Rizzo M R et al., Lowering fatty acids potentiates acute insulin response in first degree relatives of people with type II diabetes, Diabetologia, 1998, 41, 1 127-113

28. Paolisso G, Tataranni A, Foley J E et al., High concentration of fasting plasma non-esterified fatty acids is a risk factor for the development of NIDD, Diabetologia, 1995, 38, 1213-1217

29. Pick A, Clark J, Kubstrup С et al., Role of apoptosis in failure of b-cell mass compensation for insulin resistance and b-cell defects in the male Zucker diabetic fatty rat, Diabetes, 47, 358-364

30. Reaven G M, Role of insulin resistance in human disease, Diabetes, 1988, 37, 1595-1607

31. Rosenstock J. Improved insulin sensitivity and beta cell responsivity suggested by HOMA analysis of pioglitazone therapy. //Diabetologia.— 2000.— Vol.43, Suppl 1,Al 92, P.738

32. Shaffer S., Rubin C. J., Zhu E. The effect of pioglitazone on the lipid profile in patients with type 2 diabetes. //Diabetes.— 2000.— Vol.49, Suppl 1,-A125, P.508

33. Schneider R.L. and Mathisen A.L. The evaluation of baseline blood glucose levels on glycemic control in pioglitazone-treated patients with type diabetes. //Diabetes.— 2000.— Vol.49, Suppl 1.— A124, P.505

34. Shimabukuro M, Koyama K, Lee Y, Unger R H, Leptinor troglitasoneinduced lipopenia protects islets from interleukin 1 b cytotoxicity, J Clin Invest, 1997b, 1750-1754

35. Shimabukuro M, Ohneda M, Lee Y, Unger R H, Role of nitric oxide in obesity-induced beta cell disease, J Clin Invest, 1997, 100, 290-295

36. Shimomura H, Sanke T, Ueda К et al., A missense mutation of the muscle glycogen synthase gene (M4116V) is associated with insulin resistance in the Japanese population, Diabetologia, 1997, 40, 947-952

37. Shimabukuro M, Zhou Y-T, Levi M, Unger R H, Fatty acid-induced bcell apoptosis: a link between obesity and diabetes, Proc Natl Acad Sci, 1998, 95, 2498-2502

38. Taylor S I, Moller D E, Mutations of the insulin receptor gene. In: Insulin resistance; Ed. D.E.Moller, N Y, Wiley, 1993, 83-123

39. Terauchi Y, Iwamoto K, Tamemoto H et al., Development of noninsulindependent diabetes mellitus in the double knockout mice with disruption of insulin receptor substrate -1 and b-cell glucokinase genes, J Clin Invest, 1997, 99, 861-866

40. Utriainen T, Takata T, Luotolahti M et al., Insulin resistance characterizes glucose uptake in skeletal muscle but in the heart in NIDDM, Diabetologia, 1998, 41, 555-559

41. Wu Z., Xie Y., Morrison R.F. et al. PPARg induces the insulindependent glucose transporter GLUT4 in the absence of C/EBPa during the conversion of 3T3 fibroblast into adipocytes. //J.CIin.Invest, 1998, 101, 22-32


Рецензия

Для цитирования:


Балаболкин М.И., Клебанова Е.М. Инсулинорезистентность в патогенезе сахарного диабета 2 типа. Сахарный диабет. 2001;4(1):28-36. https://doi.org/10.14341/2072-0351-6105

For citation:


Balabolkin M.I., Klebanova E.M. Insulinorezistentnost' v patogeneze sakharnogo diabeta 2 tipa. Diabetes mellitus. 2001;4(1):28-36. (In Russ.) https://doi.org/10.14341/2072-0351-6105

Просмотров: 725


ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)