摘要
糖尿病心肌病是糖尿病严重并发症之一。心肌糖代谢异常是其发生、发展的重要环节,主要表现在心肌对葡萄糖的摄取能力减弱。大量研究表明,在发生糖尿病前可能已存在不同程度的与糖代谢异常相关的心脏病变的早期表现。葡萄糖转运蛋白(GLUT)是心肌摄取葡萄糖的重要载体,3-磷酸肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路、AMP依赖的蛋白激酶(AMPK)信号通路及丝裂原活化蛋白激酶(MAPK)等信号通路可以调节下游分子GLUT的表达,在糖耐量受损以及糖尿病状态下,心肌组织中PI3K/Akt、MAPK、AMPK等信号通路受损,GLUT表达下降,心肌摄取葡萄糖的能力下降。研究表明,在不同糖耐量状态下,心肌对缺氧的抵抗能力及摄取葡萄糖的能力不同。本文就不同糖耐量状态下缺氧与非缺氧心肌摄取葡萄糖的能力作一综述,为早期干预糖尿病心肌病提供临床思路。
Diabetic cardiomyopathy is one of the serious complications of diabetes mellitus.Abnormal myocardial glucose metabolism is an important link to its occurrence and development,which is mainly manifested in the decreased ability of the myocardium to take up glucose.A large number of studies have shown that there may be different degrees of abnormal glucose metabolism related to the early manifestation of cardiac disease before the onset of diabetes.Glucose transporter(GLUT)is an important carrier of glucose uptake in myocardium.Signal pathways such as PI3K/Akt,AMPK,and MAPK can regulate the expression of downstream molecules GLUT.In the condition of impaired glucose tolerance and diabetes,the PI3K/Akt,MAPK,and AMPK signal pathways in myocardium are damaged.If the GLUT expression is decreased,the heart muscle′s ability to take up glucose will also decrease.Studies have shown that under different glucose tolerance states,the heart muscle′s resistance to hypoxia is different,and the ability of the heart muscle to take up glucose is different.In this paper,the ability of hypoxic and non-hypoxic myocardium to take up glucose under different glucose tolerance conditions was reviewed to provide clinical ideas for early intervention of diabetic cardiomyopathy.
作者
吴亚纳
郗光霞
Wu Yana;Xi Guangxia(Department of Endocrinology,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Tongji Medical College,Huazhong University of Science and Technology,Taiyuan 030032,China)
出处
《国际内分泌代谢杂志》
2023年第4期313-316,共4页
International Journal of Endocrinology and Metabolism
基金
山西省科学技术厅项目(201901D111415)。
