2型糖尿病基础研究中的难题与突破  

Basic research frontiers of type 2 diabetes: the nuts and cuts

作　　者：甘立霞[1] 

机构地区：[1]第三军医大学基础医学部生物化学与分子生物学教研室,重庆400038

出　　处：《第三军医大学学报》2014年第15期1543-1547,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金(30971082;81270482)~~

摘　　要：近年来，糖尿病研究进展迅速，从刚结束的第5届国际前驱糖尿病及代谢综合征大会就可见一斑。糖尿病是以临床高血糖为特征的常见病，其中以2型糖尿病（type2diabetesmellitus，T2DM）占绝大多数（90％～95％）。糖尿病常导致心血管和微血管并发症。我国糖尿病患者约9400万。T2DM的发病过程经历了正常糖耐量→糖调节受损→T2DM，主发病机制涉及胰岛β细胞功能障碍和外周胰岛素抵抗。In recent years, tremendous progress has been made on beta cell dysfunction and insulin resislance, 2 fundamental pathological mechanisms of type 2 diabetes mellitus （T2DM）. Reduced beta-cell mass has been widely accepted as the main cause leading to insulin secretion decline, the machanism of which has been attribuled to enhanced beta-cell apoptosis, beta-cell dedifferentiation, and decreased beta-cell proliferation. Also having made a great breakthrough is the study on insulin resistance, particularly in obesity conditiml. Chronic systemic inflammation has now been recognized as the link between obesity, insulin resistance and T2DM. The enlarged adipose tissue is now recognized as the major source for the enhanced release of various bioactive adipokines and proinflammatory factors, such as leptin, resistin and TNF-c~, which act as mediators for impaired insulin signaling in the liver, muscles and central nervous system. Supported in evidence, weight-loss by bariatric surgery has achieved great success in reducing the metabolic risk factors for T2DM and is the most effective treatment for morbid obese patients. These studies and clinical practice underscore adipose tissue and the gastrointestinal tract as important endocrine organs in maintenance of glucose homeostasis. Besides, the role of gut microbiota in the development of insulin resistance and metabolic disorders has been established. This review highlighted these recent progresses in mechanisms of T2DM with emphasis on the loss of beta cell mass and obesity-associated insulin resistance.

关 键 词：β-细胞质量 胰岛素抵抗 肥胖 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]