Renal gluconeogenesis in insulin resistance:A culprit for hyperglycemia in diabetes  

作　　者：Rajni Sharma Swasti Tiwari 

机构地区：[1]Department of Molecular Medicine and Biotechnology,Sanjay Gandhi Postgraduate Institute of Medical Sciences,Lucknow 226014,India

出　　处：《World Journal of Diabetes》2021年第5期556-568,共13页世界糖尿病杂志（英文版）（电子版）

基　　金：The Indian Council of Medical Research,No.55/4/4/CARE-KD/2018/NCD-II;and the Council of Scientific&Industrial Research,No.09/590/(0159)/2016-EMR-1.

摘　　要：Renal gluconeogenesis is one of the major pathways for endogenous glucose production.Impairment in this process may contribute to hyperglycemia in cases with insulin resistance and diabetes.We reviewed pertinent studies to elucidate the role of renal gluconeogenesis regulation in insulin resistance and diabetes.A consensus on the suppressive effect of insulin on kidney gluconeogenesis has started to build up.Insulin-resistant models exhibit reduced insulin receptor(IR)expression and/or post-receptor signaling in their kidney tissue.Reduced IR expression or post-receptor signaling can cause impairment in insulin’s action on kidneys,which may increase renal gluconeogenesis in the state of insulin resistance.It is now established that the kidney contributes up to 20%of all glucose production via gluconeogenesis in the post-absorptive phase.However,the rate of renal glucose release excessively increases in diabetes.The rise in renal glucose release in diabetes may contribute to fasting hyperglycemia and increased postprandial glucose levels.Enhanced glucose release by the kidneys and renal expression of the gluconeogenic-enzyme in diabetic rodents and humans further point towards the significance of renal gluconeogenesis.Overall,the available literature suggests that impairment in renal gluconeogenesis in an insulinresistant state may contribute to hyperglycemia in type 2 diabetes.

关 键 词：Renal gluconeogenesis INSULIN-RESISTANCE Insulin Insulin receptor signaling DIABETES Gluconeogenic enzymes 

分 类 号：R587.1[医药卫生—内分泌]