The crucial role and mechanism of insulin resistance in metabolic disease

Frontiers in Endocrinology, Год журнала: 2023, Номер 14

Опубликована: Март 28, 2023

Insulin resistance (IR) plays a crucial role in the development and progression of metabolism-related diseases such as diabetes, hypertension, tumors, nonalcoholic fatty liver disease, provides basis for common understanding these chronic diseases. In this study, we provide systematic review causes, mechanisms, treatments IR. The pathogenesis IR depends on genetics, obesity, age, drug effects. Mechanistically, any factor leading to abnormalities insulin signaling pathway leads host, including receptor abnormalities, disturbances internal environment (regarding inflammation, hypoxia, lipotoxicity, immunity), metabolic function organelles, other abnormalities. available therapeutic strategies are mainly exercise dietary habit improvement, chemotherapy based biguanides glucagon-like peptide-1, traditional Chinese medicine (e.g., herbs acupuncture) can also be helpful. Based current there still some vacancies follow up consider, is need define more precise biomarkers different lifestyle interventions, explore natural or synthetic drugs targeting treatment. This could enable treatment patients with multiple combined diseases, aim treating disease holistically reduce healthcare expenditures improve quality life extent.

Язык: Английский

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SGLT2 Inhibition via Empagliflozin Improves Endothelial Function and Reduces Mitochondrial Oxidative Stress: Insights From Frail Hypertensive and Diabetic Patients

Hypertension, Год журнала: 2022, Номер 79(8), С. 1633 - 1643

Опубликована: Июль 13, 2022

Frailty is a multidimensional condition often diagnosed in older adults with hypertension and diabetes, both these conditions are associated endothelial dysfunction oxidative stress. We investigated the functional role of SGLT2 (sodium glucose cotransporter 2) inhibitor empagliflozin frail diabetic hypertensive adults.

Язык: Английский

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Insulin resistance and cardiovascular disease

Journal of International Medical Research, Год журнала: 2023, Номер 51(3)

Опубликована: Март 1, 2023

Insulin resistance (IR) and cardiovascular disease (CVD) represent two universal public health hazards, especially in today’s Western societies. A causal-effect relationship has been established that links IR with CVD. The mediating mechanisms are perplexing, under ongoing, rigorous investigation remain to be fully elucidated. is a condition encompassing hyperglycemia compensatory hyperinsulinemia. It occurs when insulin not capable of exerting its maximum effects on target tissues, including skeletal muscles, liver adipose tissue. This alteration signaling pathways results the development cardiometabolic disorders, obesity, dyslipidemia, low-grade inflammation, endothelial dysfunction hypertension, all which predisposing factors for atherosclerosis management can achieved through dietary modifications, inclusion regular exercise routines everyday life, pharmacological agents other interventions tailored each individual patient’s needs. important underline though that, although various antidiabetic drugs may improve available, no medications as yet specifically approved treatment IR. narrative review will focus current scientific clinical evidence pertaining IR, connecting CVD, well plausible strategies holistic, personalized approach management.

Язык: Английский

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The current role of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes mellitus management

Cardiovascular Diabetology, Год журнала: 2022, Номер 21(1)

Опубликована: Май 25, 2022

Abstract Type 2 diabetes mellitus (T2DM) is a chronic, complex metabolic disease characterized by chronic hyperglycemia causing from insufficient insulin signaling because of resistance or defective secretion, and may induce severe complications premature death. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are oral drugs used to reduce in patients with T2DM, including empagliflozin, ertugliflozin, dapagliflozin canagliflozin. The primary objective this article examine the clinical benefit, safety, tolerability four SGLT2 approved US FDA. increase urinary glucose excretion via inhibiting decrease renal reabsorption filtered threshold for glucose. Rather than stimulating release, improve β-cell function improving glucotoxicity, as well sensitivity. Early trials have confirmed beneficial effects T2DM acceptable safety excellent tolerability. In recent years, has been successively FDA cardiovascular death risk stroke cardiac attack adults who diagnosed disease, treating heart failure (HF) reduced ejection fraction HF preserved fraction, treat diabetic kidney (DKD), hospitalization DKD patients. expected be an effective treatment non alcoholic fatty liver disease. similar profile placebo other active control groups, major adverse events such Ketoacidosis hypotension genital tract infections.

Язык: Английский

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Diabetes mellitus—Progress and opportunities in the evolving epidemic

Cell, Год журнала: 2024, Номер 187(15), С. 3789 - 3820

Опубликована: Июль 1, 2024

Язык: Английский

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A short-term, high-caloric diet has prolonged effects on brain insulin action in men

Nature Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Фев. 21, 2025

Abstract Brain insulin responsiveness is linked to long-term weight gain and unhealthy body fat distribution. Here we show that short-term overeating with calorie-rich sweet fatty foods triggers liver accumulation disrupted brain action outlasted the time-frame of its consumption in healthy men. Hence, response can adapt changes diet before may facilitate development obesity associated diseases.

Язык: Английский

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Cardiorenal protection of SGLT2 inhibitors—Perspectives from metabolic reprogramming

EBioMedicine, Год журнала: 2022, Номер 83, С. 104215 - 104215

Опубликована: Авг. 13, 2022

Sodium-glucose co-transporter 2 (SGLT2) inhibitors, initially developed as a novel class of anti-hyperglycaemic drugs, have been shown to significantly improve metabolic indicators and protect the kidneys heart patients with or without type diabetes mellitus. The possible mechanisms mediating these unexpected cardiorenal benefits are being extensively investigated because they cannot solely be attributed improvements in glycaemic control. Notably, emerging data indicate that reprogramming is involved progression diseases. SGLT2 inhibitors reprogram systemic metabolism fasting-like paradigm, involving switch from carbohydrates other energetic substrates regulation related nutrient-sensing pathways, which might explain some their protective effects. In this review, we will focus on current understanding protection by specifically its relevance reprogramming.

Язык: Английский

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Exercise restores brain insulin sensitivity in sedentary adults who are overweight and obese

JCI Insight, Год журнала: 2022, Номер 7(18)

Опубликована: Сен. 21, 2022

BACKGROUNDInsulin resistance of the brain can unfavorably affect long-term weight maintenance and body fat distribution. Little is known if how insulin sensitivity be restored in humans. We aimed to evaluate effects an exercise intervention on this relates exercise-induced changes whole-body metabolism behavior.METHODSIn clinical trial, sedentary participants who were overweight obese underwent 8-week supervised aerobic training intervention. Brain was assessed 21 (14 women, 7 men; age range 21-59 years; BMI 27.5-45.5 kg/m2) using functional MRI, combined with intranasal administration insulin, before after intervention.RESULTSThe program resulted enhanced action level a person healthy weight, demonstrated by increased insulin-induced striatal activity strengthened hippocampal connectivity. Improved correlated mitochondrial respiration skeletal muscle, reductions visceral hunger, as well improved cognition. Mediation analyses suggest that responsiveness helps mediate peripheral leading healthier distribution reduced perception hunger.CONCLUSIONOur study demonstrates individuals restore brain. Hence, ameliorating benefits toward may provide objective therapeutic target humans challenge reduce diabetes risk factors.TRIAL REGISTRATIONClinicalTrials.gov (NCT03151590).FUNDINGBMBF/DZD 01GI0925.

Язык: Английский

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Study on insulin resistance and ischemic cerebrovascular disease: A bibliometric analysis via CiteSpace

Frontiers in Public Health, Год журнала: 2023, Номер 11

Опубликована: Март 6, 2023

It is reported that insulin resistance widely exists in non-diabetic patients with a recent history of transient ischemic attack (TIA) or stroke. There currently strong evidence to prove the bidirectional effect glucose metabolism disorders and stroke events. Therefore, it necessary retrospectively tease out current status, hotspots, frontiers cerebrovascular disease through CiteSpace.We searched Web Science (WOS) for studies related from 1999 April 2022, then downloaded data into CiteSpace generate knowledge visualization map.A total 1,500 publications relevant were retrieved. The USA had most articles on this topic, followed by PEOPLES R CHINA JAPAN. WALTER N KERNAN was prolific author, whose research mainly focused intervention after (IRIS) trial. common keywords myocardial ischemia, metabolic syndrome, stroke, cerebral association, oxidative stress, inflammation, adipose tissue. Major ongoing trends include three aspects: (1) association between patients, (2) intrinsic pathological mechanism disease, (3) early improve prognosis stroke.The results bibliometric study provide status clinical field disease. Insulin strongly associated occurrence neurological deterioration post-stroke depression, small vessel Early treatment can be an effective way prevent onset prognosis. This may help researchers identify hot topics explore new directions.

Язык: Английский

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The insulin resistant brain: impact on whole-body metabolism and body fat distribution

Diabetologia, Год журнала: 2024, Номер 67(7), С. 1181 - 1191

Опубликована: Фев. 16, 2024

Abstract Insulin exerts its actions not only on peripheral organs but is also transported into the brain where it performs distinct functions in various regions. This review highlights recent advancements our understanding of insulin’s within brain, with a specific emphasis investigations humans. It summarises current knowledge transport insulin brain. Subsequently, showcases robust evidence demonstrating existence and physiological consequences action, while introducing presence resistance pathophysiological condition goes along an impaired acute modulation metabolism response to particularly postprandial state. Furthermore, has been associated long-term adiposity unfavourable adipose tissue distribution, thus implicating pathogenesis subgroups obesity (pre)diabetes that are characterised by patterns body fat distribution. Encouragingly, emerging suggests could represent treatable entity, thereby opening up novel therapeutic avenues improve systemic enhance functions, including cognition. The closes outlook towards prospective research directions aimed at further elucidating clinical implications resistance. emphasises critical need establish feasible diagnostic measures effective interventions. Graphical

Язык: Английский

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