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中华肥胖与代谢病电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 147 -153. doi: 10.3877/cma.j.issn.2095-9605.2022.03.001

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线粒体参与2型糖尿病发生发展的研究进展
李泽1, 刘慧2, 蒲雪茵1, 刘勃志1, 吴菲菲1, 杨雁灵3,(), 王亚云4,()   
  1. 1. 710032 西安,空军军医大学基础医学院基础医学教学实验中心
    2. 716099 延安,延安大学医学院基础医学院
    3. 710032 西安,空军军医大学第一附属医院肝胆胰脾外科
    4. 710032 西安,空军军医大学基础医学院基础医学教学实验中心;710032 西安,空军军医大学口腔医院军事口腔医学国家重点实验室
  • 收稿日期:2022-03-31 出版日期:2022-08-30
  • 通信作者: 杨雁灵, 王亚云
  • 基金资助:
    国家自然科学基金(81870415); 陕西省重点研发计划(2018ZDXM-SF-082); 陕西省基础研究项目(2018JZ8003); 军队口腔重点实验室开放课题(2018KA01)

Theresearch progress on the involvement of mitochondria in the occurrence and development of T2DM

Ze Li1, Hui Liu2, Xueyin Pu1, Bozhi Liu1, Feifei Wu1, Yanling Yang3,(), Yayun Wang4,()   

  1. 1. Experimental Teaching Center of Basic Medicine, Air Force Medical University, Xi’an 710032, China
    2. Medical College of Yan'an Universit, Yan'an 716099, China
    3. Department of Hepatic Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, China
    4. Experimental Teaching Center of Basic Medicine, Air Force Medical University, Xi’an 710032, China; National Key Laboratory of Military Stomatology Department of Stomatology Hospital of Air Force Military Medical University, Xi’an 710032, China
  • Received:2022-03-31 Published:2022-08-30
  • Corresponding author: Yanling Yang, Yayun Wang
引用本文:

李泽, 刘慧, 蒲雪茵, 刘勃志, 吴菲菲, 杨雁灵, 王亚云. 线粒体参与2型糖尿病发生发展的研究进展[J]. 中华肥胖与代谢病电子杂志, 2022, 08(03): 147-153.

Ze Li, Hui Liu, Xueyin Pu, Bozhi Liu, Feifei Wu, Yanling Yang, Yayun Wang. Theresearch progress on the involvement of mitochondria in the occurrence and development of T2DM[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(03): 147-153.

2型糖尿病(T2DM)是糖尿病最常见类型,主要表现为组织对胰岛素作用不敏感即胰岛素抵抗,并伴有胰岛素分泌不足,其病理生理学机制尚未完全阐明。线粒体(mitochondria)作为细胞能量代谢中心,其结构和功能异常在T2DM发生发展中扮演了重要角色。本文回顾线粒体功能异常参与T2DM的信号通路机制与当前一线降糖药对线粒体形态与功能的影响,以期从线粒体角度阐明T2DM分子机制,为开发以线粒体为靶点的临床策略提供线索。

Type 2 diabetes mellitus (T2DM) is the most prevalent type of diabetes. T2DM is predominantly caused by tissue insensitivity to insulin action (insulin resistance) accompanied by insufficient insulin secretion. Its pathophysiological mechanism is still unclear. The latest research shows that mitochondria, as the center of cellular energy metabolism, whose abnormal structure and function play an important role in the occurrence and development of T2DM. This review mainly reviews the signaling pathway mechanism of abnormal mitochondrial function involved in T2DM, and the effects of current first-line hypoglycemic drugs on mitochondrial morphology and function. This article aims to provide an important basis for elucidating the molecular mechanism of T2DM and developing new clinical strategies by targeting mitochondria.

图1 胰岛β细胞线粒体异常参与T2DM的分子机制。当胰岛β细胞(pancreatic β cell)的线粒体功能受损时,其ATP产生减少,削弱钾离子ATP通道(K+-ATP channel),进而导致电压门控钙离子通道(VDCC)无法打开,最终Ca2+无法充分内流刺激胰岛素分泌颗粒(insulin secretory granules)向质膜移动,导致胰岛素释放减少。CAMK:钙调蛋白激酶
图2 骨骼肌线粒体异常参与T2DM的分子机制。在骨骼肌中,细胞线粒体功能受损使ROS产生增加,进而激活c-Jun氨基末端激酶(c-Jun N-terminal kinase,JNK)使IRS丝/苏氨酸位点磷酸化,从而抑制胰岛素信号传导;而这又会进一步导致线粒体β氧化功能受损,导致DAG累积,加剧IRS通路受损[18]。PKC:蛋白激酶C
图1 一线T2DM药物对线粒体结构和功能的影响。二甲双胍可抑制线粒体呼吸链复合物1降低ATP,从而使AMP/ATP比值增加,激活AMPK,进一步抑制糖异生关键酶PEPCK,最终达到抑制糖异生(gluconeogenesis)的效应。二甲双胍还可抑制线粒体上mG3PDH酶,降低FADH2,进一步抑制乳酸脱氢酶,使乳酸转化为丙酮酸减少,最终使糖异生降低。噻唑烷二酮类药物(troglitazone,TZD)通过增加AMP/ATP比值或激活PPARg而激活AMPK,最终降低糖异生;另一方面,通过使线粒体ROS生成减少,同时也抑制了糖异生。噻唑烷二酮类药物(troglitazone,TZD)可以作用于AMPK使线粒体ROS生成减少,同时也抑制了糖异生。胰高血糖素受体1激动剂(GLP-1RA)可减少ROS生成,改善细胞氧化呼吸功能。FADH2:还原黄素腺嘌呤二核苷酸;complex 1:线粒体复合物1;ROS:活性氧;ATP:腺嘌呤核苷三磷酸;AMP:腺嘌呤核糖核苷酸;NADH:烟酰胺腺嘌呤二核苷酸
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