Mechanisms of insulin resistance in obesity

作     者：Jianping Ye 

作者机构：Antioxidant and Gene Regulation LaboratoryPennington Biomedical Research CenterLouisiana State University SystemBaton RougeLA70808USA 

出 版 物：《Frontiers of Medicine》 (医学前沿（英文版）)

年 卷 期：2013年第7卷第1期

页      面：14-24页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Jianping Ye is supported by the National Institute of Health research projects(DK085495 DK068036) 

主　　题：type 2 diabetes energy expenditure inflammation lipotoxicity mitochondria hyperinsulinemia adenosine monophosphate-activated protein kinase(AMPK) 

摘      要：Obesity increases the risk for type 2 diabetes through induction of insulin *** of type 2 diabetes has been limited by little translational knowledge of insulin resistance although there have been several well-documented hypotheses for insulin *** those hypotheses,inflammation,mitochondrial dysfunction,hyperinsulinemia and lipotoxicity have been the major concepts and have received a lot of *** stress,endoplasmic reticulum(ER)stress,genetic background,aging,fatty liver,hypoxia and lipodystrophy are active subjects in the study of these ***,none of those concepts or views has led to an effective therapy for type 2 *** reason is that there has been no consensus for a unifying mechanism of insulin *** this review article,literature is critically analyzed and reinterpreted for a new energy-based concept of insulin resistance,in which insulin resistance is a result of energy surplus in *** energy surplus signal is mediated by ATP and sensed by adenosine monophosphate-activated protein kinase(AMPK)signaling *** ATP level by suppression of production or stimulation of utilization is a promising approach in the treatment of insulin *** support,many of existing insulin sensitizing medicines inhibit ATP production in *** effective therapies such as weight loss,exercise,and caloric restriction all reduce ATP in insulin sensitive *** new concept provides a unifying cellular and molecular mechanism of insulin resistance in obesity,which may apply to insulin resistance in aging and lipodystrophy.