慢性代谢性疾病的环境与遗传交互作用以及早期预防

随着我国经济的发展和营养与生活方式的迅速变迁,近年来我国居民肥胖、2型糖尿病等慢性代谢性疾病患病率激增,已成为影响国民健康最主要的威胁。有研究显示:与白种人相比,亚洲人具有较高的2型糖尿病遗传易感性,这可能与"代谢性肥胖"表型和遭遇营养转型中的"致肥胖环境"有关。大量的研究结果表明,此类慢性代谢性疾病是遗传和环境因素交互作用的结果。随着全基因组关联研究开展,目前已发现了20多个肥胖和2型糖尿病易感基因,不仅揭示了不同种族人群在基因结构和效应值方面存在着差异,但同时也发现遗传方面的差异仍无法完全解释东西方人在发病风险方面的不同。膳食、生活方式等环境因素仍被认为是2型糖尿病发病中的重要决定因素。在全基因组关联研究后时代,国际上的研究将更加强调基因—基因、基因—环境、基因—表型之间的交互作用对代谢性疾病的影响和相关的机制。事实上,有研究表明,各种基因多态性、炎性因子和脂肪细胞因子等都可能成为早期诊断的生物标记物,而通过改变膳食和生活方式则是目前国际公认的预防和控制慢性代谢性疾病最有效的方法。然而,我国尤为缺乏在大规模前瞻性流行病学研究中对导致慢性代谢性疾病流行的主要遗传和环境因素,以及基因—环境相互作用对健康的影响方面的系统的研究。而这类研究将为建立适用于中国人群遗传和表型特征的早期诊断生物标记物和有效预防干预策略奠定基础。     

二甲双胍对T2D患者肠道菌群的影响

2型糖尿病是一种由环境和遗传因素共同导致的以高血糖为主的慢性代谢性疾病,其主要的特点是胰岛素分泌不足和胰岛素抵抗。目前2型糖尿病发病率正在快速上升,给我们的未来带来了严峻的挑战。宿主肠道内正常的肠道菌群参与宿主的营养代谢、生长发育等重要生理功能,而研究表明肠道菌群失调与2型糖尿病密切相关。二甲双胍由于廉价、安全、有效成为了目前应用最广泛的降糖药之一,它不仅可以通过依赖及非依赖AMPK途径降糖,越来越多的研究表明它还可以通过改善T2D患者失调的肠道菌群发挥降糖作用。明确二甲双胍对肠道菌群的影响,有助于全面了解二甲双胍的作用机制。     

代谢性综合征干预研究获新进展

代谢综合征是2型糖尿病和心血管疾病等慢性代谢性疾病的重要风险因素。近20年来,随着我国居民的膳食结构和生活方式的日渐西化,慢性代谢性疾病的患病率迅速上升。我国目前有超过有15.1%（约7.1亿）成年人患有代谢综合征。因此,发现和建立经济有效的控制代谢综合征的方法是控制这类疾病的关键环节。     

DNA甲基化与2型糖尿病血管并发症的研究进展

2型糖尿病(type 2 diabetes mellitus, T2DM)是一种复杂的以慢性高血糖为特征的代谢性疾病。近年来,越来越多的研究发现T2DM患者体内的高糖环境可以改变DNA甲基化程度,影响相关基因功能,从而导致糖代谢、脂肪代谢和能量代谢紊乱或炎症反应,进而造成血管病变。T2DM常见的血管并发症有大血管病变引起的心脑血管疾病,以及微血管病变引起的糖尿病肾病、糖尿病视网膜病变、糖尿病周围神经病变等。DNA甲基化标记在T2DM血管并发症的早期诊断与治疗中可能有重要意义,已成为相关领域的研究热点。现主要对近期DNA甲基化在T2DM血管并发症方面的研究及其研究策略加以综述,以期深入了解T2DM血管并发症发生发展的表观遗传机制和可能的防治途径。     

2型糖尿病肠道菌群研究进展

2型糖尿病是一种常见的慢性消耗性疾病,其发病机制十分复杂,流行病学研究表明,肥胖、高热量饮食、体力活动不足及年龄增大是2型糖尿病最主要的环境因素。它是一种以胰岛素抵抗和胰岛素分泌不足为特征的代谢性疾病。肠道菌群作为进入人体的一个重要环境因素,肠道微生物的菌群变化影响宿主能量物质的吸收,调节肠道的分泌功能和非特异性免疫功能,从营养、代谢、疾病等各方面与我们生命活动相关。肠道菌群已成为我们身体的一部分,影响宿主的免疫,在肥胖、糖尿病、代谢综合征等疾病中都具有非常重要的作用。     

"中国老龄人口营养健康状况项目"简介及阶段性成果

近20年来,随着我国经济的快速发展和膳食结构的不断西化,肥胖、2型糖尿病和心脑血管疾病等一些与营养、代谢和生活方式密切相关的慢性代谢性疾病在我国的发病率急剧上升,成为我国居民健康的主要威胁和主要致死性、致残性疾病。世界卫生组织2005年一份控制慢性疾病的报告预计,如果不采取有效措施,在未来10年中仅心脏病、中风和糖尿病就将给中国带来至少5500亿美元的经济损失。此外,我国人口老龄化发展迅速,已成为世界上目前唯一的老年人口超过1亿的国家。由于老龄化本身与各种慢性疾病关系密切,发现危害老年人健康的主要危险因素,对预防疾病和促进老年人的健康至关重要。     

代谢病相关的遗传工程小鼠模型

糖尿病及肥胖症等代谢性疾病已成为影响人类健康的主要疾病,属于多基因所致的代谢综合征,遗传模式复杂多样,至今仍所知甚少。理想的实验动物模型是我们深入了解代谢病病因、遗传及环境因素的必要工具,并且可以用来研究验证新的治疗药物。近年来,已经获得了大量的遗传工程动物模型,包括转基因、基因敲除模型等遗传工程动物,对于代谢性疾病的研究意义重大。本文主要介绍近年来应用较多的糖尿病及肥胖相关的遗传工程小鼠模型遗传特征及应用。     

肥胖相关的肠道微生物群落结构动力学与功能解析研究

肥胖及相关的慢性代谢性疾病近年来已经成为威胁全球的公共健康问题。越来越多的证据表明,在宿主的营养、免疫和代谢中有不可替代的作用的肠道菌群不仅可以通过调节宿主脂肪吸收存储相关的基因,影响后者的能量平衡,更重要的是其结构失调导致宿主循环系统中内毒素增加,诱发慢性、低水平炎症,导致肥胖和胰岛素抵抗。运用微生物分子生态学、元基因组学和代谢组学的方法,揭示与代谢性疾病相关的菌群结构失调,并鉴定出相关的特定细菌类群及其功能,使得通过以菌群为靶点的营养干预手段防止慢性代谢性疾病成为可能,将带来代谢性疾病预防和控制策略的革命性的变化。     

益生菌对2型糖尿病的改善作用及其作用机制初探

2型糖尿病(type 2 diabetes mellitus,T2DM)又称非胰岛素依赖型糖尿病(non-independent diabetes mellitus,NIDDM),是一种最常见的内分泌代谢性疾病,具有遗传易感性。全球范围的研究数据显示,该病发病率在各地区都呈现急剧上升的趋势。该病的成因可能涉及一系列相关因素,如遗传因素、年龄、肥胖等。近年来相关领域的研究发现,2型糖尿病的形成与发展可能和人体肠道内的微生物群落结构的改变引起的代谢紊乱有关。越来越多的研究表明,益生菌可能参与并帮助肠道维持一种更为健康的菌群状态,从而使其在2型糖尿病中具有治疗潜力。     

肠道菌群在2型糖尿病合并骨质疏松中的作用探析

骨质疏松是一种隐匿性骨密度降低的全身骨代谢性疾病,具有较高的致残率及致死率,严重影响患者生活质量。而骨质疏松作为糖尿病在骨骼系统中的常见并发症,在临床治疗中却忽略了二者之间存在的内在联系,采用分开诊治的方案。大量研究表明,肠道菌群与多种代谢性疾病相关,而2型糖尿病患者体内存在着明显的肠道菌群失调。因此考虑肠道菌群失调可能影响糖尿病合并骨质疏松的发生发展。本文通过深入阐明三者之间的关系,积极探索肠道菌群在糖尿病及骨质疏松中的作用,发现2型糖尿病患者肠道菌群失调,可导致胰岛素抵抗、炎症反应和胰岛素样生长因子-1缺少,进一步影响骨代谢过程,进而提出调节肠道菌群是治疗2型糖尿病合并骨质疏松的新方向。     

Epidemiology,risk factors across the spectrum of age-related metabolic diseases

BackgroundPopulation aging is dynamic process of increasing proportion of older adults in the total population, which is an inescapable result of decline in fertility rate and extension in life expectancy. Inevitably, age-related metabolic diseases, for example obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease, are becoming epidemic globally along with the demographic transition.ContentThe review examines the literatures related to: 1) the epidemiology of age related metabolic diseases including obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease; and 2) the risk factors of age related metabolic diseases including genetic factors, diet, smoking, Physical activity, intestinal microbiota and environmental factors.ConclusionPopulation aging is becoming epidemic worldwide, resulting in increasing incidence and prevalence of a serious of age-related metabolic diseases. Both genetic and environmental factors contribute to the diseases, thus interventions targeting on these factors may have beneficial effect on the development of age-related metabolic diseases.     

The involvement of microRNAs in Type 2 diabetes

T2D (Type 2 diabetes mellitus) is a major health issue that has reached epidemic status worldwide. T2D is a progressive metabolic disorder characterized by reduced insulin sensitivity, insulin resistance and pancreatic β-cell dysfunction. Improper treatment of TD2 can lead to severe complications such as heart disease, stroke, kidney failure, blindness and nerve damage. The aetiology and molecular mechanisms of T2D are not fully understood, but compelling evidence points to a link between T2D, obesity, dyslipidaemia and insulin resistance. Although T2D seems to be strongly linked to environmental factors such as nutrition and lifestyle, studies have shown that genetic factors, such as polymorphisms associated with metabolic genes, imprinting, fetal programming and miRNA (microRNA) expression, could also contribute to the development of this disease. miRNAs are small 22-25-nt-long untranslated RNAs that negatively regulate the translation of mRNAs. miRNAs are involved in a large number of biological functions such as development, metabolism, immunity and diseases such as cancer, cardiovascular diseases and diabetes. The present review examines the various miRNAs that have been identified as being potentially involved in T2D, focusing on the insulin-sensitive organs: white adipose tissue, liver, skeletal muscle and the insulin-producing pancreatic β-cells.     

Mouse models of type 1 and type 2 diabetes derived from the same closed colony: genetic susceptibility shared between two types of diabetes

Except for rare subtypes of diabetes, both type 1 and type 2 diabetes are multifactorial diseases in which genetic factors consisting of multiple susceptibility genes and environmental factors contribute to the disease development. Due to complex interaction among multiple susceptibility genes and between genetic and environmental factors, genetic analysis of multifactorial diseases is difficult in humans. Inbred animal models, in which the genetic background is homogeneous and environmental factors can be controlled, are therefore valuable in genetic dissection of multifactorial diseases. We are fortunate to have excellent animal models for both type 1 and type 2 diabetes--the nonobese diabetic (NOD) mouse and the Nagoya-Shibata-Yasuda (NSY) mouse, respectively. Congenic mapping of susceptibility genes for type 1 diabetes in the NOD mouse has revealed that susceptibility initially mapped as a single locus often consists of multiple components on the same chromosome, indicating the importance of congenic mapping in defining genes responsible for polygenic diseases. The NSY mouse is an inbred animal model of type 2 diabetes established from Jcl:ICR, from which the NOD mouse was also derived. We have recently mapped three major loci contributing to type 2 diabetes in the NSY mouse. Interestingly, support intervals where type 2 diabetes susceptibility genes were mapped in the NSY mouse overlapped the regions where type 1 diabetes susceptibility genes have been mapped in the NOD mouse. Although additional evidence is needed, it may be possible that some of the genes predisposing to diabetes are derived from a common ancestor contained in the original closed colony, contributing to type 1 diabetes in the NOD mouse and type 2 diabetes in the NSY mouse. Such genes, if they exist, will provide valuable information on etiological pathways common to both forms of diabetes, for the establishment of effective methods for prediction, prevention, and intervention in both type 1 and type 2 diabetes.     

Nongenomic memory of foetal history in chronic diseases development

Foetal growth from conception to birth is a complex process predetermined by the genetic configuration of the foetus, the availability of nutrients and oxygen to the foetus, maternal nutrition and various growth factors and hormones of maternal, foetal and placental origin. Maintenance of the optimal foetal environment is the key factor of the future quality of life. Such conditions like inadequate nutrition and oxygen supply, infection, hypertension, gestational diabetes or drug abuse by the mother, expose the foetus to nonphysiological environment. In conditions of severe intrauterine deprivation, there is a potential loss of structural units within the developing organ systems affecting their functionality and efficiency. Extensive human epidemiologic and animal model data indicate that during critical periods of prenatal and postnatal mammalian development, nutrition and other environmental stimuli influence developmental pathways and thereby induce permanent changes in metabolism and chronic disease susceptibility. The studies reviewed in this article show how environmental factors influence a diverse array of molecular mechanisms and consequently alter disease risk including diseases such as metabolic syndrome and cardiovascular diseases, insulin resistance and diabetes mellitus, neuropsychiatric disorders, osteoporosis, asthma and immune system diseases.     

蛋白质组学在肥胖症研究中的应用

在世界范围内,肥胖及其相关代谢性疾病的发生率逐年增加,尤其是儿童肥胖症的普遍存在引起了广泛关注。过度肥胖是2型糖尿病、心血管疾病和一些肿瘤的重要危险因素。有关肥胖症的研究过去主要集中在脂肪组织功能改变,脂肪细胞分化,棕色脂肪转化,线粒体功能失调,以及肠道营养物质吸收这些方面的分子生物学研究。肥胖作为一种复杂的代谢紊乱性疾病,基因层面的探索并不能全面体现肥胖的机体内各种参与能量代谢的蛋白质功能的变化。高通量蛋白质组学的应用为研究肥胖的机体蛋白质表达和功能变化提供了可能,并为进一步理解肥胖症的发病机理,寻找疾病相关干预靶点提供了重要的帮助。本综述,总结了近年来关于蛋白质组学在肥胖症病理生理变化中的相关研究,并讨论参与肥胖症发生的可能机制和干预作用靶点。     

Metabolic imprinting: critical impact of the perinatal environment on the regulation of energy homeostasis

Epidemiological studies in humans suggest that maternal undernutrition, obesity and diabetes during gestation and lactation can all produce obesity in offspring. Animal models have allowed us to investigate the independent consequences of altering the pre- versus post-natal environments on a variety of metabolic, physiological and neuroendocrine functions as they effect the development in the offspring of obesity, diabetes, hypertension and hyperlipidemia (the 'metabolic syndrome'). During gestation, maternal malnutrition, obesity, type 1 and type 2 diabetes and psychological, immunological and pharmacological stressors can all promote offspring obesity. Normal post-natal nutrition can reduce the adverse impact of some of these pre-natal factors but maternal high-fat diets, diabetes and increased neonatal access to food all enhance the development of obesity and the metabolic syndrome in offspring. The outcome of these perturbations of the perinatal environmental is also highly dependent upon the genetic background of the individual. Those with an obesity-prone genotype are more likely to be affected by factors such as maternal obesity and high-fat diets than are obesity-resistant individuals. Many perinatal manipulations appear to promote offspring obesity by permanently altering the development of central neural pathways, which regulate food intake, energy expenditure and storage. Given their strong neurotrophic properties, either excess or an absence of insulin and leptin during the perinatal period are likely to be effectors of these developmental changes. Because obesity is associated with an increased morbidity and mortality and because of its resistance to treatment, prevention is likely to be the best strategy for stemming the tide of the obesity epidemic. Such prevention should begin in the perinatal period with the identification and avoidance of factors which produce permanent, adverse alterations in neural pathways which control energy homeostasis.     

Genetics of murine type 2 diabetes and comorbidities

Type 2 diabetes (T2D) is a polygenic and multifactorial complex disease, defined as chronic metabolic disorder. It's a major global health concern with an estimated 463 million adults aged 20–79 years with diabetes and projected to increase up to 700 million by 2045. T2D was reported to be one of the four leading causes of non-communicable disease (NCD) deaths in 2012. Environmental factors play a part in the development of polygenic forms of diabetes. Polygenic forms of diabetes often run-in families. Fortunately, T2D, which accounts for 90–95% of the entire four types of diabetes including, Type 1 diabetes (T1D), T2D, monogenic diabetes syndromes (MGDS), and Gestational diabetes mellitus, can be prevented or delayed through nutrition and lifestyle changes as well as through pharmacologic interventions. Typical symptom of the T2D is high blood glucose levels and comprehensive insulin resistance of the body, producing an impaired glucose tolerance. Impaired glucose tolerance of T2D is accompanied by extensive health complications, including cardiovascular diseases (CVD) that vary in morbidity and mortality among populations. The pathogenesis of T2D varies between populations and/or ethnic groupings and is known to be attributed extremely by genetic components and environmental factors. It is evident that genetic background plays a critical role in determining the host response toward certain environmental conditions, whether or not of developing T2D (susceptibility versus resistant). T2D is considered as a silent disease that can progress for years before its diagnosis. Once T2D is diagnosed, many metabolic malfunctions are observed whether as side effects or as independent comorbidity. Mouse models have been proven to be a powerful tool for mapping genetic factors that underline the susceptibility to T2D development as well its comorbidities. Here, we have conducted a comprehensive search throughout the published data covering the time span from early 1990s till the time of writing this review, for already reported quantitative trait locus (QTL) associated with murine T2D and comorbidities in different mouse models, which contain different genetic backgrounds. Our search has resulted in finding 54 QTLs associated with T2D in addition to 72 QTLs associated with comorbidities associated with the disease. We summarized the genomic locations of these mapped QTLs in graphical formats, so as to show the overlapping positions between of these mapped QTLs, which may suggest that some of these QTLs could be underlined by sharing gene/s. Finally, we reviewed and addressed published reports that show the success of translation of the identified mouse QTLs/genes associated with the disease in humans.