蛋白质组学在胰岛素抵抗研究中的应用

胰岛素抵抗（insulin resistance,IR）即指一定量的胰岛素与其特异性受体结合后所产生的生物效应低于正常。表现为外周组织尤其是肌肉、脂肪组织对葡萄糖摄取减少及胰岛素抑制肝葡萄糖输出的作用减弱．是肥胖、高血压、糖尿病及动脉粥样硬化等多种疾病的共同危险因素和基础。蛋白质组学技术的不断发展和完善,为真正了解胰岛素抵抗发生发展规律提供了可能,该文介绍蛋白质组学在胰岛素抵抗发生机制、标志物的寻找及治疗胰岛素抵抗新药开发中的应用．     

胰岛素信号通路、炎症信号通路与泛素-蛋白酶体系统的交互作用

胰岛素抵抗是肥胖和2型糖尿病的主要表征。胰岛素信号通路根据是否需要胰岛素受体底物（insulin receptor substrate, IRS）介导可分为IRS介导和非IRS介导的信号通路,其中以IRS介导的信号通路为主。肥胖可增强炎性细胞因子表达并活化IKKβ/NF κB和JNK等炎症信号通路,抑制IRS酪氨酸磷酸化,从而阻止胰岛素的信号转导,降低胰岛素的敏感性,表现为胰岛素抵抗。泛素 蛋白酶体系统作为机体蛋白降解的主要途径,与胰岛素和炎症信号通路联系密切,一方面胰岛素信号通路的阻断可活化泛素依赖的蛋白降解,另一方面,泛素依赖的蛋白降解系统也可直接降解胰岛素和炎症信号通路的关键蛋白,影响胰岛素的作用。本文拟综述肥胖时,胰岛素信号通路、炎症相关信号通路和泛素 蛋白酶体系统之间的交互作用,在分子水平上探讨胰岛素抵抗的发生机制。     

氧化应激与2型糖尿病

胰岛素抵抗、胰岛β细胞功能受损是2型糖尿病的主要病因。高血糖、高血脂导致在代谢过程中,线粒体产生大量活性氧,其可损坏线粒体功能,引起氧化应激反应。氧化应激可以激活细胞内的一系列应激信号通路,如JNK／SAPK、p38MAPK、IKKβ／NF-kβ和氨基己醣通路等。这些应激通路的激活可以产生以下结果：（1）阻断胰岛素作用通路,导致胰岛素抵抗;（2）降低胰岛素基因表达水平;（3）抑制胰岛素分泌;（4）促进β细胞凋亡等。本文主要针对活性氧的产生、氧化应激诱导胰岛素抵抗和胰岛β细胞功能受损等机制加以综述,以便进一步阐明2型糖尿病的发病机理。     

地塞米松和胰岛素调节猪脂肪细胞SOCS-3、OB、GLUT4和PPARγ基因的表达

猪是研究糖尿病最理想的模型动物,研究胰岛素和胰岛素抵抗是研究糖尿病的重要环节。为明确SOCS-3在胰岛素抵抗中的作用,分别用100nmol／L的胰岛素,300nmol／L的地基米松处理原代培养的猪脂肪细胞诱导胰岛素抵抗;利用半定量RT-PCR技术分别检测SOCS-3、OB、GLUT4和PPARγ基因表达变化。结果发现,胰岛素增加了GLUT4、SOCS-3和PPARγ基因的表达,对OB基因表达变化没有显著性影响;地塞米松诱导的胰岛素抵抗状态下OB和SOCS-3基因表达水平升高,而GLUT4和PPARγ基因表达水平显著下调。研究结果表明,GLUT4基因表达量水平的升高可能是由于PPARγ的高表达引起,SOCS-3基因的不同表达水平对胰岛素信号的抑制效果不同。地塞米松诱导的胰岛素抵抗不仅表现在对葡萄糖转运的抑制,也反映在抑制了胰岛素信号;而SOCS-3基因可能是消除胰岛素抵抗的一个有效靶基因。     

胰岛素抵抗与脂肪肝关系的研究

胰岛素抵抗(IR)是许多疾病的独立危险因素。胰岛素抵抗与脂肪代谢紊乱非常密切,研究发现它在脂肪肝的发生、发展过程中起了很大的作用。近年来,越来越多的人已经意识到脂肪肝与胰岛素抵抗之间的密切关系。在胰岛素抵抗与脂肪肝的研究中关于瘦素及瘦素抵抗在胰岛素抵抗及脂肪肝的关系中的作用是研究比较多的,本文主要介绍了胰岛素抵抗、脂肪肝的发生机制及瘦素、瘦素抵抗在其中的催化作用。     

肥胖诱发胰岛素抵抗的炎性机制

肥胖可诱发一系列慢性代谢性疾病,如2型糖尿病、血脂障碍、高血压和非酒精性脂肪肝等.这些疾病构成了当今世界人类健康的极大威胁.胰岛素抵抗是这些疾病的共有特征.胰岛素抵抗的发生与慢性低度系统炎性密切相关,涉及多条炎性信号通路的激活和胰岛素信号转导的缺陷.本文综述了肥胖、炎性与胰岛素抵抗之间的本质联系,以及肥胖诱发胰岛素抵抗的炎性机制,以期为肥胖相关疾病的防治提供重要参考.     

地塞米松和胰岛素调节猪脂肪细胞SOCS-3、OB、 GLUT4和PPARg 基因的表达

猪是研究糖尿病最理想的模型动物, 研究胰岛素和胰岛素抵抗是研究糖尿病的重要环节。为明确SOCS-3在胰岛素抵抗中的作用, 分别用100 nmol/L的胰岛素, 300 nmol/L的地塞米松处理原代培养的猪脂肪细胞诱导胰岛素抵抗; 利用半定量RT-PCR技术分别检测SOCS-3、OB、GLUT4和PPARg 基因表达变化。结果发现, 胰岛素增加了GLUT4、SOCS-3和PPARg 基因的表达, 对OB基因表达变化没有显著性影响; 地塞米松诱导的胰岛素抵抗状态下OB和SOCS-3基因表达水平升高, 而GLUT4和PPARγ基因表达水平显著下调。研究结果表明, GLUT4基因表达量水平的升高可能是由于PPARg的高表达引起, SOCS-3基因的不同表达水平对胰岛素信号的抑制效果不同。地塞米松诱导的胰岛素抵抗不仅表现在对葡萄糖转运的抑制, 也反映在抑制了胰岛素信号; 而SOCS-3基因可能是消除胰岛素抵抗的一个有效靶基因。     

胰岛素抵抗中细胞因子的作用因素分析

在Ⅱ型糖尿病中,胰岛素抵抗中的细胞因子具有十分重要的影响。众多研究成果表明,胰岛素抵抗是系统的慢性炎症反应。从胰岛素抵抗中细胞因子产生的影响作用及因素分析,为相关研究提供参考。     

水杨酸钠对胰岛素抵抗大鼠胰岛素受体底物-1的影响

目的探讨抗炎药水杨酸钠对胰岛素抵抗大鼠胰岛素敏感性的影响及其作用机制。方法分别给大鼠静脉输注脂肪乳+肝素,脂肪乳+肝素+水杨酸钠和生理盐水7 h,并在输注的最后2 h,行清醒状态高胰岛素-正血糖钳夹试验,测定血浆葡萄糖、游离脂肪酸(FFA)、胰岛素和C-肽水平,检测肝脏、肌肉中胰岛素受体底物-1(IRS-1)及307位丝氨酸磷酸化的IRS-1表达。结果输注脂肪乳大鼠葡萄糖输注率(GIR)是输注生理盐水大鼠的45%,水杨酸钠可使GIR提高1.3倍(P0.01)。脂肪乳输注组大鼠肝脏及肌肉中307位丝氨酸磷酸化的IRS-1分别为生理盐水输注组大鼠的3倍和3.8倍(P0.001),输注水杨酸钠,肝脏、肌肉307位丝氨酸磷酸化的IRS-1下降45%、20%(P0.05)。结论 FFA增高引起肝脏及肌肉中307位丝氨酸磷酸化的IRS-1水平增高,可能是导致胰岛素抵抗发生的机制之一,应用水杨酸钠,大鼠肝脏及肌肉组织中IRS-1丝氨酸磷酸化水平下降,胰岛素抵抗改善。抗炎药物水杨酸钠可能通过抑制FFA引起的IRS-1丝氨酸磷酸化,而发挥改善胰岛素抵抗的作用。     

KLF家族在胰岛素抵抗中的研究进展

胰岛素抵抗是以胰岛素生物学效应下降为特点的全身代谢性疾病,发病机制复杂,目前主要认为与脂质超载和炎症有关。Krüppel样转录因子(Krüppel-like factors, KLFs)是Cys2/His2锌指结构DNA结合蛋白的一个亚家族,参与调节心血管、内分泌、造血、免疫等系统的等多个生理过程。本文重点介绍了近年来KLF家族在肥胖、炎症和糖尿病发生发展过程中的最新研究进展,为深入了解KLF家族在胰岛素抵抗发病机制中的作用以及寻找药物治疗靶点提供参考。     

Ameliorative effect of vanadyl(IV)–ascorbate complex on high-fat high-sucrose diet-induced hyperglycemia,insulin resistance,and oxidative stress in mice

There is mounting evidence demonstrating causative links between hyperglycemia, oxidative stress, and insulin resistance, the core pathophysiological features of type 2 diabetes mellitus. Using a combinational approach, we synthesized a vanadium–antioxidant (i.e., l-ascorbic acid) complex and examined its effect on insulin resistance and oxidative stress. This study was designed to examine whether vanadyl(IV)-ascorbate complex (VOAsc) would reduce oxidative stress, hyperglycemia, and insulin resistance in high-fat high-sucrose diet (HFSD)-induced type 2 diabetes in mice. Male C57BL/6J mice were fed a HFSD for 12 weeks to induce insulin resistance, rendering them diabetic. Diabetic mice were treated with rosiglitazone, sodium l-ascorbate, or VOAsc. At the end of treatment, fasting blood glucose, fasting serum insulin, homeostasis model assessment-insulin resistance index, and serum adipocytokine levels were measured. Serum levels of nitric oxide (NO) parameters were also determined. The liver was isolated and used for determination of malondialdehyde, reduced glutathione, and catalase levels, and superoxide dismutase and glutathione peroxidase activities. VOAsc groups exhibited significant reductions in serum adipocytokine and NO levels, and oxidative stress parameters compared to the corresponding values in the untreated diabetic mice. The results indicated that VOAsc is non-toxic. In conclusion, we identified VOAsc as a potentially effective adjunct therapy for the management of type 2 diabetes.     

Insulin resistance,lipotoxicity and endothelial dysfunction

The number of people with the insulin-resistant conditions of type 2 diabetes mellitus (T2DM) and obesity has reached epidemic proportions worldwide. Eighty percent of people with T2DM will die from the complications of cardiovascular atherosclerosis. Insulin resistance is characterised by endothelial dysfunction, which is a pivotal step in the initiation/progression of atherosclerosis. A hallmark of endothelial dysfunction is an unfavourable imbalance between the bioavailability of the antiatherosclerotic signalling molecule nitric oxide (NO) and proatherosclerotic reactive oxygen species. In this review we discuss the mechanisms linking insulin resistance to endothelial dysfunction, with a particular emphasis on a potential role for a toxic effect of free fatty acids on endothelial cell homeostasis.     

罗格列酮对胰岛素抵抗高血压大鼠主动脉功能的影响

为探讨罗格列酮(rosiglitazone,ROSI)对胰岛素抵抗高血压大鼠(insulin resistant-hypertensive rats,IRHR)主动脉功能的影响及其可能机制,用高果糖饲养Sprague-Dawley大鼠8周,制备IRHR模型,并通过相关指标的检测判断造模是否成功。随后采用血管环灌流方法,观察各实验组动物离体胸主动脉环对新福林(L-phenylephrine,PE)、氯化钾(KCl)的收缩反应和对乙酰胆碱(acetylcholine,ACh)、硝普钠(sodium nitroprusside,SNP)的舒张反应：以及用一氧化氮合酶(nitric oxide synthase,NOS)的抑制剂N-硝基-L-精氨酸甲酯(N^ω-nitro-L-arginine methyl ester,L-NAME)预孵育血管30min后,主动脉环对ACh的舒张反应：同时对各实验组血清一氧化氮(nitric oxide,NO)的含量进行测定。结果显示：(1)罗格列酮能降低IRHR的收缩压、血清胰岛素水平,改善胰岛素抵抗。(2)高果糖组动物主动脉对PE、KCl的收缩反应明显增强,对ACh的舒张反应明显减弱,ROSI可逆转上述作用。(3)用L-NAME预处理后,高果糖组动物主动脉对ACh的舒张反应进一步减弱,ROSI可部分对抗上述作用。(4)各组大鼠离体主动脉对SNP的舒张反应无显著性差异。(5)ROSI对对照组大鼠主动脉功能的影响不明显。(6)与对照组相比,高果糖组动物血清NO含量显著降低,用ROSI处理后,血清NO含量显著增加。上述结果表明,ROSI能改善IRHR主动脉的舒张功能,其作用的机制可能是部分通过NOS途径促进内皮NO释放,或是通过降低血压、血清胰岛素水平,以及改善胰岛素抵抗等作用,导致血管舒张。     

Wingless-type inducible signaling pathway protein-1 (WISP1) adipokine and glucose homeostasis

Whilst the growing global prevalence of diabetes mellitus is a major healthcare problem, the exact pathophysiology of insulin resistance leading to diabetes mellitus remains unclear. Studies have confirmed that increased adiposity is linked to lower insulin sensitivity through the expression and release of adipocyte-derived proteins such as adipokines. Wingless-type (Wnt) inducible signaling pathway protein-1 (WISP1) is a newly identified adipokine that has important roles in many molecular pathways and cellular events, with the suggestion that WISP1 adipokine is closely correlated to the progression of insulin resistance. Studies have shown that circulatory levels of WISP adipokine are higher in obese patients accompanied with increased insulin resistance. However, the exact role of WISP1 adipokine in the induction of insulin resistance is not completely understood. In this review, we detail the latest evidence showing that the WIPS1 adipokine impairs glucose homeostasis and induces diabetes mellitus.     

Antioxidant and antiplatelet effects of rosuvastatin in a hamster model of prediabetes

The objectives of this study were to determine the relationships among Type II diabetes (T2DM)-dependent elevations in platelet-derived reactive oxygen species (ROS), platelet-surface protein disulfide isomerase (psPDI) NO-releasing activity, and platelet aggregation and to evaluate the efficacy of rosuvastatin in normalizing these parameters in primary cells derived from a hamster model of prediabetic insulin resistance induced by fructose feeding. Platelets from rosuvastatin-treated non-fructose-fed (NFF) and fructose-fed (FF) hamsters were analyzed for aggregability and psPDI-denitrosation activity. Platelets from NFF animals treated with xanthine/xanthine oxidase (X/XO) were assessed for the same parameters and primary aortic endothelial cells (AEC) cultivated with a range of [rosuvastatin] +/- mevalonate were analyzed for ROS production. Platelets from FF hamsters displayed statistically significant enhanced ROS production, diminished psPDI-mediated NO-releasing activity, and hyperaggregability. Suggestively, platelets from NFF animals treated with X/XO displayed characteristics similar to platelets from FF animals. Rosuvastatin elicited a normalizing effect on all parameters measured in platelets from FF animals. Further, ROS production in primary AEC from FF animals could be blunted to that of NFF animals by concentrations of rosuvastatin in the range of those achieved in the bloodstream. Diminished psPDI-dependent NO-releasing activity and increased initial aggregation rates of FF platelets may result from elevated vascular ROS production under conditions of insulin resistance. Normalization of ROS production and platelet aggregation by rosuvastatin indicates its potential use as a vasculoprotective agent.     

Diet‐induced obesity impairs AKT signalling in the retina and causes retinal degeneration

Retinopathy, a common complication of diabetes, is characterized by an unbalanced production of nitric oxide (NO), a process regulated by nitric oxide synthase (NOS). We hypothesized that retinopathy might stem from changes in the insulin receptor substrate (IRS)/PI3K/AKT pathway and/or expression of NOS isoforms. Thus, we analysed the morphology and apoptosis index in retinas of obese rats in whom insulin resistance had been induced by a high‐fat diet (HFD). Immunoblotting analysis revealed that the retinal tissue of HFD rats had lower levels of AKT₁, eNOS and nNOS protein than those of samples taken from control animals. Furthermore, immunohistochemical analyses indicated higher levels of iNOS and 4‐hydroxynonenal and a larger number of apoptotic nuclei in HFD rats. Finally, both the inner and outer retinal layers of HFD rats were thinner than those in their control counterparts. When considered alongside previous results, these patterns suggest two major ways in which HFD might impact animals: direct activity of ingested fatty acids and/or via insulin‐resistance‐induced changes in intracellular pathways. We discuss these possibilities in further detail and advocate the use of this animal model for further understanding relationships between retinopathy, metabolic syndrome and type 2 diabetes. Copyright © 2012 John Wiley & Sons, Ltd.     

Accumulation of autophagosomes contributes to enhanced amyloidogenic APP processing under insulin-resistant conditions

Alzheimer disease (AD) is sometimes referred to as type III diabetes because of the shared risk factors for the two disorders. Insulin resistance, one of the major components of type II diabetes mellitus (T2DM), is a known risk factor for AD. Insulin resistance increases amyloid-β peptide (Aβ) generation, but the exact mechanism underlying the linkage of insulin resistance to increased Aβ generation in the brain is unknown. In this study, we investigated the effect of insulin resistance on amyloid β (A4) precursor protein (APP) processing in mice fed a high-fat diet (HFD), and diabetic db/db mice. We found that insulin resistance promotes Aβ generation in the brain via altered insulin signal transduction, increased BACE1/β-secretase and γ-secretase activities, and accumulation of autophagosomes. Using an in vitro model of insulin resistance, we found that defects in insulin signal transduction affect autophagic flux by inhibiting the mechanistic target of rapamycin (MTOR) pathway. The insulin resistance-induced autophagosome accumulation resulted in alteration of APP processing through enrichment of secretase proteins in autophagosomes. We speculate that the insulin resistance that underlies the pathogenesis of T2DM might alter APP processing through autophagy activation, which might be involved in the pathogenesis of AD. Therefore, we propose that insulin resistance-induced autophagosome accumulation becomes a potential linker between AD and T2DM.     

Mechanisms of endothelial dysfunction with development of type 1 diabetes mellitus: role of insulin and C-peptide

Complications associated with insulin-dependent diabetes mellitus (type-1diabetes) primarily represent vascular dysfunction that has its origin in the endothelium. While many of the vascular changes are more accountable in the late stages of type-1diabetes, changes that occur in the early or initial functional stages of this disease may precipitate these later complications. The early stages of type-1diabetes are characterized by a diminished production of both insulin and C-peptide with a significant hyperglycemia. During the last decade numerous speculations and theories have been developed to try to explain the mechanisms responsible for the selective changes in vascular reactivity and/or tone and the vascular permeability changes that characterize the development of type-1diabetes. Much of this research has suggested that hyperglycemia and/or the lack of insulin may mediate the observed functional changes in both endothelial cells and vascular smooth muscle. Recent studies suggest several possible mechanisms that might be involved in the observed decreases in vascular nitric oxide (NO) availability with the development of type-1 diabetes. In addition more recent studies have indicated a direct role for both endogenous insulin and C-peptide in the amelioration of the observed endothelial dysfunction. These results suggest a synergistic action between insulin and C-peptide that facilitates increase NO availability and may suggest new clinical treatment modalities for type-1 diabetes mellitus.