共查询到20条相似文献,搜索用时 15 毫秒
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K. W. Taylor 《BMJ (Clinical research ed.)》1970,3(5717):267-268
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R. J. Jarrett 《BMJ (Clinical research ed.)》1970,3(5717):270-271
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Jörn M. Schattenberg Marcus Schuchmann 《Apoptosis : an international journal on programmed cell death》2009,14(12):1459-1471
The liver is a central regulator of glucose homeostasis and stores or releases glucose according to metabolic demands. In
insulin resistant states or diabetes the dysregulation of hepatic glucose release contributes significantly to the pathophysiology
of these conditions. Acute or chronic liver disease can aggravate insulin resistance and the physiological effects of insulin
on hepatocytes are disturbed. Insulin resistance has also been recognized as an independent risk factor for the development
of liver injury. In the healthy liver tissue homeostasis is achieved through cell turnover by apoptosis and dysregulation
of the physiological process resulting in too much or too little cell death can have potentially devastating effects on liver
tissue. The delineation of the signaling pathways that mediate apoptosis changed the paradigms of understanding of many liver
diseases. These signaling events include cell surface based receptor-ligand systems and intracellular signaling pathways that
are regulated through kinases on multiple levels. The dissection of these signaling pathways has shown that the regulators
of apoptosis signaling events in hepatocytes can also modulate insulin signaling pathways and that mediators of insulin resistance
in turn influence liver cell apoptosis. This review will summarize the potential crosstalk between apoptosis and insulin resistance
signaling events and discuss the involved mediators. 相似文献
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Diabetes and apoptosis: lipotoxicity 总被引:1,自引:0,他引:1
Christine M. Kusminski Shoba Shetty Lelio Orci Roger H. Unger Philipp E. Scherer 《Apoptosis : an international journal on programmed cell death》2009,14(12):1484-1495
Obesity is an established risk factor in the pathogenesis of insulin resistance, type 2 diabetes mellitus and cardiovascular
disease; all components that are part of the metabolic syndrome. Traditionally, insulin resistance has been defined in a glucocentric
perspective. However, elevated systemic levels of fatty acids are now considered significant contributors towards the pathophysiological
aspects associated with the syndrome. An overaccumulation of unoxidized long-chain fatty acids can saturate the storage capacity
of adipose tissue, resulting in a lipid ‘spill over’ to non-adipose tissues, such as the liver, muscle, heart, and pancreatic-islets.
Under these circumstances, such ectopic lipid deposition can have deleterious effects. The excess lipids are driven into alternative
non-oxidative pathways, which result in the formation of reactive lipid moieties that promote metabolically relevant cellular
dysfunction (lipotoxicity) and programmed cell-death (lipoapoptosis). Here, we focus on how both of these processes affect
metabolically significant cell-types and highlight how lipotoxicity and sequential lipoapoptosis are as major mediators of
insulin resistance, diabetes and cardiovascular disease. 相似文献
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P R Tasker 《BMJ (Clinical research ed.)》1985,290(6482):1632
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《Endocrine practice》2016,22(1):76-83
Objective: Adipsic diabetes insipidus (ADI) is a rare disorder consisting of central diabetes insipidus (CDI) and a deficient or absent thirst response to hyperosmolality. Patients with ADI experience marked morbidity and mortality. Diagnosis and management of these patients is quite challenging, even in expert hands. In this review, we aim to provide an updated overview of this difficult clinical scenario.Methods: We conducted a PubMed search for articles related to ADI. The search terms “adipsia,” “adipsic,” “thirst,” and “diabetes insipidus” were used to identify relevant literature.Results: ADI has been described in only approximately 100 patients. This rarity has limited the quality and quantity of literature to case reports, case series, and expert opinion. Diagnosis focuses on confirmation of CDI followed by documenting subnormal or completely absent thirst in response to a hypertonic stimulus. Among the described patients with ADI, the majority experience morbidity (e.g., severe hypernatremia, sleep apnea, venous thromboembolism [VTE], and obesity) and an increased mortality risk. Management focuses on frequent reassessment of daily prescribed water intake with fixed antidiuretic therapy (desmopressin) and comorbidity screening.Conclusion: The complexity of patients with ADI provides a difficult challenge for clinicians. Prompt recognition of thirst disorders in patients with CDI should lead to appropriately regimented management strategies and can result in safe outpatient care for these unique patients.Abbreviations:ACoA = anterior communicating arteryADI = adipsic diabetes insipidusAVP = arginine vasopressinCDI = central diabetes insipidusDDAVP = desmopressinDI = diabetes insipidusSDB = sleep-disordered breathingVTE = venous thromboembolism 相似文献
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