Insulin resistance and type 2 diabetes in children.
Insulin resistance and type 2 diabetes in children.
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DOI：
10.6065/apem.2040090.045
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发表时间：
2020-12
影响因子：
2.2
通讯作者：
Chiarelli F
中科院分区：
文献类型：
--
作者：
Castorani V;Polidori N;Giannini C;Blasetti A;Chiarelli F
2型糖尿病（T2D）是肥胖儿童和青少年中一种新出现的健康风险。环境因素（缺乏身体活动、营养摄入过多、久坐不动的生活方式）和遗传因素都是造成这种全球流行病的原因。青少年T2D患病率的增加也与代谢和心血管并发症发生率的持续增加有关。胰岛素抵抗（IR），即响应生理胰岛素水平的全身葡萄糖摄取减少，决定了葡萄糖稳态受损，并且被认为是成人和儿童T2D和心血管疾病的主要触发因素。特别是，IR和β细胞功能障碍导致持续高血糖，这是T2D的特征。事实上，这两种病理状态相互影响，并可能在T2D的发病机制中发挥关键的协同作用，尽管其确切机制尚不完全清楚。然而，β细胞功能障碍和IR诱导糖代谢受损，从而导致t2dm的进展。因此，了解与β细胞功能和IR下降相关的机制对于控制、预防和治疗青少年T2D至关重要。本文综述了目前关于儿童和青少年的IR和T2D的知识，并展示了针对年轻T2D患者开发新的预防方法和治疗策略的有趣机会和刺激挑战。
Type 2 diabetes (T2D) is an emerging health risk in obese children and adolescents. Both environmental (lack of physical activity, excess nutritional intake, sedentary lifestyle) and genetic factors contribute to this global epidemic. The growing prevalence of T2D in youth is also associated with a consistently increased incidence of metabolic and cardiovascular complications. Insulin resistance (IR), i.e., whole-body decreased glucose uptake in response to physiological insulin levels, determines impaired glucose homeostasis and it is recognized as cardinal trigger of T2D and cardiovascular disease in both adults and children. In particular, IR and beta-cell dysfunction lead to the persistent hyperglycemia which characterizes T2D. Indeed, both pathological states influence each other and presumably play a crucial, synergistic role in the pathogenesis of T2D, although the precise mechanisms are not completely understood. However, beta-cell dysfunction and IR induce impaired glucose metabolism, thus leading to the progression to T2D. Therefore, understanding the mechanisms correlated with the decline of beta-cell function and IR is crucial in order to control, prevent, and treat T2D in youth. This review focuses on the current knowledge regarding IR and T2D in children and adolescents and showcases interesting opportunities and stimulating challenges for the development of new preventative approaches and therapeutic strategies for young patients with T2D.