Maladaptive immune and inflammatory pathways lead to cardiovascular insulin resistance.
Maladaptive immune and inflammatory pathways lead to cardiovascular insulin resistance.
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DOI：
10.1016/j.metabol.2013.07.001
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发表时间：
2013-11
影响因子：
9.8
通讯作者：
Sowers, James R.
中科院分区：
文献类型：
--
作者：
Aroor, Annayya R.;McKarns, Susan;DeMarco, Vincent G.;Jia, Guanghong;Sowers, James R.
胰岛素抵抗是肥胖、心肾代谢综合征和2型糖尿病(T2 DM)的一个标志。胰岛素抵抗的进展增加了心血管疾病(CVD)的风险。在过去的40-50年里，美国和世界各地肥胖症及其相关并发症的发病率惊人地上升，突显了胰岛素抵抗的重要性。青少年的肥胖率也在上升。此外，与男性相比，绝经前女性患心血管疾病的风险较低，但在肥胖和胰岛素抵抗的情况下，这种保护就会消失。尽管全身和心血管胰岛素抵抗与胰岛素代谢信号受损和心血管功能障碍相关，但胰岛素抵抗和心血管功能障碍的机制仍然知之甚少。最近的研究表明，肥胖和糖尿病的胰岛素抵抗与代谢性炎症反应有关，代谢性炎症反应是一种全身和组织特异性的慢性低度炎症状态。也有证据表明，巨噬细胞和淋巴细胞的极化倾向于促炎表型，这有助于肥胖症、心肾代谢综合征和糖尿病患者胰岛素抵抗的进展。在这篇综述中，我们对一些因素，如肾素-血管紧张素-醛固酮系统，交感神经激活和胰岛素调节因子(如DPP-4)和免疫反应在肥胖和其他以胰岛素抵抗为特征的疾病中调节这种炎症状态提供了新的见解。
Insulin resistance is a hallmark of obesity, the cardiorenal metabolic syndrome and type 2 diabetes mellitus (T2DM). The progression of insulin resistance increases the risk for cardiovascular disease (CVD). The significance of insulin resistance is underscored by the alarming rise in the prevalence of obesity and its associated comorbidities in the Unites States and worldwide over the last 40-50 years. The incidence of obesity is also on the rise in adolescents. Furthermore, premenopausal women have lower CVD risk compared to men, but this protection is lost in the setting of obesity and insulin resistance. Although systemic and cardiovascular insulin resistance are associated with impaired insulin metabolic signaling and cardiovascular dysfunction, the mechanisms underlying insulin resistance and cardiovascular dysfunction remain poorly understood. Recent studies show that insulin resistance in obesity and diabetes is linked to a metabolic inflammatory response, a state of systemic and tissue specific chronic low grade inflammation. Evidence is also emerging that there is polarization of macrophages and lymphocytes towards a pro-inflammatory phenotype that contribute to progression of insulin resistance in obesity, cardiorenal metabolic syndrome and diabetes. In this review, we provide new insights into factors, such as, the renin-angiotensin-aldosterone system, sympathetic activation and incretin modulators (e.g., DPP-4) and immune responses that mediate this inflammatory state in obesity and other conditions characterized by insulin resistance.
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影响因子：
6.7
作者：
Drong AW;Lindgren CM;McCarthy MI
通讯作者：
McCarthy MI
影响因子：
16.2
作者：
Dicker D
通讯作者：
Dicker D
影响因子：
4.8
作者：
Aroor, Annayya R.;Sowers, James R.;DeMarco, Vincent G.
通讯作者：
DeMarco, Vincent G.
影响因子：
4.8
作者：
DeMarco, Vincent G.;Ford, David A.;Sowers, James R.
通讯作者：
Sowers, James R.
DOI：
10.1155/2009/108187
发表时间：
2009
期刊：
International journal of pediatric endocrinology
影响因子：
--
作者：
Allcock DM;Gardner MJ;Sowers JR
通讯作者：
Sowers JR