Insulin and the heart
Insulin and the heart
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DOI：
10.1016/s0168-8227(11)70019-5
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发表时间：
2011-08-01
影响因子：
5.1
通讯作者：
Didangelos, Triantafillos
中科院分区：
文献类型：
--
作者：
Iliadis, Fotios;Kadoglou, Nikolaos;Didangelos, Triantafillos
在生理条件下，胰岛素在心脏中的主要作用显然是调节底物利用。事实上，胰岛素通过糖酵解促进葡萄糖的摄取和利用。胰岛素促进葡萄糖作为主要的心脏能量底物，减少心肌O-2消耗并增加心脏效率。此外，胰岛素似乎增强心肌细胞收缩，同时它有利地影响心肌舒张，增加核糖体生物合成和蛋白质合成，刺激血管内皮生长因子（VEGF）并由此血管生成，抑制细胞凋亡，促进细胞存活，并最终改善心肌微循环和冠状动脉阻力，导致心肌的血液灌注增加。因此，胰岛素直接作用于心肌，并且这种作用主要通过PKB/Akt信号通路介导。在病理条件下，如2型糖尿病、心肌缺血和心脏肥大，胰岛素信号转导途径和作用明显改变。在这篇综述中，我们总结了心脏是胰岛素作用的重要靶点的证据，以及在疾病状态下消除这些作用的重要性。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
The main role of insulin in the heart under physiological conditions is obviously the regulation of substrate utilization. Indeed, insulin promotes glucose uptake and its utilization via glycolysis. Insulin, promoting glucose as the main cardiac energy substrate, reduces myocardial O-2 consumption and increases cardiac efficiency. Moreover, insulin seems to augment cardiomyocyte contraction, while it affects favorably myocardial relaxation, increases ribosomal biogenesis and protein synthesis, stimulates vascular endothelial growth factor (VEGF) and thereby angiogenesis, suppresses apoptosis, promotes cell survival and finally ameliorates both myocardial microcirculation and coronary artery resistance, leading to increased blood perfusion of myocardium. Thus, insulin acts directly on heart muscle, and this action is mediated principally through PKB/Akt signal pathway. Under pathological conditions, such as type 2 diabetes, myocardial ischaemia, and cardiac hypertrophy, insulin signal transduction pathways and action are clearly modified. In this review we summarize the evidence that the heart is an important target of insulin action and that elimination of these actions is important in disease states. (C) 2011 Elsevier Ireland Ltd. All rights reserved.