CNS control of glucose metabolism: response to environmental challenges.

CNS control of glucose metabolism: response to environmental challenges.
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DOI:
10.3389/fnins.2013.00020
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发表时间:
2013
影响因子:
4.3
通讯作者:
Sandoval DA
Sandoval DA
中科院分区:
医学2区
文献类型:
--
作者:
Arble DM;Sandoval DA

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在过去的15年里,大量的工作积累,以支持中枢神经系统在调节餐后血糖水平的作用。如本综述第一部分所述,CNS接收并整合来自传入神经元、循环激素和餐后产生的营养物质的信息,以随后指导肝脏葡萄糖输出和外周组织葡萄糖摄取的变化。本综述的第二个主要组成部分集中在外部压力的影响,包括高脂肪饮食和变化的光:暗周期CNS调节葡萄糖稳态。我们还讨论了这些不同的压力之间的相互作用,以及它们如何有助于多方面的机制,我们假设有助于2型糖尿病(T2DM)的血糖失调。我们认为,虽然目前的外周治疗有助于延缓T2DM的进展,但产生针对CNS(两种疾病功能障碍的主要部位)的肥胖和T2DM联合治疗将对两种疾病的进展产生更深远的影响。
Over the last 15 years, considerable work has accumulated to support the role of the CNS in regulating postprandial glucose levels. As discussed in the first section of this review, the CNS receives and integrates information from afferent neurons, circulating hormones, and postprandially generated nutrients to subsequently direct changes in glucose output by the liver and glucose uptake by peripheral tissues. The second major component of this review focuses on the effects of external pressures, including high fat diet and changes to the light:dark cycle on CNS-regulating glucose homeostasis. We also discuss the interaction between these different pressures and how they contribute to the multifaceted mechanisms that we hypothesize contribute to the dysregulation of glucose in type 2 diabetes mellitus (T2DM). We argue that while current peripheral therapies serve to delay the progression of T2DM, generating combined obesity and T2DM therapies targeted at the CNS, the primary site of dysfunction for both diseases, would lead to a more profound impact on the progression of both diseases.
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