INSULIN RESISTANCE IN SKELETAL-MUSCLES OF PATIENTS WITH DIABETES-MELLITUS
INSULIN RESISTANCE IN SKELETAL-MUSCLES OF PATIENTS WITH DIABETES-MELLITUS
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DOI：
10.1002/dmr.5610050602
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发表时间：
1989-09-01
期刊：
影响因子：
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通讯作者：
BECKNIELSEN, H
中科院分区：
文献类型：
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作者：
BECKNIELSEN, H
直到1970年，胰岛素抵抗才被认为在临床上起主要作用。从那时起，胰岛素受体的表征为胰岛素作用的研究开辟了一个新的领域。因此，现在已知某种程度的胰岛素抵抗是几乎所有糖尿病综合征和具有异常或甚至正常葡萄糖耐量的许多生理和病理生理状态的共同特征。高胰岛素血症可以补偿胰岛素抵抗，导致正常或轻微受损的葡萄糖耐量-补偿性胰岛素抵抗-如肥胖所见。如果p细胞不能产生补偿胰岛素抵抗所需的胰岛素量，则发生高血糖症：未补偿的胰岛素抵抗。这种类型的胰岛素抵抗在糖尿病的发病机制中起着重要作用，但也可能影响这种疾病的治疗。此外，胰岛素抵抗可能参与糖尿病晚期并发症的发展。例如，胰岛素抵抗和高胰岛素血症可增加糖尿病中动脉硬化的发展（大血管病），并且通过血糖水平的增加，还可刺激非胰岛素敏感组织中的葡萄糖摄取，这可增加例如山梨糖醇的产生（微血管病）。2胰岛素也是一种生长因子，因此高胰岛素血症被认为通过刺激细胞生长参与晚期糖尿病并发症的发展。2因此，胰岛素抵抗似乎参与了糖尿病的发病机制以及微血管病和大血管病的发展，并且似乎在糖尿病治疗期间的葡萄糖稳态中起主要作用。
Until 1970 insulin resistance was not considered to play a major clinical role. Since then characterization of the insulin receptor has opened up a new field for investigation of insulin action. Thus, it is now known that some degree of insulin resistance is a common feature of almost all diabetic syndromes and of many physiological and pathophysiological states with abnormal or even normal glucose tolerance. Hyperinsulinemia can compensate for insulin resistance, resulting in a normal or only slightly impaired glucose tolerance-compensated insulin resistance-as seen in obesity. If the p-cells are unable to produce the amount of insulin necessary to compensate for insulin resistance, hyperglycemia develops: uncompensated insulin resistance. This type of insulin resistance plays an important role in the pathogenesis of diabetes mellitus but may also affect the treatment of this disease. Furthermore, insulin resistance may be involved in the development of late diabetic complications. Insulin resistance and hyperinsulinemia, for example, may add to the development of arteriosclerosis in diabetes (macroangiopathy)'and, through an increase in blood glucose levels, may also stimulate glucose uptake in non-insulin-sensitive tissues, which may add to, for example, sorbitol production (microangiopathy). 2 Insulin is also a growth factor, and hyperinsulinemia has therefore been claimed to take part in development of late diabetic complications through stimulation of cell growth. 2 Thus, insulin resistance seems to be involved in both the pathogenesis of diabetes and the development of microangiopathy and macroangiopathy and seems to play a major role in glucose homeostasis during treatment of diabetes.