异位脂质代谢产物的堆积与胰岛素抵抗关系的研究进展.pdfVIP

临床与病理杂志 2014, 34(6) J Clin Path ol R e s 819 DOI:10.11714/j.issn.2095-6959.2014.06.034 /articles/801 异位脂质代谢产物的堆积与胰岛素抵抗关系的研究进展 宫阿娟 综述 李素梅 审校 (安徽医科大学附属安徽省立医院内分泌科，合肥 230001) [摘　要] 胰 岛 素 抵 抗 ( i n s u l i n r e s i s t a n c e ，I R ) 与 2 型 糖 尿 病 ( t y p e 2 d i a b e t e s ，T 2 D ) 、 非 酒 精 性 脂 肪 肝 (nonalcoholic fatty liver disease ，NAFLD) 、动脉粥样硬化心脏病等代谢类疾病发病密切相关。脂 质代谢物在非脂肪组织的异位堆积是导致组织产生IR 的主要原因，异位堆积的脂质代谢产物通过 影响组织对脂肪酸的摄取、脂质生成及能量代谢等方面使脂质的特异性中间代谢产物 [如甘油二酯 (diacylglycerol ，DAG) 、神经酰胺]在肝脏和骨骼肌积累使胰岛素信号通路受损而产生IR 。本文就 近年来脂质的特异性中间代谢产物的堆积导致IR及其机制作一简述。 [关键词] 异位脂质代谢产物堆积；胰岛素抵抗；甘油二酯；神经酰胺 Research progression of the relationship between accumulation of ectopic lipid metabolites and insulin resistance GONG A’juan, LI Sumei (Department of Endocrinology, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China) Abstract Insulin resistance is closely related with the pathogenesis for many of metabolic diseases, including type 2 diabetes (T2D), nonalcoholic fatty liver disease (NAFLD) and atherosclerotic heart disease. Mainly due to non-adipose tissue insulin resistance is the accumulation of ectopic lipid metabolites. The accumulation of ectopic lipid metabolites is closely linked to changes in fatty acid uptake, lipogenesis, and energy expenditure that converge to promote the accumulation of specific lipid metabolites (diacylglycerols and/or ceramides) in liver and skeletal muscle, leading to impaired insulin signaling and insulin resi