Epigenetics of the Pathogenesis and Complications of Type 2 Diabetes Mellitus.

Velmurugan Mannar, Hiya Boro, Deepika Patel, Sourabh Agstam, Mazhar Dalvi, Vikash Bundela
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Abstract

Epigenetics of type 2 diabetes mellitus (T2DM) has widened our knowledge of various aspects of the disease. The aim of this review is to summarize the important epigenetic changes implicated in the disease risks, pathogenesis, complications and the evolution of therapeutics in our current understanding of T2DM. Studies published in the past 15 years, from 2007 to 2022, from three primary platforms namely PubMed, Google Scholar and Science Direct were included. Studies were searched using the primary term 'type 2 diabetes and epigenetics' with additional terms such as 'risks', 'pathogenesis', 'complications of diabetes' and 'therapeutics'. Epigenetics plays an important role in the transmission of T2DM from one generation to another. Epigenetic changes are also implicated in the two basic pathogenic components of T2DM, namely insulin resistance and impaired insulin secretion. Hyperglycaemia-i nduced permanent epigenetic modifications of the expression of DNA are responsible for the phenomenon of metabolic memory. Epigenetics influences the development of micro-and macrovascular complications of T2DM. They can also be used as biomarkers in the prediction of these complications. Epigenetics has expanded our understanding of the action of existing drugs such as metformin, and has led to the development of newer targets to prevent vascular complications. Epigenetic changes are involved in almost all aspects of T2DM, from risks, pathogenesis and complications, to the development of newer therapeutic targets.

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2型糖尿病发病机制及并发症的表观遗传学研究。
2型糖尿病(T2DM)的表观遗传学拓宽了我们对该疾病各个方面的认识。这篇综述的目的是总结在我们目前对T2DM的认识中涉及疾病风险、发病机制、并发症和治疗方法演变的重要表观遗传变化。从2007年到2022年的过去15年里,在PubMed、Google Scholar和Science Direct三个主要平台上发表的研究被纳入其中。研究使用主要术语“2型糖尿病和表观遗传学”进行搜索,附加术语如“风险”、“发病机制”、“糖尿病并发症”和“治疗方法”。表观遗传学在T2DM的代代相传中起着重要的作用。表观遗传变化也与T2DM的两个基本致病因素有关,即胰岛素抵抗和胰岛素分泌受损。高血糖诱导的DNA表达的永久表观遗传修饰是代谢记忆现象的原因。表观遗传学影响T2DM微血管和大血管并发症的发生。它们也可以作为预测这些并发症的生物标志物。表观遗传学扩大了我们对二甲双胍等现有药物作用的理解,并导致了预防血管并发症的新靶点的发展。从风险、发病机制、并发症到新治疗靶点的开发,表观遗传变化几乎涉及T2DM的所有方面。
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